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CITY OF SANTA ANA <br />PLAN CHECK - CHECKLIST <br />JOB ADDRESS' f 40 3 /0 (161; i]0 91(% <br />TRACKING #:10.17 93 55 DATE:8-1-13 <br />FOR PLANCHECK STATUS CAII (714) 647-5800 <br />PLEASF INITIAI FACH ITEM RFI OW <br />C C, <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 />-lk 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 />33- 4 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 />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 Public Works Agency approval if my project valuation exceeds <br />$30,000 or has added plumbing fixtures, or.ad(led bedrgems, or exceeds 500 sq.ft. <br />ARRFFI-) TOBY APPLICA <br />Applicant's Signature - <br />Print Name (L(fit>\c-44 £(Alavreqq 840 5. rzooj-£640* P,I'C- onkt,-40 <br />Telephone Numbe 3640-DE5-S- Fax - 7601 <br />FOR OFFICE USE ONLY: "Checklist of items discussed" APPROVALS & FEES REQUIRED: Y/N <br />1.-Planning Department <br />260-Public Works Agency <br />346·Fire Departmemt <br />4.1*-Police Department <br />5AM·School District <br />6Health Department <br />7*Title 24 (Energy ) <br />84*-Title 24 (Disabled Access) <br />9AA-Roof Mounted Equip. <br />10.1vfist of Subcontr. <br />11_Elildg. Pmt. Info. <br />12.-PSummary of Appr. Reg. <br />13.-PFY Information <br />14.-5Constr. Act. Reg. <br />15A*Res. Dev. Fees <br />16. 05-MIP <br />17.Microfilming <br />18.Const. Debris Recyc. <br />19CWP Surcharge <br />2dPLOA/Owner-Builder Ver. <br />PERMIT TECHNICIAN -- LJ--244 44-2. <br />Form 58: 3-26-04 <br />\62,