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CITY OF SANTA ANA <br />PLAN CHECK - CHECKLIST <br />JOB ADDRESS'2 10-3 E GkaND <br />TRACKING #: 101 rl 90 9 6 DATE: 6 - 504.-4-S <br />FOR PLANCHFCK STATUS CALL (714) 647-5800 <br />PLEASF INITIAI FACH ITF.M RELOW <br />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 />2.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 />L 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.I understand that I shall submit separate plans, applications and plancherk 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 />5.I understand that I shall visit the Public Works Department to verify whether a field <br />inspection of the property is required. 1 understand that prior to the issuance of the Building <br />permit I am required to obtain !3*lic Works Agency approval if my project.valuation exceeds <br />$30,000 or has addet? lurr*ifig fixtures, or added bedrooms, or exceeds 500 sq.ft. <br />AGRFFD TO BY APPLICAN;F-6(4(;_- _,g <br />P/T <br />Applicant's Signature ---.. -- 1 <br />Print Name Vi · DE:#-1=4•©ELS 1-A,2:sci,-3 Addrpeq l4937 te, · LA->09,2-L•€2.- <br />Telephone Number3 lf) 241- O.47 Fax- -1. 3 242,*/6:*7 <br />FOR OFFICE USE ONLY: "Checklist of items discussed" APPROVALS & FEES REQUIRED: Y/N <br />1 K Planning Department <br />2._ Public Works Agency <br />3._ Fire Departmemt <br />4._ Police Department <br />5._ School District <br />6._ Health Department <br />PERMIT TECHNICIAN <br />Fonn 58: 3-26-04 <br />7._ Title 24 (Energy ) <br />8._ Title 24 (Disabled Access) <br />9._ Roof Mounted Equip. <br />10._ List of Subcontr. <br />11._ Bldg. Pmt. Info. <br />12._ Summary of Appr. Reg. <br />13._ FY Information <br />re <br />14._ Constr. Act. Reg. <br />15._ Res. Dev. Fees <br />16.»MIP <br />174Microfilming <br />18._ Const. Debris Recyc. <br />19.-WP Surcharge <br />20._ LOA/Owner-Builder Ver.