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4tiLtcxtoN AND <br />IUIECHANICAL PERMIT <br />o o <br />ITYPEWRITE OB PRINT IN INK) <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA <br />834-4186 f/rA <br />APPLICANT FILL IN AR BELOW <br />@g <br />Izo <br />o0, <br />F <br />545-)gELnanu-tL <br />9a,w. .,- <br />LZL\ 9 MV_ <br />12rd,.d <br />t'" s.A <br />Ownc. Euillnn Oeclaral'o,r <br />ho.. lhm rhn tundl.d do{.6 (95OOl <br />D so.ur rOree l. 8 orrx. ol rh. ,ac..ty, or ,iy @r <br />9..r..tb., wl & Itr. Et, d tt rtrrcl!6 i. rcl nt .r,.d <br />D S*tion rOqg l. .! o*m. ol th. pr@.ny, sm .rclu3wry cmr..nn! wln lrc..-d @ <br />t&lor! lo co.r&uct tryoFcr. <br />O.l.- ovsrslc r- <br />l?asSr*rov <br />AilonEsszq*z lr1,ovM <br />,,, ln..l"ff/-tolo <br />?apq-'-{ srAIFrTrP <br />,*^.2;l:7* .,* 84 <br />I ldt <br />qz8 qzz <br />Contrrto.Ut. Only <br />** 4=l!'t\i'rac,o,,s,s r r. <br />qz[,*l,ha <br />L/ <br />Work6.3 Comp6n3ation Oocl6ralion <br />ro rho \ b.r., 3 Comp.. <br />.4 -|-1942 <br />lc..!ty rh.r n lh. parldm.rc6 ol rh6 wdt lo <br />l,, rrr.r rd'nC rhs C.ir'lE r.olE <br />oro o.os.roi! o, th. L.bo. Codr,!l b. d.fid r6tdt <br />Notico To Applicanr <br />tlr <br />,.,en h ..y m.nn$e.!ro becomo $bFct lo <br />cril.- A!er.a^r ts{ t- <br />NO EACH TOTAL <br />FIXTURES <br />EACH FURNACE INCL OUCTSANOVENTS <br />EACH AASORPTION SYSTEM <br />IL| <br />,)l <br />, ,l <br />EACH COMPNESSOB, BOILER- OB HEAT PUMP <br />EACH AIR HANOLING UNIT <br />MISCELLANEOUS <br />800 <br />ltm <br />r5.00 <br />22.fi <br />37 50 <br />600 <br />I1.00 <br />l5.m <br />22.fi <br />37.50 <br />4.60 <br />450 <br />10.@ t <br />200o <br />10.00 <br />10m <br />TOIAL PLFIMIT FEE . : <br />| | ro oo l/O-T'ooof <br />10.@ <br />6.00 <br />4.50 <br />ach Vent Fan Connscr€dloa Duct ,ry14ro <br />6.m <br />10.00 <br />6.@ <br />5.00 <br />6.00 <br />6.00 <br />4.50 <br />5 <br />PERMIT NO <br />loa <br />BTE? <br />00F <br />OATE t- <br />Erdrrddr <br />Th't p.m'r thtll6rp.o by I'm'tato. ..d b€.om6 n!ll..d vod ,l lhe wolk rurhonz.d by lh'! D{h'l L <br />nol comm.nc.d wtrhrn 180 days lrom ih€ ddrs ol lh,s D€, hr r or I wo.k :orhoded bv th,! p€'m't l <br />Appllcani ! D.chrano. <br />t!rp..r&d d tbanddEd ,l .hy nru .ll.. Itr <br />F.fr 3h., !. Ohra,rrd ,r!r 6.toE lfh wd <br />iort 13 cofr@rc.d lo. ! D.rEd ol 18O drv! An w <br />Distribulion: I lnspGctor Copy 2. Fil€Copy 3 Finance Copy 4 Applicantcopy <br />I + <br />r"--1 <br />rs.oo I <br />l <br />d <br />Fan Col lnstallalon <br />Dry Chsmical Sysbm <br />Each Ev6por6tive C0016r <br />lnc'denrrlG6s Piprng <br />Fr16 Damp6l lnstall6tion <br />E6ch Applianc€ or Equ'pmenr Rsgubr€dby <br />rh's Codo but nol spsc,tcally I'sl€d abovo <br />Hood wlth Duclend Frn <br />t <br />I <br />-,,1: t f d^*r.., o <br />^se.i,s." <br />wYl -di,---,-J <br />-siTR !tlgVALIDATION IOFFICE T]SE ONIYI <br />laccouNT,lr-ar5r 3500:b 31ttse