HomeMy WebLinkAbout2205 N Poplar St - Misc. Permit (4)47.,a aAPPI,ICATION AND
JI'IECHANICAL PERMTT
(TYPEWRITE OR PRINT IN INK)
CITY OF SANTA ANA
20 CIVIC CENTER PLAZA
834-4186
APPLICANT FILL IN AREA BELOW
@c
Izo
ooa
NO TOTALEACHExesidential n Indusr'ial E Comms.cial
FIXTUflES
I
E
JOBAODFESS
CI., OUCTSANO VENTS
I
j\
M.oooBru r0.00
Over l00.OO0 BTU
EACH AASOAPTTON SYSTEM
CITY
Up ro 1O0,00O BTU 6.00
500.001 io 1.000-000 BTU
1,000,001 to 2,O00.OO0 BTU 22 5A
EACH COMPAESSOB, BOILEB, OB HEAT PUMP
37 50
600Up lo 5 HP
6lo l5 HP 1r.00
l6lo 30 HP 15.00
3l to 50 HP
Own .-Edld.r D.claldo'l
lhersby alrim thal I sm Exohpr f.om ln6 Co.tEcio/s Licen$ Law fo. th€ foll rg rcgson (Se.
7O3I 5. Eusinos 8nd P.ol8doB Cod6r AnV ciry o. county which roqutss a pemir ro consrucl,
3lror. im!.o!o, dsmolish, or rsran any $ructu.e, pnor o irs rssuancB, also r6qui.6s lh6 applicrnr lor
slch p€mir ro lile 6 signed sr.lo@nr lhar tu is ticensed pus@ ro lh€ pdisio.. ot dE Co.lEc-
ro.'s Lic€.se llw lchaOlsr 9 lcommenong wirh Selim 70OOl o! Divisio. 3 ol rhe Busi..s rnd
Prolgssions Codol o. rhar h6 is.xempi ln6,€tDm and lhe basis to. rhe alle!€d exompion. Any vaola-
tim ol Setim 7031.5 by a.y applicEnr lor a @rmt slbj@rs the apdi@nr lo a ciul po.slrY ol nol
mors han,iv€ hundr€d dorl6c ($5OOl:
D Socton ToaaA l, ss ow., ot lhe poo€rry, or my omproves wth wag.s ss |nstr sore c@-p.nslid, will do lho wo,t, a.d rho sftucture is nor i.E.ded or ofler€d ld el6.
l, as orner ol lhe p,openy.! s6cr,on Toaa
Ove. 50 HP 37 50
EACH AIA HANDLING UNIT
up 1o 2,0o0cFM 4.50
Conrr.cror Usa Only
PHONE
4502.001 to 10.000 CFM
Over 1O.O00 CFM I0.00
MISCELLANEOUS
Outdoor Dual Packaged H &20 00,
CITY SIAIE/ZIP
,o o{
I \ r c{00L\dro
Itoo
undor rh6 provisionsofChapler 9, Division 3 ot lhe Busitu+s and
Cont.clo, rSe )-
licens€ is in lull iorc6 End ellecl
\rdoo
sor
Cooting I
t 600
Ductand FanRange Hood 4.50
400
\an cotttnsratft,in I ^
o.ool.r
o\r,".iy'sy""ffi$. tbd
)Jo )
\)u*lnc dsnElGas Pipi
500
t'0.\"Each Appllance or Equipment
lhisCode bul not specirically li
o.ro- Aoor(an slo r-
I cenity lhar in lhe pe ormance ol rhe wod lq which
l{ollc. To Applcant:
ll. afle, makno rhisCerril cale ol Exenpnon. you should beohe subject lo lhe Wor[er's Compen
slron provrsro.sor lhe Labo. Code, you musllonhwnh comply wilh su.h p.ov'srons or lh sperh t
shall be deemed revoked
rsoas ro b€cohe subp.lto the
Oaro Exoir€a V6dDd 8v (Sig
\J'rtl
4t \jP
Hoodwilh Ouci and Fan r
SU
Penally Fee Iwhen applicable )
Violalion Fee {minimuh $35.00}
t0
Plan Check Fee (minimum S15.00)
TOTAL !m S3s.0o)
DAIE
E4lr.don
Th6 pa.mil shallexpne bv lir.ilarion 6nd b€com6 noll3nd void l, the wolk authonzBd bv thG o€rm is
nor commsncod wilhin l80dsys,rom lhe d.le ot rhis pe,mitor il wql aulhori.ed by lhispsrmirG
esp..ded d.b6.doBd.r..v tm6 6h..lhe wqt ir cmmo@d lo.. p6.iod ol l8O d€ys AEw
p6mil sh.ll bo oblai.od li.si belo.s such wo* .an b6 rocmmened
Appllcanf r D.cl..!tlon
ce.1ly thal lhave read rh's6pplcanon and srale rhar rheabove 'nlormaron,s cofecl agree ro
.omply wlh alctV o,dr.ances a.d sraie aws re arng io b! ld,nqconslrucno.. and herebys!rhc
n?e.epre$.ratvesotrhiscirylo6nle.upo.lhe.bo@-ren oned
,"r"?/b Appk6nro.Agsr lS'g I
PEBMIT ISSUEO SY (Siq.l9/VERIFIEO BY (Sig r7
-SATR 3?,5 3500: b 30538
Bt]ILDING
VALIDAT ION IOfTCE USE ONTY
'laccouNTtrl-415t
Distribution: l.lnspectorCopy 2.FileCopy 3 Finance Copy 4. ApplicantCopy
#/-
,rr'?6t?a&.nA
&
\rJbrko6 Comp.nration Doclar.iion
I he'ebv alirm th.l I have a .erri'.ab ol con*nt io sell rnsure, or a cenfrcate o1 Worke. s Cohpen
salonlnsurance Cert,'€d copy
's
I'red w lh rhe C'ry bu ld'ng nspecron deparlhcnt
100,001 to 50O,O00 BTU
15.00
1100
15.00
Over 2.000,000 BTU
22.50
Froo, Fu,nace I
I
F;:**, (r /{a
-PC
No.
R€marksOatelnspector Approval
lSignaturel
a O
MECHANICAL INSPECTION RECORDS
Forced Air Furnace
Wall Heater
Sr.rspended Heators
Air Handlors
Heat Pump
Plenum and Ducts
ComDressor
Boiler
Outdoor Dual Package Unit
Decorative Fireplace
Range Hood - Ductand Fan
Fan and Duct
Appliance Vent Through Rool
Evaporative Cooler
Repat, Alteralion, Ducts
Fan Coil lnstallelion
Gas Piping
Fire Damper
Rough lnspectron
Frnallnspeclion
o
Notes
*