HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (23)t a
APPLICATION AND
PLUMBING PERMIT
(TYPEWRITE OR PRINT IN INK)
CITY OF SANTA ANA
206 W. 4th Street
667-2738 h"
APPLICANT FILL IN AREA BELOW
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Kesidential Dlndustrial ECommercial NO.EACH TOTALJO8 ADORESS*z"iVa- )-",A 7u U^lL-,-UaZo
SYL -o//a
PHONE*%h*r-0*.o FIXTURES
Dental Unit or Medical Gases
each plumbing firlure/trap 5.00
10.00ILING
L7htu--b
SEWER
1st 100'+Conn.1 15.00 /5-
Ea. Add'l Conn.5.00
Ea. Add'l 10O' or Frac{ion 5.00
Private Sewage Disp. System 30.00
Orn ?€ullrar Oadtalbo
I hereby sllirm thst I am exempt lrom the Cslraclor's Licens€ Llw lor the tollowinO r6a3on (Soc.
7(Xr'l 5. Business tnd Prot6sions Code. Any cily or county which requir6s a p€rmit lo consttuct.
aller, improvs. demolBh. or 16pair any struclur6. prior to its rssuance. al3o r€quires the applicsnl
,or $ch permil lo ,ile 8 sqnod statment that he as liens€d po6uanl to th€ provi3ions o, the
Conlnctor's Licen$ Llw (Chaptgr 9 (commencing wilh Soction 7m0) ol Divilion 3 ot the
Business and Prot6sioG Co{re) or th8l he is exempl thorarrom and the basis lor the allsg€(,
eramplion. Any violelion o, S€c,tion 7031.5 by any spplidnt lor I p€rmrt 3ubjects the applicsnl lo
a civil ponally ot not mor6 than liv€ hundrod dollars (Ssm):
E S*tion zOgl l. 8s ounor ol lh€ propsny. ormyomploygoswrth wago8 as lheirsolecompon-
gltion, will do tho rcrt. and lh€ strrctura is not intof,ded or ollered tor $la.
E S*tion 7O4aB I. s omd o, the propody. 6m exclusively cmtreting with licemed
contractoB to con3trucl lhe pioiect.
Oate Owner (Srg.)
ConlrrioB tjt. Only
WTi'ff ,-,,,), I fi lA / rr-fi---b74- o7o7
PHONE
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STATE/ZIPCITY
I hereby allirm that I em lrcensed und€r ths provi3ions ol Chapts
Prol6srons Code. and my licen$ rs in lull lorce and
oa" S! 5 8J- contractor (sis.)
3ol the Busan6s and
7Lrcense No fu*Ofr",""
subioc,t to the Worker's Comp€n$tion Lsws ol
Nodc. To Aeglbrl:
ll atter makrng lhrs Cerlricale ol Exemplron, you should become sublat to lhe Worker's Compen-
salron provrsrons ol lhe Labor Code. you must lorthwrlh comply wrlh such provrsrons or thrs
permrl shall be demed revoked
(sig.)
OGlr.tbn
thepensaloncow
Date
VeriliedExprres
I hereby allirm lhal I havs e ol consent lo a certificato ol Worttrs Com-
insp€ction departmenl.
whichlhis pormit is issusd, I shall nol omployany
Dete
-
(Sig 1
orr^s-tS -8? Appricanr
I cartily thal in the p€rtormenceoltho
pe73m in any mnn€r !o as to
Celilomia
Alt. or Repair of Drainage - Vent Piping
't0.00
I
Water Service Ea. 100'
Over 2"
Backflow Device 2" or Less
Over 5
Vacuum Breakers 1-5
Repair/Alt. Drainage or Vent
PIPING
GAS SERVICE 1 to 4 Outlets
Ea. Add'l Outlet
GasRepair or
Temporary Gas Service
MISCELLANEOUS
Water Heater - Electric or Gas
Water Ea. 100'
Rain Whter Piping (burid) Ea. 100'
Water Softner
Bain System - Per Drain
lnd. Waste
Pool Traps
- Per DrainDeck Drain
5.00
100.00
1.00
5.00
5.00
10.00
10.00
10.00
8.00
5.00
4.00
1.00
10.00
5.00
6.00
10.00
10.00
3.00
8.00
5.00
Subtotal
Fenalty Fee (when applicable)
Violation fue
Plan Check 650/. of subtotal
Pc#Receipl llo.
