HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (42)APPLICATION AND .
f TTdECHANICAL PERMIT
(TYPEWRITE OR PRINT IN INK)
o CITY OF SANTA ANA
206 W. 4th Street
667-2738
APPLICANT FILL IN AREA BELOW
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-3JOB ADORESS Sa,tb7*-
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I hereby altirm thal I am ermpt lrom lha Contracto/s Licffs Lm ld lhs follorying reeson (Scc.
7(8t.5, Businoss and Prcl6sions Coda Any city or county which r€quir6 a p€tmil to construcl.
aller. improva. demolish, or rapaar any struclu16. prior to it3 63uanca, ds r€quiro8 tho applicent
lor such permit to lilo a signod 3trtomenl that ha B licon3€d puEuant lo the provisions o, ths
Conlractor's Licsss Lff (Chspts 9 (@mm€ncing wilh S€c'tion 7m) ol Divbion 3 ol lh€
Busine$ 8nd Prol63ions Cod€) or that he ia sxsmpl lhorotrom 8nd the bab ld the alleg€d
oxmption. Any violrlion ol Seclion 7031.5 by any applicrnt tor 8 permit subiecls the spplicanl to
a civil penalty ol nol more than tivs hundr€d dollrB ($500):
E S""tion 704{A l. as owna ot ths properly. or my omployc with w.9€3 6 lheir sle compen-
sslion, will do the woit. and the structure B not int€nded or oflsod tot sale.
E S*tion 7O4,lB l. ss ownd ol the property, em exclusivoly contracting with licensod
contraclof,3 lo construct the pro,st.
Dale Owrer (S19.)
ContrEto[ tXo Only
""*%-0, T */e-az?-7200
PHONE
CITY STA o
EACH FURNACE INCL. DUCTS AND VENTS
EACH COMPRESSOR, BOILER, OR HEAT PUMP
EACH AIR HANDLING UNIT OR VAV BOX
Outdoor Dual Packaged Healing or Cooling
EACH TOTALD lndustrial ! Commercial NO.
Up to 100,000 BTU
Over 100,000 BTU
EACH ABSORPTION SYSTEM
100,000 BTU to 1 ,000,000 BTU
1,000,001 BTU to 2,@0,000 BTU
Heat Pump Compressor less than 5 HP
5HPto30HP
31 to 50 HP
Orcr 50 HP
Air Handling less than 2,000 CFM
2,000 CFM to 10,000 CFM
Over 10,000 CFM
MISCELLANEOUS
Floor Furnace
Heater; Suspended, Wall or Unit
Com'l Drler Vents
Decorati\€ Fireplace (Wood or Gas)
sys.Bepair, Alt. or Add. to any
Range Hood with Duct and Fan (Type l)
15.00
20.00
25.00
30.00
25.00
40.00
25.00
30.00
10.00
10.00
10.00
25.00
15.00
'15.00
10.00
15.00
15.00
15.00
I hereby elti,m thet I am licssed under th6 provisions ot Chapler 9. Oivision 3
7c-70Code. ild my license E in lull torce and eff*t.YfWnGsand
on" lttl't? contracror
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7o.no
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tUortan Coil?ailrabn D.drtbo
I h6r6by arlirm lhat I hev€ a cerlilicals ot @n3mt to sell-insura. or a csrtitacta ot Woiksr's Cor
I cerraty that rn the perlo.manceol lhe work lor whach this
porson in any mrnner !o I lo b€come 3ubieci lo th. Worte/s Comp€rrgation Liws o,
Calilomis
Nollcc To Apdkit:
ll alts makrng lhrs Cerlrficateol Exemptron, you should becomesubiet lo theWorker's Compen-
salron provrsrons ol the Labor Code. you musl lorthwith comply wrlh such provisrons or this
permrt shall be demed revoked
t2-7t-t7Oale Applicsnl (Sig )
Date Applicant (Sig.)
with the inspection department
I shall not mploy sny
gansatEn lnsu,rance Cdtirred @py B tilod
?:l:,,* l/?a vs,r,ed By (s,e )
Each Vent Fan Connected to a Duct
Hood with Duct and Fan (Type ll)15.00
OI by
(50.00)
Fire Damper lnstallation
Fan Coil lnstallation
Fire Extinguishing System
Each Elaporatiw Cooler
lncidental Gas
15.00
15.00
20.00
10.00
15.00
15.00
Subtotal
Violation Fee
Penalty Fee (when applicable)
Plan Check 650/0 ot subtotal SZ Q (minimum 20.-00)
Receipt No.Pc#Date
6.5nPlan Check (Adjustment)(*t)tb
lssuance Fee 10.00
Erpkdon
This permit shall axpire by limitation and bocoma null and void il th€ woIk authorizod by lhis
p€rmit is not commenced within l@days trom lhe date ol this pormil or i, wort sulhori2ed by this
tE.mit is suspended s abandoned al my tima alts ths wort is cmrenced tor a period ol 180
days. A new permit shSll b€ obtained fiat beloro such work can be rocommscod
Apgllcmt,r O.drdo.r
I cGrtrty that I hee rdd this spplacatim and state that the ebove intormstion is corroct. I er€€ to
comply with ell cily ordinanG and slala laws ralaling to building coarstuclion. end hsr€6y
authoaized ropre6entation ol this city to ents upon the abovemmtioned propsty lor ioFpetim
Applrcant s Agent (Srg ):::;-u4 TOTAL PERMIT FEE
o^rE /2
€(mlnimum $35.00)
PERMIT NO.
flLOqr.",FrEDBY(sie) ylBUILOING
PERMIT No PERMTT TSSUEO BY (Slg )
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1-412]-rn,4-/a{6,f 2
Orslribution t lnspftlor Copy 2 Frle Copy 3. Finance Copy 4. Applicant Copy
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Dat6 lnrpcctor Approval
(Slgnaturol
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MECHANICAL INSPECTION RECORDS \
Remarts
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
[.vaporative Cooler
Repair, Alteration, Ducts
Fan Coil lnstallation
Gas Piping
Fire Damper
Rough lnspection
Final lnspection
Notes