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APPLTcATToN AND a
<br />MECHANICAL PERMIT
<br />(TYPEWRITE OR PRINT IN INK)
<br />o CITY OF SANTA ANA
<br />206 W. 4th Street
<br />667-2738
<br />APPLICANT FILL IN AREA BELOW 4rL.
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<br />JOA AOOBESS
<br />3708 Santa Fe Village Dr., Unit D
<br />E Residential E lndustrial E Commercial NO.EACH TOTAL
<br />EACH FURNACE INCL. DUCTS AND VENTS
<br />Up to 100,000 BTU 15.00
<br />Orcr 100,000 BTU 20.00
<br />EACH ABSORPTION SYSTEM
<br />100,000 BTU to 1,000,000 BTU 25.00
<br />1,000,001 BTU to 2,000,000 BTU 30.00
<br />EACH COMPRESSOB, BOILER,
<br />OWNER
<br />Sunflower Associates
<br />PHONE
<br />7 t4 I s46-Ort0
<br />MAILING AODRESS
<br />3315 Fairview Rd.c''[osta Mesa
<br />STATE/ZIPcA 92626
<br />Olltt{ulld.t O.dtabo
<br />I hersby Itlirm that I am orffipt lrom the Contracto/s Liconse Lew ,o, tha ,ollowing r8m (Se.
<br />78t.5. Busins3s and Pror6sions Code. Any cily or county which requarB s p€rmit lo cmrltucl.
<br />alter, improve, demolBh. oi ropsii any struclure, prior to ils i33uance. al3o roquire3 lha lpplicant
<br />lor such ptrmil to lilo a sign€d 3trtemonl that he b liconssd purEuant lo lha provi3bns ol lh€
<br />Conlractor's Licms Lrr, (Chepts 9 (@mmoncing with Selion 7mO) ol Oivision 3 ot tho
<br />Busins and Prot€3sions Cod6) or lhet he i3 oxmpl therolrom and the barB ,or lh€ allooed
<br />exemption AnyviolationorS€clionT03l.5bysnyepplicanllorapormilsbisclslhaapplicanlto
<br />I civil p€n8lly ot not more lhan live hundrad dollaB (35m):
<br />E S""f,on 7Ol4A l. as own6r ol the properly. or myemployss with wa96 a thoir solecompen-
<br />sation, will do tho wod(. and lh€ 3lructur6 is nol inlendod or olltrod tor sale.
<br />E S*,ion 70448 l. as ownsr ol tho prcpsny. em exclusryely cmtrrting with lacensod
<br />contreclors to conslrucl lhe proisct.
<br />Oate Owner (Sr9 )
<br />Contrrlon l,!. Only
<br />PHONESteel T. AlC 279-3200
<br />AOORESS
<br />3180 Broken Arrow
<br />CITYNorco 'H76',o
<br />Heat Rrmp Compressor less than 5 HP I 25.00 2s.00
<br />5HPto30HP 25.00
<br />31 to 50 HP 30.00
<br />Orcr 50 HP 40.00
<br />EACH AIR HANDLING UNIT OR VAV BOX
<br />Air Handling less than 2,000 CFM 10.00
<br />2,000 CFM to 10,000 CFM 10.00
<br />Owr 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 Dryer Vents 15.00
<br />Decorative Fireplace (Wood or Gas)15.00
<br />Repair, Alt. or Add. to any Heating/Cooling sys.10.00
<br />Range Hood with Duct and Fan r)15.00
<br />I hareby allirm lhat I am liceosed under the provisions r
<br />Pror6sions Cod6. and my lrcense 6 rn tull lde snd
<br />.,"*3(?o-trgztz c,o. c2o
<br />ol Chapltr 9. Orvrsion 3orthe Bujrnqsandleltsc,r. .fLa-
<br />0150127
<br />Each Vent Fan Connected to a Duct 4 15.00 60.00
<br />tlo.tart Coipfi dbo Oadrlbo
<br />I haraby attirm lhst I hevo I cortilicate ot cons6nt to sll-insure. or a erlirieleot Wb.ttr's Com-
<br />ponsation lnsurance. Certiried @py is tilgd wilh the City building departmenl.
<br />Osle 4 90Expires Verified By (Sig.)
<br />Dale f?-2?-*7 Applicsnt
<br />I certify thal rn the pertormanceol tha work lor which this I shell not employ eny
<br />pe6on an any manner I es to be@me subiect to the
<br />Cali,ornaa
<br />Compensation Laws of
<br />Oate Applicanl (Sig.)
<br />ttlollc. To Apdlcit:
<br />ll atltr makrng thrs CertrlcateolEremptron. you sh@ld beomesub,ettotheWorker'sComper
<br />salion provrsrons of the Labor Code. y@ must fonhwilh comply wtth such provistons or thas
<br />Permrl shall be deemed revoked
<br />Fan Coil lnstallation 1 20.00 20.00
<br />Fire System 15.00
<br />Each Evaporative Cooler 15.00
<br />lncidental Gas Piping 10.00
<br />Fire Damper lnstallation 15.00
<br />or by
<br />bul not aboE 15.00
<br />Hood with Duct and Fan (Type ll)15.00
<br />Subtotal
<br />Penalty Fee (when applicable)
<br />Violation Fee (s0.00)
<br />Plan Check 650/0 of subtotal 68.25 (minimum 20.00)
<br />Receipt l.lo.Pc # 69L7 Date 2 3
<br />105.00
<br />Erpkdon
<br />This p€rmil shall sxpire by limitalion 6nd b€come null aod void it th€ work suthori:od by thi3
<br />permit 6 not commGnctd wilhin l@ dsys trom the dato o, thi3 pormil or il work 8uthorized by this
<br />permil is suspond€d or rbendonod Et any timo arls lhe worh is cmmncod lor a poriod o, rA)
<br />drys. A nil permil shall be obtainod li'8t baloro such work cln be racommenced.
<br />ADoLcfral D.Crdo.r
<br />o","12@fl Applrcant or Agent
<br />Plan Check (Adiustment)Credit 13.00
<br />lssuance Fee 10.00
<br />' rorAL PERMTT FEE (minimum $35.00)-0-
<br />DATE
<br />'
<br />a.4 - Eq PERMTT No. 1,37 62
<br />PERMIT ISSUED 8Y (Srg )'/t^/h
<br />VALIDATION (OFFICE USE ONLY)
<br />(ACCOUNT rl r-4r2)ALL FEES PAID ON M10865 :n12-
<br />Orslribulion I lnspectoi Copy 2. Ftle Copy 3. Financo Copy 4. Applicant Copy
<br />cs-618
<br />o"r"l7Z8:fl conrracror (sie
<br />I certrty
<br />comply
<br />thsl I have roed this Epplicalion and slale that the abova inttrmalion is corr61. I
<br />authorized repr6entstion ol thig cily lo 6ntd upon
<br />purpos6.
<br />inspelion
<br />gg$,lm 5t/ af,{F,F,ED By (sig )c,+,-
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