HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (22)o tAPPLICATION AND
PLUMBING PERMIT
(TYPEWRITE OR PRINT IN INK)
CITY OF SANTA ANA
206 W. 4th Street
667-273€WAPPLICANT FILL IN AREA BELOW
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Residential Dlndustrial DCommercial NO.EACH TOTALJOA
7 o2,U
FIXTURES,#rorue
kerz -DrD each plumbing fixture/trap q 5.00 4s-
Dental Unit or Medical Gases 10.00'o''5 Xl;> J.r,*Jt*,,t? tt )2"C-.,rr!&fi_a STATE/ZIP
Ourar.lulk.r Oadralbo
I hereby sttrrm thal I sm exmpl lrom tlE Cotraclo/s Lics* L8w tor the tollowing re8soo (S6.
7@l.5.BusinessndPror63ronsCod€ Anycityorcountywhachroquiresapormittocon3lruct.
alter. improve, d€moll8h. or roptar any 3ttucture. prior to it3 i&suence. al3o r6quira3 tho applicant
lor sch p€rmil to file a 3€n€d slatement lhat he is licsns€d pursulnl lo the piovisions ot the
Conlraclor's Liconso Lil (Chapts 9 (commencang wilh Soction 7m0) of Oiyision 3 o, lh€
Busrnos and Prot6sioru @de) or thet he is ermpt thorarrom and the basis tor th€ dl€ged
exmplron Any violalion o, Sociion 7031.5 by any applicant ror I pormit subjocB tha appliclnt lo
a civil penalty ot not moro lhln ,ive hundr€d dollars (ts(I))
E S*,ion 7@lA l. as owner ol lhe property. d myemployeswrth w6g6aar theirsol€compon-
3alion. wall do lhe wort. and the 3lr$ture is not inlsdod or otterod lor sale.
E S*t,on 70448 l, as ownd ol th€ propefly, am exclu3ively contracling with licsnsad
conlncloB to construcl lha proisct.
Dale Owner (Srg.)
s.00
1st 100'+Conn.
Water Heater - Electric or Gas
Ea. Add'l Conn.
MISCELLANEOUS
Ea. Add'l 100' or Fraclion
'Temporary Gas Service
Private Sewage Disp. System
Repair or Beplace Gas Piping
GAS PIPING
Ea. Add'l Outlet
GAS SERVICE 1 to 4 Outlets
15.00
30.00
5.00
5.00
5.00
100.00
1.00
5.00
Conlreton Ur. Only
Water Piping Ea. 100'10.00
b7*- ozaT
PHONE
Rain Water Piping (buried) Ea. 100'8.00
Water Softner 4.00
Alt. or Repair of Drainage - Vent Piping 10.00CITYSTATE/ZIP
6.00
10.00
8.00
5.00
Prol6srons Code, end my licens€ rs
L,cmsNo Stf|0r. 1",r""
s.b <- l3 'Sfconrracto,
Orvtsron 3 ol lhe Eusings6 andof
and
I hereby sltirm lhat I am lacensed Rain System - Fer Drain
Deck Drain System - Per Drain
Lawn Sprinkler
lnd. Whste lnterceptor
Poql Traps
3.00
Repair/Alt. Drainage or Vent 10.00
Vacuum Breakers l-5 /5.00
Over 5 1.00
Backflow Device 2" or Less /5.00
Over 2"10.00
llodc. To A0dbrl:
ll alts makrng thrs C6lricateolEremptron, you should become sub,trl tolhe Wqke/s Comgen-
provi3ions ot lhe Lsbor Code. you must lorthwith comply wih such prolrisions or thi3
shsll b€ d€6m€d raoked
Erparrfion
This p€rmit shal, orprre by limrlation and become null and void il the work aulhqized by this
i3 nol @mmencod wilhin lSOdays trom the dale ot this p€rmit d irworl authorizod by lhis
is susp€ndod or abandoned rt any timo atld lho work is commnc€d tor a psriod ol 180
A new ptrmit shall be obtsined tirst before such work can be rocommencod.
