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rJ(Fesidential . I lndustrial - rCommercial NO.EACH TOTAL <br />Res. Hotels, Motels, Apt. Sq. Fl ///O 03 73.30 <br />Gar. or Carports Sq. Ft.417?02 F,7/ <br />Receptacles 50 <br />-;;;Z- fi4h 7n tMr-*--trL+ f <br />o\,$rH z. ,a odoNr <br />Aoa-ez*fu .f46'o//o <br />MAI rNGA@REssiit"-;ar;;,,.<r 4il <br />Cl fY SIATF/7|PC*"b 'XZ-e---^- & 7a'6;z'L Switches 50 <br />Fixlures 50 <br />IAir Conditioners <br />Each <br />20 00 ZO. t--t) <br />1Approned Factory WiEd Uniit Dt t D P;List ,1e4 5.00 3 r,0a <br />Busways, special raceways, under floor <br />duct, trolley or plug-in busways ea. 110' or <br />fraction thereof <br />5.00 <br />Frre Signaling -System. Minimum ,ee <br />Outlet, fnok.Uor heat SenSor <br />10.00 <br />.50 rQ <br />Lighting Standards with One Lamp <br />Each Add'l fixture on same standard <br />5.00 <br />1.00 <br />Owner Builder Declaration <br />Maintenance Permil (annual)50.00 <br />Service Meters <br />Up to 400 amps, per meter <br />Over 400 amps, per meter <br />Over 1200 amps, per meter <br />15.00 <br />35.00 <br />75.00 <br />/r.n <br />Signs and high potential gas lube lighting 15.00 <br />Swimming pools, tountains, spas 35.00 <br />molor control center oGDSwitchboard@Eacn <br />/15.00 //5:, P <br />Temporary construction meter service <br />pole <br />Each digffiution pole <br />25.00 <br />5.00 <br />cor.rrRacron contractor Uge onlv <br />#-s-ru_Sa-r#-Q.l- _ <br />I herebv allrrm that I am |censed rnder the provisrons of Chapter 9, Drvrsron 3 ol lhe Busrness and <br />')5-{z -34/3 <br />PHONE <br />TsTATIbEIZIP <br />722!L <br />o <br />frq, <br />Crly Lrcensc sTr <br />."bt@r ary construction lighting <br />500 lamps or less <br />Over 500 lamps <br />2.00 <br />4.00 <br />Time clock or photo electric cell 3.00 <br />POWER APPARATUS : Generators, <br />motors, transformers, rectifiers, industrial <br />/heating, cooking, or baking equipment <br />and other apparatus as lollows: <br />Up to and including 1 HP KW KVA <br />OveT 1 and not over 10 HP KW KVA <br />0161 10 and not over 50 HP, KW. KVA/Over 50 and not over 1OO HP KW KVA <br />Over 100 and not over 500 HP, KW, KVA <br />Over 500 HP, KW KVA <br />2.00 <br />5.00 <br />10.00 <br />20.00 <br />30.00 <br />40.00 <br />workers Compen r.tl*ro*{r/rc" A <br />I herebv aflrrm that I have a ceilrl,cate ol consent to setl-'nsurJ/r a cerrrlrcate of Worker's Compcn- <br />saton lnsLrrarrce Cerlied copy rs frled wrlh the Crly burldrng rnspeclron deparlmenl <br />lr, alter making thrs Cerlrlcate of Exemplroo, you should become sublect to the Worker's Compen- <br />slron provrsrons ol lhe Labor Code. you musl lorlhwrth comply wrlh such provrsrons or thrs permrl <br />shall ba deemed revoked <br />,.1./-* <br />s <br />rg) <br />DateExenesLl-€g ven'red By (sis )- <br />I shall not employ any <br />Laws of <br />I certrfy thal rn the p€rlormance ol the work for <br />Notice To Applicant: <br />oa"U)41 Appr'canr{s,s ) <br />,::JXW;",:; <br />Subtotal /27, sz <br />Penalty Fee (when applicable) <br />Violation Fee (s0.00) <br />Plan Check 650/o ol subtotal .tJ. f 2-(minimum 20.00) <br />Receipt No.-1767 Pc # 4333 Date <br />Plan Check (Adlustment) <br />lssuance Fee 10.00 <br />-#OTAL PERMIT FEE (minimum $35.00)/ 37.52 <br />Expiratiorl <br />l <br />At)Dlicant's Declaratiorr <br />fize represenlalrves o! lhrs crly lo enter upon lhe above-menlroned property <br />Apphcanr or Agenr lSig,",112-fq oarc // -2-8? | esnurrno. 23552 <br />Pr BN4 r ssr.rr{) B! is s I |tlb Sa <br />/,5212 <br />16/:2 VERIFIED BY lS'g l-4*z'. <br />II/EIW 3;55Fr{ +13 r1S7.5B <br />BUILDING <br />PEHMIT No <br />VALIDATION IOFFICE USE ONLYI <br />(ACCOUNT lrl l-413, <br />I o oAPPLICATION AND <br />ELECTRICAL PERMIT <br />(TYPEWRIIE OR PRIN I IN INK) <br />CITY OF SANTA ANA <br />206 W. 4th St. <br />667 -2738 W,3 APPLICANT FILL IN AREA BELOW <br />@gr0zo <br />o(],ma <br />@ <br />N <br />N <br />\ <br />F <br />\ <br />C S.613Distribution: 1. lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy