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JOB AOORESS <br />3708 Santa Fe Villlage Dr. //4, <br />OWNER <br />Sunflower Assoclates <br />MAILING AOORESS <br />3315 Fairview Rd. <br />CITYCosta Mesa, <br />ERosidential D lnduslrial ECommercial <br />EACH FURNACE INCL. DUCTS AND VENTS <br />Up to 100,000 BTU 15.00 <br />olrcr 100,000 BTU 20.00 <br />EACH ABSORPTION S\6TEM <br />100,000 BTU to 1,0@,000 BTU 25.00 <br />Ourr-Eulda? Daarralbn <br />I haraby atrirm lhat I am axempt ,rom tho Conlrsclo/s Liconso L8w lor th€ tollowing re8m (S6c. <br />7€81.5. Busin$ and Prol6sions Cods. Any city or @unty which r€quir6 a permat to construcl, <br />,lt6r, improvs. demolish. or rapaii any 3lruclura, prior lo its ilauance, al$ r6quir6 tho epplicel <br />lor such pormil to tile e signod 3trlement thal ho is licansad puEuant to the proyisiong ol lhg <br />Contraclor's Li6* Lff (Chapt6r I (@moncing with Smlion 7@0) ol DivBion 3 ol th€ <br />8u8ine$ and Prolsims Coda) or thst hs is orempt thererrom and lhe b8!is lor the sllogod <br />examplion. Any viohlion ot Soction 7031.5 by eny applidnl ,or a pormit subjects tho epplicenl to <br />a civil p€n8lty ot nol moro than riva hundr€d dollars ($500) <br />E S*f ion 7O4,aA l. as owner ot the proparly, or myomployo€3with wag6 as lheir8olecomp€n- <br />sation, will do lha wofi. and the slruclure B not inlended or ottergd tor 3ale. <br />E S*tion 7O4ilB l. 8s ownff ol the proporty. am oxclusively contrrtang wilh lrcms€d <br />@ntractm lo construCt the p.Oioct. <br />Oste <br />- <br />Owrer (Sig.) <br />Conlrclo[ t .. Only <br />CONTRACTOR <br />Steel T. A/C 279-3200 <br />AODRESS <br />3180 Broken Arrow <br />CITY STATE/ZIP9t760Norco <br />1,000,001 BTU to 2,000,000 BTU 30.00 <br />EACH COMPRESSOR,HEAT <br />Heat Pump Compressor less than 5 HP 1 25.00 25.00 <br />5HPto30HP 25.00 <br />31 to 50 HP 30.00 <br />Orcr 50 HP 40.00 <br />EACH AIR HANDLING UNIT OB VAV BOX <br />Air Handling less than 2,000 CFM 10.00 <br />2,000 CFM to 10,000 CFM 10.00 <br />Over 10,000 CFM 10.00 <br />MISCELLANEOUS <br />Outdoor Dual Packaged Healing or Cooling 25.00 <br />Floor Furnace 15.00 <br />Heater; Suspended, Wall or Unit 15.00 <br />Com'l Vents 15.00 <br />Decoralire Fireplace (Vllrod or Gas)15.00I hereby Itlirm that I am licensed und€r th6 provision3 ol Chaptg I Oavisbn 3ol tho BusinBs and <br />Prof6sions Cod€. &d mv lrconse rs <br />1el"9."q.550717 cro" <br />in lull lorce and ottoct.* <br />27 <br />orr" |L'Z7E crnrracror (sie <br />Repair, Alt. or Add. to any Heating/Cooling sys. <br />Range Hood with Duct and Fan (Type l) <br />Each Vent Fan Connected to a Duct <br />10.00 <br />'15.00 <br />1 15.00 <br />tlo*.n Coltp.nraba O..rra5o <br />I hsreby Itlirm that I have a cerlilicate ol @nssl to selt-insur€, or a cortilicate ot Worktr's Com- <br />pemation lnsuranco. Crlilied @py is tiled with the City brJilding impection department. <br />Oate <br />Expires 4 90 Venlied By (Sig ) <br />,? <br />o^" t2:?-? q Appridnr <br />I c6rlity thal in lhe perlo,manceolthe work lor whrch lhis I shall not smploy any <br />porlon in any msnntr ao a3 to bo@me 3ubiocl to tho <br />Calitomia <br />Laws ol <br />O.t6 <br />- <br />Appticant (SiO.) <br />l{otlca To Appllcnl: <br />lf atls makrng thrs Cerlrficaleol Exemptron, you should b6com€ subl*t to theWorkar's ComfEn- <br />sation provrsrons ol the Labor Code. you must lonhwith comply with such provtsrons or this <br />permtl shall be deemed revoked <br />Fan Coil lnstallation <br />Fire Extinguishing System <br />Each Elaporatire Cooler <br />lncidental Gas <br />Fire Damper lnstallation <br />Emh Apphance or Equrpment Regulated by <br />lhis Cod€ but nol spscifrellv listed abm <br />1 20.00 20.00 <br />15.00 <br />15.00 <br />10.00 <br />15.00 <br />15.00 <br />Hood with Duct and Fan (Type ll)15.00 <br />Subtotal 60.00 <br />Penalty Fee (when applicable) <br />ErDlrabo <br />ThB permil shall sxpire by limitation and be@me nult end void r, ths work authtri2ed by this <br />permrt n not commenced wilhin 180 dsys trom the date o, this permit or irwork authoriz€d by this <br />p€rmit i3 suspmded or abandonod at any time alls the work is commoncod lor I p€riod ot IEO <br />days A nor pdmrt shell b€ oblainod riBl b€fore such work can bo rocommenced <br />epgflenl't O.drrlloo <br />I conaly that I have r€ad this applicetion and state that tho abov6 inlormation is corroct. I eoi€a to <br />comply wilh all city ordinsnc6a and stete taws releting to buitding cmstuction. and h€roby <br />authorized raprGentation ol this city to enter utpn lhe sbovFmtrtionod prclDrty tor inspetion <br />:::bu+Applicanl or Ag6nl (Sig.) <br />Violation Fee 39--(s0.00) <br />Plan Check 650/o of subtotal (minimum 20.00) <br />Receipt No.Pc # 69L7 Date 2 /3 <br />Plan Check (Adjustment)Credit t6.25 <br />lssuance Fee 10.00 <br />TOTAL PERMIT FEE (minimum $35.00)-u- <br />DATE / a-"4. Sal PERMIT NO.137s9 <br />.r,.o,"o54 bJI <br />PERMTT No- , VER|FIED 8Y (Sig )o+' <br />VALIOATION (OFFICE USE ONLY) <br />(ACCOUNT rr 1-412) <br />T ALL FEES PAID ON M10865 l) -2?_n<>? r <br />APPLICATION AND T <br />MECHANICAL PERMIT <br />(TYPEWRITE OR PRINT IN INK) <br />a I <br />CITY OF SANTA ANA <br />206 W. 4th Street <br />667-2738 IW <br />APPLICANT FILL IN AREA BELOW <br />(!g <br />Izo <br />oot <br />m <br />U)U' <br />(f,) <br />\to@ <br />a <br />0)t <br />r+ <br />OJ <br />trlo <br />H.HPs <br />0ao <br />U <br />Fl <br />p <br />H. <br />r-t <br />Orstnbutron I lnspector Copy 2 Frle Copy 3 Frnance Copy 4 Applicant Copy <br />cs-618 <br />7t4-546-0tLO <br />STATE/ZIPcA 92626 <br />NO.EACH TOTAL <br />15.00 <br />PHONE <br />PEFMrrrssuEo "rr",n, \ul- q CL&/A-