HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (45)o IAPPLICATION AND
PLUMBING PERMIT
(TYPEWRITE OR PRINT IN INK)
CITY OF SANTA ANA
206 W 4th Street
667-273a
APPLICANT FILL IN AREA BELOW
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JOB AOORESSa?oq SAtrmA fe utcucC DK,E#
s,.rrrrfuou.te.t< A sso(-OWNER
5q6-0rro
PHONE
Ssls fqtnutca., 'RD
MAILING ADORESS
"''brrstn Mesn U',''Tzc2c
NO.EACHD lnduskial fl Commercial
5.00
10.00
each plumbing fiLture/trap
Ea. Add'l 100'or Fraction
Dental Unit or Medical Gases
Ea. Add'l Conn.
SEWER
lst 100'+Conn.15.00
5.00
5.00
ftivate Sewage Disp. System 30.00
GAS PIPING
GAS SERVICE 1 to 4 Outlets I 5.00 6cD
O$r.r-lu[.br D.drrfbn
I heraby alrirm thal I am exempt ,rom lhe Contractor's Lrcms Law ,or the lollowing reson (S*
7(El 5, Bugrna$ and P.ol6srons Code. Any city or county which requires a permit lo conslruct.
alter. rmprove. demolish, or .epaar eny slructure. pfltr lo its rsuance. al$ requires the applient
lor such permrl lo lile I signed stet€monl thsl h6 is licensad puBuanl to lhe provisions o, the
Conlrsclois Lrcens Lrw (Chepter 9 (commencrng w,th Setaon 7(m) ol Davision 3 ol the
Business and Prol6sions Code) or that he ig erampt lhorelrom and lhs basis tor th€ allegod
exemption Any violalion ot S€clion 7G3l 5 by 8ny applicanl tor I pormil sb,els lhe applicant to
8 civil penslly ol not moie than live hundred dollec (35@)
E Section 7Oa4A l, a3 ownor ol the prop6ny. ormyomployoeswrth wag6 I lheir solecompen-
galaon. will do the $ork, and tho struclurg is not ,nt6nd6d or otlorod tor sela
El S*rion 70448 l. as omer ot lhe proporty. am €xclusively contmling with licsnsed
conlradoB lo construcl the prolrct
Date Owner (Srg )
ConlrEton t,!. Only
'llli3'ibn, )tu L fWirsri r/^?*0707PHONE
2 o
that I am licensd un@. tha provisaons ol Chaptor 9.
subiocl lo the Worker's Comp€nsation L*s o,
Noilc. To ADPllcrl:
ll atter makrng lhrs Cerlrtcate ol Exemplron. you should become sub,ftt to the Worker's Compen-
ion provrsrons ol th€ Labo. Code. you musl lorthwath comply wath such pr@6ons o, thig
3ot lhe Busr
Worker's Com-
shall be dEmed revoked
ettrct
3
Verified
Contiactor (Sig )
Clss
Date Applicsnt (Sig.)
I hereby allirm
penstron I copy is liled with
Calilornaa
Applicant (Sig.)
r n t he perrorma nce ol the
in eny menner s s to
this permit is issuad, I 3h8ll not 6mployeny
I heve a of consent to sll-
Date
Expires
Erpardo.r
ThB p.rmit shsll sxpire by limitetion tnd bGcoms null and void rl tho wort lutho.irod by thi3
permil is rct @mmanced wilhin 180 days trom lhe date ot this p€rmit or il wort authoriz€d by thii
lErmit is $sponded d abandonod al 6ny lim atlor lh€ wort is cmmncod lor e potbd ol l&
days. A nd !trmil 3h8ll be obtain€d lir3l botors such worl can be Ecommncod.
r c€rr,y rhet rhsvs ro.drhisappri"r,m*ffi;*I agrs lo
the
Applicanl o, Ag6nl
comply wrth all crty and stata lsws releting to
ot this city lo entdauthorizod
purpos.
Device 2" or Less
10.00
C.$L
a)
o
Ea. Add'l Outlet
Temporary Gas SeMce
Repair or Replace Gas Piping
1.00
100.00
5.00
Water Heater - Electric or Gas
Owr5
Water Piping Ea. 100'
Vacuum Breakers 1-5
Rain Water (buried) Ea. 100'
Water Softner
- VentAlt. or Repair of
Lallrn Sprinkler
System - Per Drain
lnd. Waste lnterceptor
Pool 1?aps
Deck Drain System - Per Drain
or VentRepair/Alt.
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
5.00
Orcr 2"
Water Service Ea. 100'
Subtotal
Penalty Fee (when applicable)
Violation Fee
Plan Chec'k 650/o of subtotal
Pc#Receipt M.
Plan Check (Adiustment)
lssuance Fee
TOTAL PERMIT FEE
DATE
(s0.00)
(minimum 20.00)
Date
O?y*ilyl,b?Gl
^*
(sig )PERMIT ISSUEO 8Y (Sig O.
fees Pb. oru \q 20
1-1121
/Yl
Orstrbulron t Copy 2 Fila Copy 3 Frnance Copy 4 Applrcsnt Copy
a-
CS-61 1
roraY
FIXTURES
q Ll 5u
I t3@
8.00
l
No
and my lcense rs rn
t O
PLUMBING INSPECTION RECORDS
Remrrki
Ground Work (Soil)
Ground Work (wale4
Water Service (Ground)
Gas Service and Underground
Lawn Sprinklers
Wasle lnl€rceptor
Pool Traps
Sewer
Rool Drains
Water Healers
Waler Soltnet
Fl6ntal or Mec,ical Gases
}-
Rough Plumbing
Final Plumbing
Temporary Gas Service
Noles
Oat.lnrpoctor Approvel
(Slgneturcl
rlsfu d,r*r
r:lrA ./% /,/r*
at
//,7h lLt*4-
tl
fu*@
-2%_zZfudz'
ill/tn ,4, Ur-
t,
o
APPLICATION AND T o CITY OF SANTA ANA
206 W. 4th Street
667-2738- MECHANICAL PERMIT
(TYPEWRITE OR PRINT IN INK)
APPLICANT FILL IN AREA BELOW
(!
srIzo
oot
mao
\
tr"rbJOB €
4//a
MAILING
'ATE/ZIP
,t44v I
Orr-ldld.t D.dtibn
I horsby attirm thal I am sxempl trom tho Contrsclor's Licon3€ Llw lor the tollowing roaon (Soc.
7031.5, Busin€.s md Prol6sions Code. Any city or @unly which require3 a psrmit to conslrucl,
aller. imprcvo, dmolBh, or repair arry strucluro. prior to itE irguancg, al3o r€quird th6 applicent
lor $ch permit to lilo I3ignad statomsnl thal he B licens€d puBusnt to tho prcvisions ol lhe
Contractor's LicerB€ Law (Chaptd 9 (commoncing with S€c,tion 7q)) ot Division 3 ol tho
8u3in€3s 8nd Proto$ions Cods) or lhsl ha is oxompt lherelrom and the basE lor th€ allegod
exomplion. Any violalion ol S€dion 7031.5 by any applicenl tor a pormil subiects tho applianl to
a civil ponslly ol not more lhan ,ive hundr€d (bllars (35@):
E S*tion zOUl l, s3 om6r ot th6 proprny, 07 my employG wilh wag€3 as thoar 3ol3 comper
salbn. will do the work. and the slructuro 6 not intended or otls€d lor sslo.
E S*tion 704{8 l. 8s owner ot the prop€rty. am oxclusivsly conlrrcling wilh licens€d
@ntreclofs lo construcl the pfol€ct.
Oale Owre. (Sig.)
I horeby allirm lhat I am lrc6sed under th€ provisions ol Chaptd 9, Orvision
Conlrelon (,3. Only
?o
CITY
andfl@,"o"
C-7Prolssrons
#{^k"
Cod€. md my license is in lull lorce and 6tl*1.