Atflc.nl'. O.d...d6
I certity thet I have rud lhis spplicslion and state thst the rbovo
comply with sll city ordrnancG and stste l8m relating to
orr.5:15-fr1
Dclfdlon
12f Veriliod By
Applrcant or Agent
Date Applicanr (si9.)
copy is liled with the
ot consent lo
I cerlity lhal rn lho perlormancso, the
pe.son rn any menne, I 6 to
Californra
and heieby
I 8916 lo
I heroby allirm that I hava_
ponsalion lnsurance.
e cartiricata ol Wortor's Com-
I inspeclion dopldmont.
Oale
Erpirgs
oan-C'21'Sl Appric8ot (sis.)
authorired r6praaonlalion ot this cily to Gntor
purpoG.
Water Service Ea. 100'10.00
Subtotal
PERMIT
Receipt 7 -l Pc*
Fee (when applicable)
Violation Fee
Plan Check 650/0 ol subtotal
Plan Check (Adjustment)
lssuance Fee
TOTAL PERMIT FEE
(s0.00)
-Sa (minimum 2o.oo)
Date
10.00
\ 0-''?!*i,y?"|flpy' ",,,(sig I
^vt-E *O-PEHMIT ISSUEO BY (Sig.)
ar.2-.]*"- p h\- lvt 7q 70 ,WO / /i,L
VALIDATION (OFFICE USE ONLY)
(ACCOUNT rrt-'l1a
Orstributron t lnspElor Copy 2 File Copy 3 Frnance Copy a Applacant Copy
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SEWER
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sublect to Worker's
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PLUMBING INSPECTION RECORDS
Remarkr
Ground Work (Soil)
Ground Work(Water)
Waler Service (Ground)
Gas Service and Underground
Lawn Sprinklers
Waste lntsrceptor
Pool Traps
Sewer
Rool Drains
Water Heaters
Waler Sottner
Flental or Medical Gases
Rough Plumbing
Final Plumbing
'' Temporary G'as Service
Noles
Oal.ln.p.ctor Approvrl
(Slgn.tur.)
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JOB ADORESS -a0
ING
CITY
n lndustrial D Commercial NO.EACH TOTAL
EACH FURNACE INCL. DUCTS AND VENTS
Up to 100,0@ BTU 15.00
Over 100,000 BTU 20.00
EACH ABSORPTION SYSTEM
100,000 BTU to 1,000,000 BTU 25.00
1,000,001 BTU to 2,000,000 BTU 30.00
EACH COMPRESSOR, BOILER, OR HEAT PUMP
Heat Rrmp Compressor less than 5 HP 25.00 UA
5HPto30HP 25.00
31 to 50 HP 30.00
Owr 50 HP 40.00
EACH AIR HANDLING UNIT OR VAV BOX
Air less than 2,000 CFM 10.00
Oilrar-Ould.r D.drtbn
I hsr€by sltirm that I am exmpt trom lho Contracto/s Licmla Law ,or the tollowing ro8on (Soc.
7G)1 5. Busin6r md Prot63sims Code. Any city or @unty which r€quires a p€rmil to conslrucl,
aller, imprcve. (bmoligh. or rspair any slruclure, prior to itg i3tuanc6. algo roquirgg th€ rpplicant
lor sch pormit to fil6 a signed statment thal hs is licons€d pursuanl to lhe provisions ol lho
Contraclor's Licen* Law (Chapter 9 (commancing wilh Seclion 7@0) o, Div6ion 3 ol lhe
Busaness and Prol6sions Cods) or that hs is sxmpt lher€lrom 8nd the begB lor ths allegsd
oxemplion Any violelion ot S€clion 7031.5 by any epplicant ,or a pormil $biect the applicanl lo
I cival pooslty o, not more than rive hundr€d dollers (t500):
E S*tion ZOal l. I owner ot lha pr@srly, d myemployes with wag€6I theirsole comp€F
setion. will do lhe work. and lhe slructuro is rct intondod or olltred lor sala
E S*tion TOil,lB l. 8s owner ol the properly. am exclusivaly contreting with licansed
conlracloB lo construcl the pro,ect.
