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CITY OF SANTA ANA <br />PLAN CHECK - CHECKLIST <br />JOB ADDRESS 1 (406 9 ki' 12-o-,n <br />TRACKING #:1,01-19 2-40 Do 1 526 16 DATE:7 -/ s--/3 <br />FOR PLANCHECK STATUS CAI L (714) 647-5800 <br />PLFASF INITIA[ FACH ITEM RFI OW <br />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 />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.l understand that I shall submit separate plans, applications and plane.heck fees for the <br />following when plan checkis 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 1 -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 addedplumbing fixtures, or added bedrooms, or exceeds 500 sq.ft. <br />AGRFFn TORY APPLICANT OR AGENT <br />Applicant's Signature 0- <br />Print Name UbIDATHAN C.Ru Addreqq at 5 l W {AM-EaRT 124, STE.1 11 <br />Telephone Number 62-6 -390-6 9 9.6 Fax 9-46 ·-229 -1 099 <br />FOR OFFICE USE ONLY: "Checklist of items discussed" APPROVALS & FEES REQUIRED: Y/N <br />1. '/Planning Department <br />2-Public Works Agency <br />3!4 Fire Departmemt <br />4A**dice Department <br />50£'School District <br />6*Health Department <br />7»-Title 24 (Energy ) <br />8MTitle 24 (Disabled Access) <br />9.2-Roof Mounted Equip. <br />10.251ist of Subcontr. <br />11.-SBIdg. Pmt. Info. <br />12.Kbummary of Appr. Reg. <br />13.215¥ Information <br />1404 Constr. Act. Reg. <br />151Res. Dev. Fees <br />160*SMIP <br />1768Microfilming <br />18.k-Const. Debris Recyc. <br />19.AAFCWP Surcharge <br />20*100\/Owner-Builder Ver. <br />PERMIT TECHNICIAN Ab VM A U z <br />Form 58: 3-26-04