Conlractor (Sig )
&ala
",o"o",h'ilfi
So.f.6 Corf.oibo O.dr.lbn
I hereby altirm lhal I have a cortilicate ot @nsent to rlf-ansure. or a corlilicato ol Workff's Com-
I cerlity lhat in lhe p€rlormance ol the work lor which this
p€r3oo in any manner s a lo bG@mo lubiod to lho Worto/3 CompaIr3rlbn L!w3 ol
Caliromia
ilo$c. To Ap9llc l:
ll atler making lhrs Certrficate ol Eremption. you should become subi&t to the Worke/s Compen-
salron provrsrons ol lhe Labor Code, you must forthwrth comply wrth such provrsrons or thrs
permit shall be deemed revoked
lil6d wilh the
(sig )
Oate Applicant (Sig.)
anspection dopartment.
I shall nol employ any
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
Repair, Alt. or Add. to any Heating/Cooling sys.
Zfr rtt
15.00
/OO
EACH TOTAL
or by
E lndustrial D Commercial NO.
15.00 t({tz
Hood with Duct and Fan (Type ll)
Up to 100,000 BTU
Over 100,000 BTU
EACH ABSORPT]ON SYSTEM
100,000 BTU to | ,000,000 BTU
1,000,001 BTU to 2,000,000 BTU
Heat Pump Compressor less than 5 HP
5HPto3OHP
31 to 50 HP
Over 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 Dryer Vents
Decorative Fiteplace (Wood or Gas)
Range Hood with Duct and Fan (Type l)
Each Vent Fan Connected to a Duct
Fan Coil lnstallation
Fire Extinguishing System
Each Evaporative Cooler
Fire Damper lnstallation
15.00
20.00
25.00
30.00
25.00
40.00
25.OO
30.00
10.00
10.00
10.00
25.00
15.00
15.00
15.00
15.00
10.00
15.00
20.00 ,,r?
15.00
15.00
10.00
15.00
Subtotal
Penalty Fee (when applicable)
Violation Fee (s0.00)
Plan Chec*65%of subtotal STAO (minimum 20.00)
Receipt No.Pc#'/ 7 Date
Plan Check (Adiustment)i.zf,
lssuance *e 10.00
TOTAL PERMIT FEE (minimum $35.00)€
Erpktfo,r
This p€rmil shell expire by limitation and bacome null and void it lhe work suthdized by lhis
petmil B not commoncod wilhin IEO dsys rrom lhc dste ot this permit or il wort suthorizod by this
fprmit is suspsded or sbandonsd at any time alls the work i3 comrnenced tot I poriod ol l@
days A new permil shsll b€ obtainod lirst belore such work csn be rrcommmcod.
AoDfcrta3 Nrdo.r
I certiry that I hevo r6ad this spplicalio and stste that the abovo intormatbn is corr61. I agr6 to
comply with all cily ordinancG and state laB rolsting to building cmEtuclion, and her.6y
aulhorizod rcprmnlrtion ol thB city to antor upon lhc
pu7po36.izr€e*Oate Applicanl or Agent (Sig
lor insp€clion
DATE l2-2u--t7 PERMIT NO.
BUTL'TNG a4bt>
PERMTT r'ro g__l_l_i vEHtFtEO By (Sig )+r PEBMTT rssuEo ev rsis1 Ln"(*
l2 -/o 84//-rVALIOATION (OFFICE USE ONLY)(ACCOUNT
'11-412)
Drstribulion I lnspeclor Copy 2. File Copy 3. Finance Copy 4. Appl,cant Copy
cs-6r8
'4
/
lncidental Gas Piping
'15 00
6a
Date Applrcant
(L.
MEcf,NrcAL rNSPEcroN *r.t*
Bemartc
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 Boot
Evaporative Cooler
Repail Alteration, Ducts
Fan Coil lnstallation
Gas Piping
Fire Damper
Rough lnspection
Final lnspection
Dsto lnrpcctor Approval
lSlgnaturel
t1
4rtb oil*^
@ro !-/ .
o*a0".*,
Notes