Oale Owner (Sig.)2,000 CFM to 10,000 CFM 10.00
Over 10,000 CFM 10.00
MISCELLANEOUS
Outdoor Dual Packaged Healing or Cooling 25.00
Floor Furnace 15.00
Heater; Suspended, Wall or Unit 15.00
Com'l Dryer Vents 15.00
Decorati\re Fireplace (Wood or Gas)15.00
Repair, Alt. or Add. to any 10.00
Range Hood with Duct and Fan (Type l)15.00
Each Vent Fan Connected to a Ducl 15.00 ,O-n
Fan Coil lnstallation 20.00 fr
Fire Extinguishing System 15.00
Each Evaporati\,e Cooler 15.00
lncidental Gas Piping 10.00
Fire lnstallation 15.00
Each OT by
this but
Hood with Duct and Fan (Type ll)
Subtotal
funalty Fee (when applicable)
Violation Fee (50.00)
Plan Check 65% of subtotal 6b (minimum 20.00)
'Receipt No.Pc#Date
ContrEloo t.b. Only
CITY STATE/ZIP?tzla
I hereby 8lti,m that I am licensed under th6 provisions ol Chapts g Division 3ol rlf!!g"""no
Proldsrons Code. md mv [cens B
l,*I0"" ffazr 1 .,n
o"" ITD'fi contractor
in lull lorce and erlacl.c License
(si9
Uo.tm Coipirlabn Oadraabn
I hsgby atli.m tiat I havs a cenaticale o, conEont lo slr-insuro. or a cartilicata o, Worttr's Com-
pemallon lnsurtnce Certifigd @py is liled
?ii",* tko vdiried By (sie.)
with ths Cily inspsclion departmsnt.
""" ltZgS? Appric8nr (sis
I certrly lhal rn the performanceof the work tor which this I shall not mploy any
person in any manner s 6 to be6me sub,ect to the Work6r's Compensation Lils of
CalilornE
Oate Applicant (Srg )
Nollc. To Applbil:
ll after makrng lhrs Ce.lilrcalool Eremptron. you shoutd be@mesubitrt lo theWorke/s Compen-
salron provrsrons o, the Labor Code. you must torthwith comply with such provtstons or lhrs
permrt shall be deemed revoked
Erdrdo.!
Th6 permit shell expiro by lamitalion 8nd become nul and void it the work autho([ed by this
permit€nolcommencedwithtn 180dayslromlhodateotthi3pormilorilworkauthorizedbythis
permit is suspended or abendoned at any limo stt€r the work is commencsd for a poriod of 180
days. A nil permit shall be obtained li6t beloro such work can b€ r6commencod.
AFDIcmal O.drdo.t
I certit thst I have .oad thB applicstim 8nd st8l6 that th€ above inlormation is corrocl. I agie to
@mply wrth all city ordimnG and state lawg rolating to buitding constuclion, and hereby
authorized rop.ffilalaon or lhis cily to enld upon the abocmalioned proptrly ltr insp€clion
purpos6
:":ikntn App,cant n on"n'r.,@
-Plan Check (Adiustment)7. )(
lssuance Fee 10.00
TOTAL PERMIT FEE (minimum $35.00)-€-
D^rE / * Ar4 PERMTT No. -_37 41
EHr.,1ifi" flbo Y,,,,,, ",)PERMIT ISSUEO BY (Stg.) -t^-t- sl Ct
a// fu prz.d-*,'"- /o 76t-?- fTvALroATroN (oFFrcE USE ONLY)
(ACCOUNT fi 1-412)l)
APPLICATTON AND .
MECHANICAL PERMIT
(TYPEWRITE OR PRINT IN INK)
a CITY OF SANTA ANA
206 W. 4th Street
667-2738
APPLICANT FILL IN AREA BELOW
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Drstilbutron ! lnspector Copy 2 Frle Copy 3 Frnance Copy 4 Apptrcanl Copy
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15.00
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Dete lnspcctor Approval
(Slgnaturel
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MEcleNrcAL rNSPEcrroN nectos
Remarks
Forced Air Furnace
Wall Heater
Floor Furnace
Suspended Heaters
Air Handlers
Heat Pump
Plenum and Ducts
Compressor
Boiler
Outdoor Dual Package Unit
Decorative FirePlace
Range Hood - Duct and Fan
Fan and Duct
Appliance Vent Through Boof
Evaporative Cooler
Bepair, Alteration, Ducts
Fan Coil lnstallation
Gas Piping
Fire Damper
Rough lnspection
Final lnspection
Notes