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rndustriar commerciar l* lEAcHl
<br />rorAL!f,Residential
<br />Res. Hotels, Motels, Apt. Sq. Ft. f (e(.03 22-?z-
<br />Gar. or Carports Sq. Ft +7?.02 3.7(
<br />Receptacles .50
<br />JOB ADDBESSi iai Jr-,,,A7-. Y//haZ;l+. q
<br />il;*rur*, C*;d*"*/t'/ //aU?)Y'hz;;,*-ht'"t4v,5Yl-*ru- 'bf z)(zL Switches 50
<br />Fixtures .50
<br />/Air Conditioners
<br />Each /20.00 So.tt)
<br />Factory Wired Unil Qll)Approved
<br />LiSt L 5.00 3a'ro
<br />Busways, special raceways, under floor
<br />duct, trolley or plug-rn busways ea. 110' or
<br />fraction thereof
<br />500
<br />Fire Signaling System. Minimum fee
<br />Outlet, frolD or heat sensor I 10.00
<br />.50 so
<br />Lighting Standards with One Lamp
<br />Each Add'l hxture on same standard
<br />5.00
<br />1.00
<br />Owner Buil(ler Declaration
<br />Dr lI Owner {Srg )
<br />Maintenance Permit (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 />/f'O-l
<br />Signs and high potential gas tube lighting 15.00
<br />Swimming pools, fountains, spas 35.00
<br />motor control center o(ilbSwitchboard
<br />@+')tach
<br />r 5.00 /f .rc
<br />Temporary construction meter service
<br />pole
<br />Eacf distribution pole
<br />25.00
<br />5.00
<br />+riporary construction lighting
<br />500 lamps or less
<br />Over 500 lamps
<br />200
<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 />Over 1 and not over 10 HP, KW KVA
<br />Over 10 and not over 50 HP, KW KVA
<br />-der 50 and not over 100 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 />I hereby aflrrm lhal I am lcenscd rnder the provrsrons ol Chapler 9, Drvrsron 3 ol the Busrness and
<br />I cerlrly lhal rn the perrormance ol the work lor whrch lh
<br />I hereby aflrrm thal I have a cernfrcate of consent to sell'rnsure. or a certrfrcate ol Worker's Compeil'
<br />satronlnsurance CertfredcopyrsIledwrlhlheCrlyburldrngrnspeclrondeparlmenl
<br />ll. al16r makrng lhrs CerlrlEale ol Exemplron, you should become subtecl lo the Worker's Compen-
<br />satron provrsrons ol the Labor Code. you musl iorthwrth comply wrth such provrsrons or lhrs permrt
<br />shall be deemed revoked
<br />Expiration
<br />Applicant's Declaraliorr
<br />Contractor Use Only
<br />724o
<br />CITY I o--r
<br />ll not emplov anvls
<br />,","1 I -2- 87App,can,., As,,n, s,q
<br />ADDRESS
<br />4.__
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<br />tr!
<br />?/tt "
<br />RTOCONTRAC
<br />Contractor (Srg )
<br />- Crty Lrcense
<br />Date Verilred By (Srg )
<br />Date App|cant (Srg )
<br />Notice To
<br />Code, and my liceose rs rn lull force and etfect
<br />ilze represenlafves ol thrs crly to enter upon the ProP.rrly lor
<br />Workars Compsnsation
<br />,(l
<br />Z ,,,'" C
<br />9- ,J .*4alrt
<br />'::'Wfrff""::
<br />Subtotal /8.ra
<br />Penalty Fee (when applicable)
<br />Violation Fee (s0 00)
<br />Plan Check 650/o ol sublotal 7l, f3 lminimum 20.00)
<br />Receipt tto. 6717 pc* 63 23 oate
<br />Plan Check (Adjustment)
<br />lssuancefte 10.00
<br />*r{tPERMrr FEE (minimum $35.00)
<br />p/M//-z-8?DATE PERMrrNo. 23554
<br />B:l.fiiff" ETL ar .VERIFIED BY lSrg )-
<br />u4 rrY)
<br />6**s1
<br />ll/Wffi S:SPI{ 413 ll?2.m
<br />VALIDATION (OFFICE USE ONLY)
<br />IACCOUNT lrrl 413)
<br />I o oAPPLICATION AND
<br />ELECTRICAL PERMIT
<br />ITYPFY'/RITE OR PBINT IN INK)
<br />CITY OF SANTA ANA
<br />206 W. 4th Sr.
<br />667 -2738 $fid3APPLICANT FILL IN AREA BELOW
<br />@g-Oza
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<br />Distribution: 1. lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy cs.6r3
<br />Prolesgor6-/01/t
<br />I
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