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CITY OF SANTA ANA <br />PLAN CHECK - CHECKLIST <br />JOB ADDRFRR· <br />TRACKING #:LD / POK-/3 06)/S-3462ATE:3-9:I# <br />FOR PI ANCHECK STATUS CAI I (714) 647-5800 <br />PLEASE INITIAL FACH ITEM BELOW <br />J L 1.I agree to pay a plancheck fee established for this project with the understanding that this <br />payment is not a guarantee that a permit will be issued and that this fee is not refundable <br />once a plancheck has commenced. <br />I understand that I may request an "Accelerated Plancheck" at an additional cost to me. <br />This plancheck will be performed by an in-house plan checker with the intention of reducing <br />plancheck time for the Building & Safety Division. <br />281 3 I understand that the project valuation (from which plancheck and permit fees are <br />calculated) will be reviewed during the plancheck process and that said valuation shall be <br />adjusted up or down in accordance with established fee computation regulations. <br />4-L4.I understand that I shall submit separate plans, applications and plancheck fees for the <br />following when plan check is required: <br />a. Electrical Plans - 2 complete sets c. Mechanical Plans - 2 complete sets <br />b. Plumbing Plans - 3 complete sets d. Grading Plans - 3 complete sets <br />JU <br />5.I understand that I shall visit the Public Works Department to verify whether a field <br />inspection of the property is required. I understand that prior to the issuance of the Building <br />permit I am required to obtain Public Works Agency approval if my project valuation exceeds <br />$30,000 or has added plumbing fixtures, or added bedrooms, or exceeds 500 sq.ft. <br />AGRFFn TO RY APPLICANT OR AGENT <br />Applicant's Signature .Lit 6 4 - <br />Print Name Jant Liul .Addresq *M W LA m Lat /20(, Sa He 11 1, grea, Cl <br />Telephone Number 8 1.3 - 60 6 -2 696 Fax 414 -676-8&81 <br />FOR OFFICE USE ONLY: "Checklist of items discussed" APPROVALS & FEES REQUIRED: Y/N <br />1.15Planning Department <br />2€0-Public Works Agency <br />3.4- Fire Departmemt <br />4.1 Police Department <br />5.1 School District <br />6.1 Health Department <br />7A*Title 24 (Energy ) <br />8,(UR-itle 24 (Disabled Access) <br />9.-v-Roof Mounted Equip. <br />10.-k-List of Subcontr. <br />11.-PIBIdg. Pmt. Info. <br />12.-Fbummary of Appr. Reg. <br />13.XFY Information <br />14.Ktonstr. Act. Reg. <br />152* Res. Dev. Fees <br />16.06MIP <br />17,6*Microfilming <br />18!5Const. Debris Recyc. <br />1 QU¥FCWP Surcharge <br />20Nk-[OA/Owner-Builder Ver. <br />PERMIT TECHNICIAN l-<42 1 a .4#* <br />Form 58: 3-26-04