HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (26)T
APPLICATION AND
MECHANICAL PERMIT
(TYPEWRITE OR PRINT IN INK)
ia O CITY OF SANTA ANA
206 W. 4th Street
667-2738 tur
APPLICANT FILL IN AREA BELOW
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trResidential Elndustrial ECommercial NO.EACH TOTAL*ei'irV (o-iln]*ln/ndl", - E EACH FURNACE INCL. DUCTS AND VENTS
15.00up to 100,000 BTU
PHONE 4//0
20.00Over 100,000 BTU
EACH ABSORPTION SYSTEM
"'" wYnoaa-100.000 BTU to 1,000,000 BTU 25.00
30.001.000,001 BTU to 2,000,000 BTUOur.r€ufabr Dadrtlon
I ho.6by alfirm thal I em ermpt ,rom tho Ctrl.ac1or's Licgns Law lor ths lollowing resm (Se.
7031 5. Busin63 and Prol6sims Code. Any city or @unty which roquira3I pormit to construcl,
alter, improve, demolish. or repair any slructuro. prior to its isuancs, also requirgs the applicml
for sch parmit to lile e 3ignsd stalment thal ha B licssad pureuanl to the provBions ol lhe
conlrectois Licms6 Lil (Chapter 9 (@mmencing with Section 7@0) ol Oivision 3 ol the
Busino3s and ProlGs3ions Code) or lhat h6 is exompt lherelrom and the bais lor lhs sllegad
6xsmption. Any violllion ol Section 7031.5 by any applicant tor I permit sbjets the applicanl to
a civil penally ol not mor6 than liva hundrod dollars (t5@):
E S""tion 7O44A l. as ownfi ol lhe proparty. or mysmploy€oswith wag6 s lheirsolecompen-
setion. will do the worl, end the structure is nol intmded or otlorod lor sale.
E S*tion 70448 l. I owns ol the prop€rty, am oxclusively conlreling walh licensod
contraclors lo conslruct the proltrl
Osle
--
Owner (Sig.)
CdtrEtor l.lr Only
TtPo
CITY STATE/ZIP
6a
AOORESS C/-*rtau
lhat I am licmsed under the provisions ot Chspts 9. Orvision
ProlqB3ions Code. md my license rst?{?"0*.-&Ja .,*"
o", tL?jl-T contracror
I hereby and"YEy*"rn lull torc€ and etlftt
(sr9
Uortn Corpfiabn D.drtbn
I haeby attrrm that I have a cenilldte ol @n!mt to sll-insura, or e cedilicate ol Works's Cofr
I certity that in the perlormance olthe work ror which lhis
p€Gon in any manner I as to b6@ma subiGcl to lhe Worke/3 Compensation LawB ol
l{odc.Io lrDalcrll:
lt 8n€t making lhis CorlilicateolExemplion, you should bocom€subiocttoth€Wo.ke/sComper
salron prorisaonB ol th€ Labor Code. you must todhwith comply with such provisions or this
p€rmat shall be d€omod revoked.
tbLT+7Oale Applicant (Sig.)
wrth lhe inspelion department.
lshall rct employany
Crlitomie
Orte
-
Applicant (Sig.)
p€nsatron lnsu,rnce. Cstitied @py B liled
?:f,,* 4/?? ve,r,ed By (sis )
EACH COMPRESSOR, BOILER, OR HEAT PUMP
Heat Pump Compressor less than 5 HP
EACH AIR HANDLING UNIT OR VAV BOX
R@air, Alt. or Add. to any Heating/Cooling sys.
(50.00)
I tJo
by
abow
Hood with Ducl and Fan (Type ll)
5HPto30HP
3l to 50 HP
Over 50 HP
Air Handling less than 2,000 CFM
2,000 CFM to 10,000 CFM
Owr 10,000 CFM
MISCELLANEOUS
Outdoor Dual Packaged Healing or
Floor Furnace
Heater; Suspended, Wall or Unit
Com'l Drpr Vents
Decorative Fireplace (Wood or Gas)
r)Range Hood with Duct and Fan
Each Vent Fan Connected to a Ducl
Fan Coil lnstallation
Fire Extinguishing System
Each Evaporative Cooler
lncidental Gas Piping
Fire Damper lnstallation
25.00
40.00
25.00
30.00
10.00
10.00
10.00
25.00
15.00
15.00
15.00
15.00
15.00
15.00
10.00
15.00
15.00
'10.00
15.00
15.00
20.00
15.00
Subtotal
Penalty Fee (when applicable)
Violation Fee
Plan Check 65% of subtotal (minimum
DateBeceipt No.Pc#
&pardo.r
This pormil shall €xpire by limitation and bsom6 null and vord al the work aulhorized by lhrs
permil E not commenced wilhin 180 dsys lrom the dste ol this permit or il work authorized by thB
fErmil is suspanded or abandoned al any time stter tho work is commencad lor a EEriod ol l8O
days. A n* pormit shall b€ obtained tiBt b€lore such work can be rocommenced.
ADpllc.nl'. D.d.rdon
I cenity lhel I have raad this application and state thal lh€ obove inrormation is correct. I agre to
comply with all city ordinances and state laws relating lo building constuclion. and hergby
authorized reprBentalion o, this city to enl6 upon lhe sbovemenlioned grcgqly lot
BY (S'g I
tzal-91Date Applicant or Agent (Sig.)
purpos6
BUILOING
PERMIT No PERMIT ISSUEO BY (Sig )
0-2
10.00
Plan Check (Adjustment)
lssuance Fee
TOTAL PERMIT FEE
D rE /2-
(minimum $35.00)
PEHMIT NO.
& fu fa--r\o>4- //-/aP/r l) -7-rVALIDATION (OFFICE USE ONLY}
(ACCOUNT r11-4r2)
Orstilbutron 1 lnspector Copy 2 Frle Copy 3 Frnance Copy 4 Applicanl Copy
I STATE/ZIP
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PHONE
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MECHANICAL INSPECTION RECORDS
Remerts
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 Roof
f,vaporative Cooler
Ropaic Alteration, Ducts
Fan Coil lnstallation
Gas Piping
Fire Damper
Rough lnspection
Final lnspection
Date lnrp.ctor Approval
(Slgnaturcl
t- ft?o z-,ur
%u t/
Notes