Plan Check (Adiustment)
lssuance Fee
TOTAL PERMIT FEE
DATE
(50.00)
Date
(minimum
PERMIT
.9O (minimum 20.00)
ErDh.lton
This p€rmit shall arpiro by limilstion and b€como null and void rl the mrk ruthtrizod by thir
p€rmit is nol commcncad within 100 d8ys |rom the dats ol lhis pormil d if rcrkrulhorizod by lhi!
pormit i3 susponded or sbendoned al any tim efis ths worl is cmmncsd lor a Friod o, 180
days. A new psmit sh8ll be obteinod liBl b€lor6 $ch work can be rocommnc€d.
I catfity th.l I havo rsd lhB app,,*rffi;ffi*
o,,".G1.582 Applicenl or Agent
I e€rs to
andcomply wrth all crty ordimncB and suite law!
authotirod reprosanlalion ol lhis city lo enld
purpos€3
hb?i*ilifr .S<t/-o{"r^,,,.K.,o-PERMTT ISSUEO 8Y (Sig )
o-e-!-W @ et- 7?7a!-ffifvALroATroN (oFFrcE usE oNLY)
(ACCOUNT r11-41?)
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Oistribution I lnspfftor Copy 2. Fle Cogy 3 Fanance Copy 4 Applicant Copy
cs-61 r
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Lawn Sprinkler
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PLUMBING INSPECTION RECORDS
Ram!rkt
Ground Work (Soal)
GrounclWork (Waler)
Watei Service (Ground)
Gas Service arld Underground
Lawn Sprinklers
Waste lnterceptor
Pool Traps
Sewer
Roof Drains
Waler Healors
Water Sortner
Bental or Medical Gases
Rough Plumbing
Final Plumbing
Temporary Gas Service
Noles
Ort.ln.p.ctor Approv.l
(Slgnrtur.)
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APPLICATION AND I
MECHANICAL PERMIT
(TYPEWRITE OR PRINT IN INK)
t CITY OF SANTA ANA
206 W. 4th Street
ffi7-2738
APPLICANT FILL IN AREA BELOW W
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NO.EACH TOTALFBesid€ntial ! lndustrial ECommercial*':;"ii7 fr4b 7t-V)Zta- d". - e-EACH FURNACE !NCL. DUCTS AND VENTS
TIA^ r% (tz/t"-;*:,f,(('otroPHONE
Iifu-rrc lbontss*ij"irM
t'" ('*r*- h.-ooa,STATE/ZIP?ilzC
EACH COMPRESSOR, BOILER, OR HEAT PUMP
Heat Rrmp Compressor less than 5 HP
15.00
20.00
Up to 100,000 BTU
Over 100,000 BTU
EACH ABSORPTION SYSTEM
100,000 BTU to l,000,0@ BTU
1,000,001 BTU to 2,000,000 BTU
5HPto30HP
25.00
30.00
25.00
25.00
Orn t€ulorD.drtbn
I hereby allirm thel I am gxmpt lrom lho Contracto/3 Licmss L8w for ths ,ollowing roaon (S€c.
703t 5. Bu3inats 8nd Profa$ions Cods Any city or munty which requir6 e psrmil lo con3trucl,
alter, amprove. d6moligh. or raperr any 3lruclure, prior to its isuance, alSo rcquirs the applicant
lor such permil to lilo I signod staloment that he is licensod puBuanl to the provision8 ol lho
Conlracto.s Licmso Lil (Chspts I (@lmencing with S6tion 7m) ot DivBion 3 ol lh8
Bu3in6ss and Prot6sioos Codo) or thal he i3 €xmpt therolrom 8nd the b8i3 lor tho dbged
exomption. Any violstion ol S€ction 7O31.5 by 6ny 8pplicant tor a pstmil 8ub,oc1s the applicsnt to
a crvrl penrlty of not more than live hundrod (bll8B (35@):
ES""tionZOaa l,aSownorolthoproperty,ormyamployffiwithwtg€66theirsolecompen-
sstion. will do the work. and tho structure b not intgndsd or otlsed lor 3al€.
E S*tion 7oil48 l. as owner ot the prope.ty. 8m exclusively contr*ting with licmssd
conlractors lo conslruct the prolel
Oate
-
Owner (Srg )
Conlrrlm t,!. orrly
I hereby alfirm that I am licensed under lhe provisaons ol Chapls 9.
