|
Residential - lndustnal Commercral
<br />|
<br />,o. I .o." rorAL
<br />03Res. Hotels, Motels, Apt. Sq Ft. I I I O s5.3 a
<br />Gar. or Carports Sq. Fl.tti?.02 l, zf
<br />Receptacles .50
<br />i'V2; Ja^to 7n t/21* ,&.. - aW.*;-'ff?!?,,.
<br />:)"i'fi ? ,",,;--'> R,9,,,,
<br />0.^X- 10n,.- a- O- I 2L ?h Switches 50
<br />Frxtures 50
<br />Air Conditioners
<br />Each I 20.00 )lo, o 'Approved Factory Wired Unit D 4)Lrst Dp. t*o od 7 5.00 Zf.o o
<br />Busways, special raceways, under floor
<br />duct, trolley or plug-in busways ea. 110' or
<br />lraction thereol
<br />5.00
<br />Frre Signalino System. Mrnrmum fee
<br />Outlet.@okDr heat sensor I 10.00
<br />.50 .ro
<br />Lighting Standards with One Lamp
<br />Each Add'l fixture on same standard
<br />5.00
<br />1.00
<br />Ownor-Bullder Declaratlon
<br />I hereby atlrrm thar I am exempl rrom the Conlractor's Lrcense Law lor the followrng reason lSec
<br />7031 5, Busrness and Prolessrons Code Any crty or counly whrch requrres a permrl to conslrucl,
<br />alter, rmprove, demolsh, or reparr any struclure, pnor lo rls rssuance, also roqu[es lhe appIcanl ,or
<br />such permrl to frle a srgned stalemenl that he rs lrcensed pursuanl lo lhe provrsrons ol lhe Contrac-
<br />tor's License Law lChapter I lcommencrng wrth Section 7000) ol Drvrs,on 3 of the Busrness and
<br />ProlessronsCode)orlhatherserempttherelromandlhebasrslortheallegedexemptron Anyvrola-
<br />lron ol Sectron 7031 5 by any applcanl lor a permri subtecls Ihe app|canl to a crvrl penally ol nol
<br />more lhan l,ve hundred dollars l S5001
<br />E S"auon7O44A I,asowneroltheproperty,ormyemployeeswrthwagesaslhefsolecom-
<br />lEnsaton. wrll do the work. and the struclure rs nol rnlended or orlered for sale
<br />n Secton 70448 l. as owner of lhe property, am exclusrvely contractrng wrth lrcensed con-
<br />traclors lo conslrucl lhe pro,ect
<br />l)ar le Owner (Srg )
<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 meter
<br />I 15.00
<br />35.00
<br />75.00
<br />/.loo
<br />Signs and high potential gas tube lighting 15.00
<br />Swimming pools, fountains, spas 35.00
<br />motor control center o@Switchboard,@
<br />Each I
<br />15 00 t.f- o o
<br />Temporary construction meter service
<br />pole
<br />Each distribution pole
<br />25.00
<br />5.00
<br />I hereby aflarm lhal I am hcensed rrnder tha p(ovtsrons ol Chapter 9. Drvrsron 3 ol the
<br />Contractor Use Only
<br />Ri: a.t "r- il"-^'L fi4 -, 2 t 3
<br />?,? ro 5o' STu--*i,,,,
<br />)4-"A* 6t.<--. &- ?r7 O-{
<br />lull andorce '"tu)
<br />b lO curr,r.,.r. Ot 21 515
<br />lSrg ))empor ary construction lighting- 500 lamps or less
<br />Over 500 lamps
<br />2.00
<br />4.00
<br />Time clock or photo electrrc cell 3.00
<br />POWER APPARATUS : Generators,
<br />motors, transformers, rectiliers, industrial
<br />_heating. cooking. or baking equipment- and other apparatus as follows:
<br />Up to and including 1 HP, KW KVA
<br />Over 1 and not over 10 HP, KW, KVA
<br />Over 10 and not over 50 HP, KW KVA
<br />Over 50 and not over 100 HP, KW KVA- Over 100 and not over 500 HP KW KVA
<br />Over 500 HP, KW, KVA
<br />2.00
<br />5.00
<br />10.00
<br />20.00
<br />30.00
<br />40.00
<br />t )7.59
<br />wo*ers Compengarlon De(/ararlo n U
<br />I h€r€by aftrm that I have a certricate ot consenl lo sellinsure, or a cerliicato ol Worker's Compsn-
<br />$tron lnsurance Csrtilied copv rs frled with lhe Crty burlding rn
<br />ll, after mak.ng lhrs Certrfrcale of Exemplron, you should become sublecl to the Worker's Compen-
<br />satron provrsrons ol lhe Labor Code, you musl ,orlhwrlh comply wrth such provrsrons or thrs permrl
<br />shall be deemed revoked
<br />s
<br />I certrly lhal rn lhe perlor mailcc ol lhe work Ior whrch lhrs
<br />Notice To
<br />departmenl
<br />Oate e,p,,es{-J;9O
<br />,""//-)KJ
<br />Verrfied By lSrg I
<br />Apphcant (Srg l_
<br />Subtotal
<br />Penalty Fee (when applicable)
<br />Violation Fee (s0 00)
<br />Plan Check 65o/o of subtotal I 2.7 ] (minimum 20.00)
<br />Receipr No L 7 LTP; # LV ) l, Date
<br />Plan Check (Adjustment)
<br />lssuance Fee 10.00
<br />(minimum $35.00)FEE 137'z
<br />Expiri!tior)
<br />Applicant's Declaration
<br />I i (,rl 1v llrrl fr,r!r,,, .r(l ll :,rtrt ,r..rl,or rrrrl ,r,rl, lrr,,r ll,' ,ll)()v,, ,rl{)r,r,,rl r I l,rqrli 1{r
<br />,,)rill)!u/ll,.rl, lv()rlr1r),,.s,ri11\rJrrl.rw\il,rlfLll()lruLi,f(l(rorslrLrlrLrri .rilleit,!.rLrlt()
<br />,","il-&Applcanl oi Agent lSrg (
<br />n?e represenlalrves of thrs crly lo enler upon the nlroned prop.rrty lor
<br />o^rE // .2 - tr?PERMIT NO.23564
<br />Z.t- q
<br />PERMIT ISSUED BY (Srg I
<br />ol f r7)lt/ww 3!ffil 413 t1S7.S
<br />iril^ii'l f,? c 3/ ,,u, ,,,*\ s,, rh
<br />VALIDATION IOFFICI USI ONIY)
<br />TACCOUNT #l I 413r
<br />APPUCATION AND
<br />ELECTRICAL PERMIT
<br />(TYPEWRITE OR PRINT IN INK)
<br />_r
<br />a o CITY OF SANTA ANA
<br />206 W 4th Sr.
<br />667 -2738 W
<br />APPLICANT FILL IN AREA BELOW
<br />TDCrIzo
<br />oaam
<br />I
<br />N
<br />N
<br />\
<br />Distribution: 1.lnspectorCopy 2. FileCopy 3. FinanceCopy 4. ApplicantCopy CS 613
<br />l
<br />nol employ any
|