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CITY OF SANTA ANA <br />PLAN CHECK - CHECKLIST <br />* <br />JOB ADDRESS /31 7 3' M<R .0 1/< <br />TRACKING #:l 0 2 7 7 31/DATE'3-11-12 <br />FOR PLANCHECK STATI]S CALL (714) 647-5*Q <br />PLFARF INITIAL EACH ITEM BELOW <br />L.Li.I agree to pay a plancheck fee established for this project with the understanding that this <br />payment is not a guarantee that a permit will be issued and that this fee is not refundable <br />once a plancheck has commenced. <br />F c 2.I understand that I may request an "Accelerated Plancheck" at an additional cost to me. <br />This plancheck will be performed by an in-house plan checker with the intention of reducing <br />plancheck time for the Building & Safety Division. <br />E_C_ 3.I understand that the project valuation (from which plancheck and permit fees are <br />calculated) will be reviewed during the plancheck process and that said valuation shall be <br />adjusted up or down in accordance with established fee computation regulations. <br />k C 4.l understand that I shall submit separate plans, applications and plane.heck fees for the <br />following when plan check is required: <br />a. Electrical Plans - 2 complete sets c. Mechanical Plans - 2 complete sets <br />b. Plumbing Plans - 3 complete sets d. Grading Plans - 3 complete sets <br />f-C 5.I understand that I shall visit tile Public Works Department to verify whether a field <br />inspection of the property is required. 1 understand that prior to the issuance of the Building <br />permit I am required to obtain Public Works Agency approval if my project valuation exceeds <br />$30,000 or has added plumbing fixtures, or added bedrooms, or exceeds 500 sq.ft. <br />AGRFED TO BY APPLICANT OR AGFNT <br />Applicant's Signature f._.:za z-» 6,0,7 <br />Print Name f v 1/1 L;A €/2 v i.Adriresq Br:i MAaNDUA 145- <br />Telephone Number 14 . 98(0. 2€54 Fax <br />FOR OFFICE USE ONLY: "Checklist of items discussed" APPROVALS & FEES REQUIRED: Y/N <br />1.-hilanning Department <br />2.25'Public Works Agency <br />3»: Fire Departmemt <br />42 Police Department <br />5j* School District <br />*L Health Department <br />PERMIT TECHNICIAN <br />Form 58: 3-26-04 <br />7tritle 24 (Energy ) <br />E,!1-Title 24 (Disabled Access) <br />Sd#Roof Mounted Equip. <br />10.-0[.ist of Subcontr. <br />Idg. Pmt. Info. <br />ummary of Appr. Reg. <br />w._ . T Information <br />\2112 14 4+ <br />12__,S <br />19 V C <br />14.PEonstr. Act. Reg. <br />1 %* Res. Dev. Fees <br />16.2SMIP <br />17.2'Microfilming <br />18.kI'Const. Debris Recyc. <br />19.k<*CWP Surcharge <br />20.kf'LOA/Owner-Builder Ver.