Prol$srons Code. md my lrcensa rs
(ll&"o". &7/7 c,o"
o"r, lZtlftconrracror
STATE/ZIP
PHONE
CITY /o
C)
in tull lorc€ and eflect
(sig )
Divisi.n 3oufe Busin€ss and
tlbltit Co0?a6tlon D.dribn
I hdsby allirm that I have a certilicate o, @n8€nt to s€ll-insur6. or a cerlilicale ot Wort-'s Coc
I certrty thal an the portormanceol the work
peGon in any manner I I to bo@me
Califomia
Date
--
Applicant (Sig.)
,'otle To Apdl6l:
ll alls makng lhrs Cerlrlrcaleol Exemptron, you should become sublsl lo lhe Worker's Compen-
salion provrsrons ol lhe Labor Code. you musl lorthwrlh comply wilh such provrsions or lhrs
permil shall be demed revoked
or" lz-z?s? Apprienr
lor whrch thrs
subject lo the Worke/s
wilh the City inspection departmenlpemation lnsurtnc€. Cstiliod copy is lilod
?:f,* {/90 veririod By (sE )
EACH AIR HANDLING UNIT OB VAV BOX
Outdoor Dual Packaged Healing or Cooling
Hood with Duct and Fan (Type ll)
or by
.l-2
oO
Date
30.00
40.00
31 to 50 HP
Fire Damper lnstallation
Over 50 HP
lncidental Gas Piping
Each Emporatile Cooler
Air Handling less than 2,000 CFM
Fire Extinguishing System
2,000 CFM to 10,000 CFM
Fan Coil lnstallation
Over 10,000 CFM
Each Vent Fan Connected to a Ducl
MISCELLANEOUS
Range Hood with Duct and Fan (Type l)
Floor Furnace
Heater; Suspended, Wall or Unit
Com'l Dryer Vents
Decoratiw Fircplace (Wood or Gas)
Repair, Alt. or Add. to sys.
10.00
10.00
10.00
25.00
15.00
15.00
15.00
15.00
15.00
10.00
15.00
15.00
20.00
15.00
15.00
10.00
15.00
'I
ttfl
Subtotal
Penalty Fee (when applicable)
Plan Check 65% of subtotal
Violation Fee (s0.00)
Receipt No.Pc#
'r& (minimum 20.00)
72rPlan Check (Adjustment)
lssuance Fee 10.00
Erplrdo.r
Thas p€rmil shall erpire by limitation and bocom€ null and void i, tho wdk suthorized by lhis
permit is not commenc€d within l80 days lrom tha dats of this pormit or il work suthorizod by this
p€rmil is suspendod oa abandoned et my lims attgr tho worl is cmmned ,or! psiod ol 180
days A nil psmil shall bo oblained li6l b€tor6 sch work can be mommoned.
Apdlc.rft O.drdlon
I certity that I have .oad thas applicatim and ilA€ that the abov6 intormation is corr6cl. I ere to
@mply wilh all cily ordinancB end state laws relating to building co.rstuclion, and her€by
authori:ed reprBenlation of this cily to 6ntd upon thg above,mentionGd proprty lor inipection
Applicant or Agenl:::tu6a TOTAL PERMIT FEE (minimum $35.00)
37DATB /2-,PERMIT NO.
BUILDING
PERMIT No
s?6 0#,",,PERMIT ISSUEO BY (SIg )
d?L 4- /o7/r11 1-4r2)<-)4/2
Dlstribulion 1 lnspeclor Copy 2. File Copy 3. Finance Copy 4. Applacsnl Copy
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MECHANICAL INSPECTION RECORDS
Remar*e
Forced Air Furnace
Wall Heater
Floor Furnace
Suspended Heaters
Air Handlers
Heat Pump
Plenum and Ducts
Compressor
Boiler
Outdoor Dual Package Unil
Decorative FirePlace
Range Hood - Duct and Fan
Fan and Duct
Appliance Vent Through Rool
Evaporative Cooler
Ropail Alteration, Ducts
Fan Coil lnstallation
Gas PiPing
Fire Damper
flough lnspection
Final lnspection
Date lnspcctor Approval
lSlgnaturel
/-/tz /u^.p,r
%a -7-dl,urn
Notes