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[ResiOentiat lndustrial Commercral
<br />Res. Hotels, Motels, Apt. Sq rt l.l I 0
<br />NO.EACH TOTAL
<br />Gar. or Carports Sq. Ft.43q 02 y .7'
<br />Receptacles 50
<br />.,i.v
<br />3 7 to A*L 7* f.Z.n l, : Fh/!r,* *efi. ' ,rfl'?,,o
<br />J > t r 7a--r-t---*.^> R9-
<br />STATE/ZIPO- ?zsalo
<br />C ITY&-f- W\e/--Switches 50
<br />Fixtures 50
<br />Air Conditioners
<br />Each I 20.00 2+.oo
<br />Approved
<br />List
<br />Factory Wired Unil L> l'l)
<br />DO. |*oa&7 5.00 Ji ao
<br />5.00
<br />Busways, special raceways, under floor
<br />duct, trolley or plug-in busways ea. 1 10' or
<br />lraction thereof
<br />Frre Signalrn[System. Mrnrmum fee
<br />Outlet, f,mokAor heat sensor I 10.00
<br />.50 {o
<br />Lighting Standards with One Lamp
<br />Each Add'l fixture on same standard
<br />s.00
<br />1.00
<br />Owner Brrilrjer Declaratiotl
<br />Maintenance Permit (annual)50 00
<br />Service Meters
<br />Up to 400 amps, per meter
<br />Over 400 amps, per meter
<br />Over 1200 amps, per meler
<br />I 15.00
<br />35,00
<br />75.00
<br />/f.o o
<br />Signs and high potential gas tube lighting 15.00
<br />Swimming pools, fountains, spas 35.00
<br />motor conlrol center or@Switchboard.@
<br />Each
<br />/15.00 /-f. o o
<br />Temporary construction meler service
<br />pole
<br />Egch distribution pole
<br />25.00
<br />5.00
<br />'6i,.+drfii^. euzc:,+'bo
<br />9o. STa--il-,.4-
<br />Busriless and
<br />^d4/
<br />Lrcen
<br />Contractor Use Only
<br />'3 8t3
<br />3>{a
<br />C- 7zz
<br />/ L/ ,5-rg
<br />ler 9, Drvrsron 3 of lhe
<br />d{2--a
<br />C ITY ,r-.fuer /*
<br />-#mporary construction lighting
<br />500 lamps or less
<br />Over 500 lamps
<br />2.
<br />4.
<br />00
<br />00
<br />Time clock or photo electric cell 3.00
<br />POWER APPARATUS : Generators.
<br />motors, lransformers, rectif iers, industrial
<br />heating, cooking, or baking equipmenl
<br />and other apparatus as follows:
<br />Up to and including 1 HP, KW KVA
<br />OveilI and not over 10 HP, KW, KVA
<br />10 and not over 50 HP KW KVA
<br />50 and not over 100 HP, KW KVA
<br />100 and not over 500 HP KW, KVA
<br />Over 500 HP KW KVA
<br />Over
<br />oder
<br />-over
<br />2.OO
<br />5.00
<br />10 00
<br />20.00
<br />30.00
<br />40.00
<br />workers Gompensatlon (laratio n /
<br />I hereby affrrm lhat I have a ceilrlrcate ol consenl lo sell-rnsure. or a cerlrfrcale ol Worker's Compefi
<br />satron lnsurance Certrfied copy rs Iled wrlh the Crly burldrng rnspeclroo deparlment
<br />oateExpnes.1?l'/.&e,,reaey$'s, 4
<br />Dare Applrcant (Srg ) _
<br />lf, alter making thrs Certifrcale of Exemplron, you should become sublecl to lhe Worker's Compefi
<br />satron provrsrons ol lhe Labor Code, you must torthwrlh comply wrth such provrsons or thrs permrt
<br />shall be deemed revoked
<br />)"Jl
<br />Notice To
<br />whrch thrs permil rs
<br />the Worker's
<br />I shall nol employ any
<br />Laws ol Calilornra
<br />I cerlrly that rn the perlormance ol the work
<br />Subtotal / 27,59
<br />Penalty Fee (when applicable)
<br />Violation Fee (50.00)
<br />Plan Check 65% of subtolal , Lq r. (minimum 20.00)
<br />Receipt No. L7 b7 Pc # L g )! Date
<br />Plan Check (Ad,ustment)
<br />lssuancp Fee 10.00
<br />4Jq(ALPERMTT FEE (minimum $35.00)/37- o
<br />Explradon
<br />Thrs permrl shall €xpile by Imrtalron and become null and vord rl tho work authorrzed by thrs permrt rs
<br />not commenced wrthrn 180 davs lrom the date of thrs permrl or rl work authoilzed by thrs permrl rs
<br />suspendedorabandcnedatanynmealtertheworkrscommencedforapenodof180days Anew
<br />permrl shall be oblarned f[sl belore such work can be recommenced
<br />Applicant's Declaralion
<br />flze represenlatrves ol this crly to enler upon lhe ly lor
<br />"",1 I-L?J appr,""n,., as"n, r
<br />D^rE // -z- tr PERMIT NO.
<br />I
<br />Jrcvt
<br />PERMTT TSSUED BY (Srg )h_b :n,,l,i., i,. r5TL I Z ', i.r r ,r\ , , /,,,n
<br />lt/ol/g? 3!53Pil 413 trrt.SB
<br />VALIOATION IOFFICE USE ONLYI
<br />{ACCOUNT #1r.4r3)
<br />APPLICATION AND
<br />ELECTRICAL PERMIT
<br />ITYPEWBITE OB PBINT IN INK)
<br />o o CITY OF SANTA ANA
<br />206 W 4th Sr.
<br />667-2738
<br />5 APPLICANT FILL IN AREA BELOW W
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<br />Distribution: L lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy c s .613
<br />I
<br />03
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