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APPLICATION AND a o CITY OF SANTA ANA
<br />206 w. 4th Street
<br />667-2738MECHANICAL PERMIT
<br />(TYPEWRITE OR PRINT IN INK)
<br />APPLICANT FILL IN AREA BELOW h,-
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<br />)P Residential E lndustrial D Commercial NO.EACH TOTAL
<br />3708 Santa Fe Vlllage Dr., Unlt E
<br />JOB ADDFESS
<br />EACH FURNACE INCL. DUCTS ANO VENTS
<br />Up to 100,000 BTU 15.00
<br />Over 100,000 BTU 20.00
<br />EACH ABSORPTION SYSTEM
<br />Sunfl-ower Associates 7 14 I s46-OLr
<br />MAILING ADORESS
<br />STATE/ZIPcA 92626
<br />OWNER PHONE
<br />3315 Fairview Rd.
<br />Costa Mesa 100,000 BTU to 1,000,000 BTU 25.00
<br />1,000,001 BTU to 2,000,000 BTU 30.00
<br />EACH COMPRESSOR, BOILER,HEAT
<br />Oiln atrtld.?D.drtbr
<br />I hereby attirm lhat I am oxompt lrom th€ Cdlraclo/s Lic6ns Law lor ths lollowing roaon (S€c.
<br />708 1 . 5. EusinB and Prot6sions Code Any cily or @unly which roquir6 8 pormil to conEtruc-|,
<br />aller. improva. dgmolbh, or rgpair any strucluro. prior lo its isulnce. also roquireS lha appllcanl
<br />fo. such permil lo tile a sign€d slatamont that he is licmlod puBuanl to tho provisions ot th€
<br />Contractor's Licmle Le (Chaplor 0 (commencing wilh S€clion 7@0) ol DivEion 3 ot lha
<br />Eusan6s and Protcaim3 Codo) or lhal he is exompl lharetrom and the basis lor tha allsgod
<br />exmption. Any violslion of S€ction 7001.5 by lny spplicrnt lor a rErmil subjecls tho appliclnt to
<br />8 civil panally ol not mor6 then five hundred dollac (35m)i
<br />E Section zoga l, a8 ownor ot the proparly, or myomployGwith wsgB Glheirsole compor
<br />sstion. will do the wort. and the 3tructure is not intsndad or oltsed tor sale.
<br />E S*tion 70448 l. a owns o, lhe prcperty. m 6xclusiv6ly contr&ting with licansad
<br />contractors to construct the proirct.
<br />Date Ownor (Sig I
<br />Cmlilclon t,.. Only
<br />CONTRACTOR
<br />Steel- T. A/C 279-3200
<br />PHONE
<br />Heat Pump Compressor less than 5 HP
<br />EACH AIR HANDLING UNIT OR VAV BOX
<br />Outdoor Dual Packaged Healing or Cooling
<br />Repair, Alt. or Add. to any Heating/Cooling sys.
<br />25 .00125.00
<br />40.00
<br />25.00
<br />30.00
<br />5HPto30HP
<br />31 to 50 HP
<br />Over 50 HP
<br />Air Handling less than 2,000 CFM
<br />2,000 CFM to 10,000 CFM
<br />Over 10,000 CFM
<br />MISCELLANEOUS
<br />Floor Furnace
<br />Heater; Suspended, Wall or Unit
<br />Com'l Dryer Vents
<br />Decoratiw Fireplace (Wood or Gas)
<br />Hood with Duct and Fan (Type l)
<br />10.00
<br />10.00
<br />25.00
<br />15.00
<br />15.00
<br />10.00
<br />15.00
<br />15.00
<br />15.00
<br />I hereby alrirm lhal I 8m licensed under tho provEions of Chrpter 9. Oivision 3
<br />Prol6sions Code, md mv hcgnse rs
<br />.,"*3#o---i5oil u,*,
<br />onrll:L? 8? conrra,or
<br />Broken Arrow
<br />Norco
<br />AODRESS
<br />3 180
<br />CITY
<br />in lull force and etl6ct.
<br />orthe Bu3ir3and./L6'-
<br />STATE/ZIP
<br />9r760
<br />Each Vent Fan Connected to a Duct 4 15.00 60.00
<br />1 20.00 20.00
<br />15.00
<br />10.00
<br />15.00
<br />15.O0
<br />15.00
<br />Fire Extinguishing System
<br />Each Evaporatile Cooler
<br />Firc Damper lnstallation
<br />Each Appliance or Equipmenl Ragulatad by
<br />!!!q Code but not specifically lisled abore
<br />Hood with Ducl and Fan (Type ll)
<br />Subtotal
<br />Fan Coil lnstallation
<br />lncidental Gas Piping
<br />105.00
<br />Uo.f m Con?.mtbn Oaarrdbo
<br />I hdaby attirm thal I have a corliliots ol consl to sell-insure. or a cerlilacrlo ol Wortd's Com-
<br />p€ruation lnsurance. Co,lilisd @py is liled with the Cily building inspaction deprrlmonl.
<br />peBon an any manner so as lo becoma subiecl to the Worker's Compensation Lils ol
<br />Calilornia
<br />t{otlc. Yo A9pllcnl:
<br />ll alts makrng lhrs Cerlricaleof Exemptron, you should becomesubjet to the Worke/s Comper
<br />salaon provrsrons ol the Labor Code, you must tonhw[h comply with such provisions or thrs
<br />permrl shall be demed revoked
<br />o^"iZ:U-fr Appricanr
<br />I cerlity thal in lho p€rlormancoortha
<br />(si9.
<br />work lor which this
<br />Dale Applicant (Si9.)
<br />I shall rcl amploy any
<br />Pil?", -{90 venried By (s,s )
<br />Penalty Fee (when applicable)
<br />Violation Fee (s0.0o)
<br />Plan Check 650/o of subtotal 68.25 (minimum 20.00)
<br />Receipt No.Pc * 6917 Date 213
<br />Plan Check (Adjustment)Credit Ii-00
<br />lssuance Fee 10.00
<br />TOTAL PERMIT FEE (minimum $35.00)-0-
<br />Erpkibn
<br />This permit shall expiio by limitatim and bsome null and void i, th6 wort authorizod by thig
<br />permit is rcl @mmsncod within lSOdey3lrom the dale ol thi3 permit or ilwork authorited by this
<br />tBrmit is suspendod or absdonad et any timo atts the work is cmmncod tor a p€riod ot 180
<br />days. A nfl ptrmit shtll bo obtainod lirst bolore such wqk can bo reommgncod.
<br />ArglcJrl'. Mrdo.r
<br />I cartity that I havo road this applicslion and stste thal ths above inlormation i8 corr€cl. I 4re to
<br />comply with all cily ordimnc€s and state laws retating to buitding cmstuc'tbn, and heroby
<br />reprGenlaton of this city to enttr utDn lhe abovFmfftion6d
<br />r12J+Oale Applacant or Agenl (Sig.)
<br />lor insp*timaulhorized
<br />purpos6
<br />DArErA.>-q-81 PERMIT NO.13763
<br />831.,?i$.51
<br />q ) k",,,. o ",,,,n,o,+^>.ly S-qPERMIT ISSUEO BY (Srg )
<br />USE ONLY)
<br />1-412)ALL FEE oN M 10865ID
<br />Drstnbulron 1 lnspector Copy 2 File Copy 3 Frnance Copy 4 Applrcant Copy
<br />10.00
<br />15.00
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