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JOB AODRESS Dr., Unlt A3710 Santa Fe Vil <br />OWNER <br />Sunflower Associates <br />1 Fairview Rd. <br />MAILING AOONESS <br />CITYCosta Mesa <br />& Residential E lndustrial tr Commercial <br />EACH FURNACE !NCL. DUCTS AND VENTS <br />EACH AIR HANDLING UNIT OR VAV BOX <br />10.00 <br />NO.EACH TOTAL <br />PUMP <br />15.00 <br />20.00 <br />25.00 <br />30.00 <br />25.00 <br />40.00 <br />25.00 <br />30.00 <br />Up to 100,000 BTU <br />Air Handling less than 2,000 CFM <br />Over 100,000 BTU <br />EACH ABSORPTION SYSTEM <br />Owr 50 HP <br />100,000 BTU to 1,000,000 BTU <br />31 to 50 HP <br />1,000,001 BTU to 2,000,000 BTU <br />5HPto30HP <br />Heat Pump Compressor les.s lhan 5 <br />EACH COMPRESSOR, BOILER, <br />Ottra?-Aulbt Dadraaba <br />I hsoby srrirm lhal I am oxmpt from tlle Contracto/s Licmse Law ld tho tolloring ro8on (S€c. <br />7031.5, Busin6s and Prolsions Codo. Any cily or counly which roquiro3 a pormit to con3ltucl, <br />sller. improve. d€molish. or repeir any 3tructuro. prior to ils isuanca, al$ r€quirsS lho applicant <br />lor such permit lo lile e 3ignad 3telmonl lhat h6 B licmsad puBuml lo lho pIovi3bn8 ol lha <br />Contractor's Licensa Lar (Chaplar 9 (commoncing with S€ction 7@O) ol Division 3 ol lhe <br />Businoss 8nd Profs$ions Cod€) or thel he is oxmpt th€refrom and th€ b83i3 lor the sllegod <br />oxemption. Any violation ol Socllon 7031.5 by any spplicant tor a pormil $biecB tho epplic8nl to <br />6 civil p€nrlty ol not more than live hundrod dollsrs (tgn): <br />ES€ction7O44A l,asownerotthoproperty,ormy€mployoeswilhwag€aasthgirsolecomp€n- <br />3ation. will do the wort. and tho structure E nol inlmded or otlred ,or sale. <br />E S*tion 7Oa4B l, as ownd ol the prcperty. am axclusively cmtreting with licms€d <br />conlractm lo construct the proitrt. <br />Oate Owmr (Sig.) <br />Conlrtcio[ Ll. Only <br />CITY <br />Norco <br />Broken Arrow <br />Contractor <br />CONTRACTORSteel T. AIC <br />orr"tL-77-?'1 <br />Outdoor Dual Packaged Healing or Cooling <br />Repair, All. or Add. to any Heating/Cooling sys. <br />Range Hood with Duct and Fan (Type l) <br />Hood with Duct and Fan (Type ll) <br />1 5 <br />20 <br />1 <br />1 <br />00 <br />00 <br />10.00 <br />10.00 <br />2,000 CFM to 10,000 CFM <br />Fire Damper lnstallation <br />Over 10,000 CFM <br />lncidental Gas Piping <br />MISCELLANEOUS <br />Each Evaporative Cooler <br />Floor Furnace <br />Heater; Suspended, Wall or Unit <br />Com'l Dryer Vents <br />Decorative Fireplace (Wood or Gas) <br />Each Vent Fan Connected lo a Duct <br />Fan Coil lnstallation <br />Fire System <br />25.00 <br />15.00 <br />15.00 <br />15.00 <br />15.00 <br />15.00 <br />15.00 <br />10.00 <br />15.00 <br />'t5.00 <br />10.00 <br />15.00 <br />15.00 <br />20.00 <br />15.00 <br />or <br />but nol abow <br />by <br />Subtotal 60.00 <br />tloltrs Corp.B.abn O.drtbn <br />I htreby at irm that I have 8 cerlitimto ot consont to selt-insure. or a @rtilicats ot Worltr'3 Com- <br />pensation lnsurance. Ctrlilied copy is lilad with lhe City building impection d6p8nm6nl. <br />peison in eny manner so as to be@me subjecil to the <br />Calilornia <br />l,lollc. To Apdlcil: <br />l, aller makrng lhrs Cerlricale o{ Exemplton. you should b€come subjct lo the Wo(ke. s Compen- <br />satron provrsrons of the Labor Code, you musl forlhwrth comply w(h such provrsrons or lhrs <br />permrt shall be deemed revoked <br />o,rJT'tl +7 Appri*nr (sis) <br />I cerlity that in the pertormanceoltho work 1forwhichthis <br />Date Applicanl (Sr9 ) <br />oste 4 l90Expires -=-1- Venfied 8y (Srg ) <br />Penalty Fee (when applicable) <br />Violation Fee (50.00) <br />Plan Check 65% of subtotal 39 (minimum 20.00) <br />Receipt No.pc # 6917 Date 213 <br />Plan Check (Adjustment)Credi-t t6.25 <br />lssuance Fee 10.00 <br />rOTAL PERM]T FEE (minimum $35.00)-0- <br />Crplrdo.r <br />This pormit shall expire by limitation end become null and void it |tr€ work aulhoriz€d by this <br />parmit is nol commanced within lS0days lrom lho dsts ot this p€rmit or il work authorizod by this <br />,Ermit is sGpanded or abandon€d at eny time ettor th6 work is commncqd lor a tEriod ol ld) <br />days. A n* p*mil sh6ll b€ obtainod ,i6t belore guch work can b€ recotmenced <br />Appllc.nt.' O.dr.lton <br />I cenily that I have read thb spplacation and stalo that the 6bove informataon is corrtrt. I agreo to <br />comply with 8ll city ordimncB and slale laws rolatino to building constuction. and hsrcby <br />represenlation ol lhis city to onl6r upon the above.mslioned property ror <br />tuJ&Oate Applicent or Agsnt (Sig.) <br />aulhorized <br />pu.pos6 <br />oArE , A-u -81 PERMrrNo. 13 7 6 4 <br />HA.,gis.u&aJ VERIFIED BY (Sig )PEFrMrr rsSuED r" ,r,n, - -d9',- ba- <br />ALL FEES PArD 0N M1086s //_ a7 _ f ? <br />Ii"'8dr'i?'l {?'o!'cE <br />usE oN LY) <br />{AUUUUNT "'C L .{4//q <br />t <br />APPLICATTON AND . <br />MECHANICAL PERMIT <br />(TYPEWRITE OR PRINT IN INK) <br />I CITY OF SANTA ANA <br />206 W. 4th Street <br />667-2738 W <br />APPLICANT FILL IN AREA BELOW <br />(D <br />C-Izo <br />oo], <br />m <br />U)u) <br />b <br />ron I lnspector Copy 2 Frle Copy 3 Frnance Copy 4 Applicant Copy <br />cs-618 <br />(,{ <br />O <br />U) <br />0)5 <br />r+ <br />0r <br />rd <br />o <br />l*HP <br />0)gq <br />o <br />UFl <br />c <br />E <br />P.rr <br />/546-017 <br />2626 <br />1 25.ot) <br />9t760 <br />3oftho