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XResidential lndustnal Commercral NO.EACH TOTAL
<br />Bes. Hotels, Motels, Apt. Sq. Ft. 7L I 03 2),? L
<br />Gar. or Carports Sq. Ft.Jr?.o2 t/.t7
<br />Receptacles
<br />rr i{r n t)Dt{ SS I/
<br />d
<br />"/o.{rr.,,t-
<br />7r- Y.t/-*
<br />/a^-/Zn r.* a,.;ra;-i..
<br />r.l^r r'. , fiDarFiS .
<br />33 r S- fia-a-r^i.*> /U'[r-2.-- ttt ---
<br />,O,L - /
<br />t"t,,r.' (7tj)
<br />'Ya -octd
<br />STATE/ZIP
<br />&,- 7lt )te Switches .50
<br />Fixtures
<br />Air Conditioners
<br />Each I 20 00 .Ao,o o
<br />Approved Factory Wired Unit
<br />List 6 5.00 90, oo
<br />Busways, special raceways, under floor
<br />duct. trolley or plug-in busways ea. 110' or
<br />fraction thereol
<br />5.00
<br />Fire SignalinoSystem. Minimum lee
<br />Outlet, r<ffiirt'? or heal sensor /10.00
<br />.50 ra
<br />Lighting Standards with One Lamp
<br />Each Add'l fixlure on same standard
<br />5.00
<br />1.00
<br />Owner Builcler Declaralion
<br />;:.
<br />I'
<br />Maintenance Permrt (annual)50 00
<br />Service Melers
<br />Up to 400 amps. per meter
<br />Over 400 amps, per meter
<br />Over 1200 amps, per meter
<br />/15.00
<br />35.00
<br />75.00
<br />/.fi oo
<br />Signs and high potential gas tube lighting 15.00
<br />Swimming pools, fountains. spas 35.00
<br />@
<br />Each
<br />Switchboard, motor conlrol center or@ 15.00 t,f. o o
<br />Temporary construclion meter service
<br />pole
<br />Epch distribution pole
<br />25.00
<br />5.00
<br />Contractor Use Only
<br />4*l l,..lr* il.12,L'ff'!)te, t
<br />3 2+a 5o. 5fH-/4-Lrl*
<br />I hereby atfirm lhat I am lcensd [nder the provisions of Chapter L DMsron 3 ol the
<br />CITY4*L
<br />L
<br />,orce and elfect
<br />LO-c'rvt
<br />aa4-1-.
<br />8"""rfr)
<br />'nU4*
<br />ISTATETZIP',4 eelo-f
<br />O t?/5rS
<br />-lempor ary construction li ghting
<br />500 lamps or less
<br />Over 500 lamps
<br />2.00
<br />4.00
<br />Time clock or photo electric cell 3.00
<br />POWER APPARATUS: Generators.
<br />motors, transtormers, rectifiers, industrial
<br />heating, cooking, or baking eguipmenl
<br />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 />-zOver 10 and not over 50 HP, KW KVA
<br />Over 50 and not over 100 HP, KW KVA
<br />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 />ll /WorkersCompensationDCclaration ./
<br />::
<br />ll, aller makrng thrs Cerlrficate of Exemplron, you should become subiect to lhe Worker's Compen
<br />$lron provrsrons ol lhe Labor Code, you must lorthwrth codrplv wrlh such provrsrons or lhrs permrl
<br />shall be deemed revoked
<br />,:",::J{WM
<br />,ou., .u,,.. /4' ?4,,,,,.,'
<br />,,",//-gL;V
<br />^,,,,, ,,
<br />I cerlrfy thal rn the performancc ol
<br />Applcanl (Srg
<br />Notice To
<br />.1 , l, ' l!,, rrrr r' .rl
<br />nol employ anV
<br />satron Laws of Ca
<br />Subtotal .10?,20
<br />10 00
<br />,","[l'28q App,can, o, asenl
<br />PEBMIT ISSUED BY lSis.l )tUfl
<br />el fzr-t
<br />DATE
<br />,o
<br />tt/w./w 3:55Pr{ 413 t117.80
<br />Penalty Fee (when applicable)
<br />Violation Fee
<br />Plan Check 65% of subtotal
<br />PcReceipt No.
<br />Plan Check (Adjustment)
<br />lssuance Fee
<br />PERMIT FEE
<br />(50.00)
<br />Date
<br />(minimum 20.00)
<br />nz€ repre$nlalrves ol lhrs qly lo enler upon lhe above-mentroned property tron ourposes
<br />(minimum $35.00)
<br />PERMIT NO.
<br />Erplration
<br />Thrs permrl shall exprre by hmrlatron and become null and vord rl lhe work authofized by thrs permrt rs
<br />not commenced wrlhrn 180 days lrom lhe date ol lhrs permrl or rl work authoilzed bv lhrs permrl rs
<br />suspended or abandcned al any lrme aller lhe worl rs commenced lor a penod ol 180 days A new
<br />permrl shall be obtarned lrisl belore such work can be .ecommenced
<br />' f4b"7
<br />VALIDATION (OFFICE USE ONLY)
<br />TACCOUNT Tll'413r
<br />Applicant's Declaratiorr
<br />APPLICATION AND
<br />ELECTRICAL PERMIT
<br />ITYPF\iVRITE OR PRINT IN INK)
<br />f
<br />o a CITY OF SANTA ANA
<br />206 W. 4th Sr.
<br />667 -2738 WAPPLICANT FILL IN AREA BELOW
<br />@c-ozo
<br />ooamaa
<br />s
<br />l
<br />\
<br />t
<br />x
<br />\
<br />I
<br />Distribution: 1 lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy
<br />.50
<br />.50
<br />)
<br />ls
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