HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (50)o IAPPLICATION AND
PLUMBING PERMIT
(TYPEWRITE OR PRINT IN INK)
CITY OF SANTA ANA
206 W. 4th Street
667-273a /h,,-
APPLICANT FILL IN AREA BELOW
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(Qesidential D lndustrial E Commercial NO.EACH
X ;5'E )^f--?r- I t ; r/.*- u &L o
sll'at t o
PHONE
-t\,
MAILING
"'ufu V^r4ar STATE/ZIPq 2b>b 15.00
Ea. Add'l Conn.
t2 5.00
10.00
TOTAL
FIXTURES
each plumbing fixtue/trap
Dental Unit or Medical Gases
SEWER
1st 100'+Conn.
Ea. Add'l t00' or Fraction 5.00
Private Sewage Disp. System 30.00
GAS PIPING
Ortl. -tulld.r O.drnbn
I hereby Itlirm that I am ox€mpl lrom the Cslraclo/s Licas Law tor the tollowing rsaon (Soc.
TGil 5. Busines and Prot8srons Code Any c(y or counly which requirs e p€rmrl to construcl,
alter, improre. demolrsh. or rgparr any structure. prior lo ils issuonce, also reguiros the applicanl
,or such permit to tile I sign€d slatemsnt that he is licqnsod puBuanl lo tha prcvisioru ol lhc
Conlracior's Lacense Law (Chapler 9 (commncing with Soction 7m) o, Oivision 3 o, th€
Susiness and Prore3siom Cod6) or thot he is oxmpl tharalrom and the bsis lor the allog€d
exemplaon. Any vaolalion ot Soclion 7031 5 by Eny rpplienl tor I permit sbi*ls the applicant lo
a ciul penally ol nol moro thln tive hundred (bllaB (3500):
E S."tionZO{A l.!sownerolthepropony,ormyampblEssrthwsgessth€irsolacompen-
38tion. will do the rcrk. and lhe structuro is rcl rntond€d d ollsod ,oi sal6.
E S""tion 70448 l. a! ownor ol lho propeny. am exclusryely cmtreting wilh lcans€d
contracloE to comlruct lhe projecf
Oate Owrer (Srg )
Contrrton t,!. Only
CONTRACTOR
1|io--4o* -- l- aztztaZ,;tzlt-O707
PHONE
AooRESs / f/ 7 7rt D"-,8
STATE/ZIP
&-qr)3o
I hereby atlirm lhel I am lacens€d under Ihe provBiom o, Chapts g
subiecl to the Worker's Comp€n$tion Lews ol
l{olbr fo Agdlcnl:
ll alter makrng thrs Certrtrcate ol Eremptron. you shoutd b€come subirt to the Worke/s Compen-
provrsrons ol the Labor Code. you must tonhwrlh comply wtth such provtsions or lhls
shall be dftmed revoked
ErCra0on
This pormit shall sxpirs by limitstim and b€como null and void il th€ worl luthorizod by this
pormit i3 not commencod within 180 days lrom tha dsle ol this permit Or il rcrk aulhtrized by this
pormit is 3uspondod or lban(bnod rl any lime artd lha mrl is cmmncod lor a ,Eriod o, 'l8O
A nar psmil shsll be obtorned ,i6l b€rore such w6k can b€ @mmencod.
eggfcad'. D.d.ntqr
I cerlity thal I have roed thB apolicrlim rnd slrls thal lhs rbovo
3ol the Busin6s andal
Contracto. (Si9.)
ot Worker's
Applicant (Sig.)
7
insp€ction
Verfred
Oete
Expires
lhe
Applrcant or Agenl (Sig
Code, and my hcense is rn lull fo.c6 and etl*t.
Cslilornrs
DGlrdlon
ol @nsst lo sll-insure,
copy is lilsd uth the City
I lprcby afti.m lhat I have a
pensatron lnsurance.
whrch this permit is issued, I shall nol omploy 8ny
I agrs
andto8nc slete lawscomply wilh all
o, this city to
Ods
-
(sig.)
olth€
autho.ized
purpos6
anymannersBto /o-
10.00
GAS SERVICE 1 to 4 Outlets
Water Service Ea. 100'
Ea. Add'l Outlet
Over 2"
Repair or Replace Gas Piping
Backflow Device 2" or Less
Temporary Gas Service
Over 5
MISCELLANEOUS
Vacuum Breakers 1-5
Water Heater - Electric or Gas
Repair/Alt. Drainage or Vent
Water Piping Ea. 100
Deck Drain System - Fer Drain
Pool Traps
lnd. Waste lnterceplor
Rain System - Per Drain
Lawn Sprinkler
Rain Water (buried) Ea. 100'
Water Soltner
Alt. or Repair of Drainage - Vent
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
TOTAL PERMIT FEE
Penalty Fee (when applicable)
lssuance Fee
Violation Fee
Plan Check (Adjustment)
Plan Check 65% of subtotal
Pc#Receipt No.
(50.00)
Date
(minimum 20.00)
BUILDING
PERMIT No (si9.l ?1"9- da o-PERMIT ISSUEO BY (Siig.)
ed /4 74 7O4,,6-19.9?
(ACCOUNT r1 1-412)a-(L
Drstributron 1 lnsp*to, Copy 2 Fna Copy 3 Frnance Copy 4 Applicanl Copy
cs-6r l
a
5.00
t
a t
PLUMBING INSPECTION RECORDS
Rcm!rkr
Ground Work (Soil)
Ground Work (Water)
Water Servico (Ground)
Gas Service 6nb Underground
Lawn Sprinklers
Waste lnt€rceptor
Pool Traps
Sewer
Roof Drains
Water Heaters
Water Sortner
Rental or Medical Gases
a-
Rough Plumbing
Final Plumbing
femporary Gas Service
Notes I L.o f"
i' '\ t'l'
O!tc ln!9.ctor Approvrl
(8le n.tur.)
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JOB ADDRESS
CITY
b EACH FURNACE INCL. DUCTS AND VENTS
EACH COMPRESSOS, BOILER, OR HEAT PUMP
Heat Pump Compressor less than 5 HP
Up to 100,000 BTU
Ovell00,000 BTU
! lndustrial ! Commercial
EACH ABSORPTION SYSTEM
100,000 BTU to 1,000,000 BTU
1,000,001 BTU to 2,000,000 BTU
5HPto30HP 25.00
31 to 50 HP 30.00
Over 50 HP 40.00
EACH AlR HANDLING UNIT OR VAV BOX
Oill;{ul.d.r O.drtbn
I hsreby sltirm that I am exmpt lrom the Contrecto/s Lacenso Law lor tho lollowing reaon (S€c.
7@1.5, Businas and Prol83sions Coda. Any city or counly which rsquirs 8 p€rmil to con3trucl,
aller. improv6. domolish, or roptir arry Btrucluro. prior to its i$uance, also roquiros tho spplienl
for $ch permit to ,il6 a signod strtomont lhal h6 6 licmssd pur3ust to lho provisions ot tha
Contraclor's Licslo Law (Chapler I (comancing with S€ction 7@0) ot Oivision 3 ol tho
Busin6s and Pror6sions Cod€) or that he i! exompt lhoretrom and the ba3rs for tlre all6g6d
exmption. Any vrolslion ot S€clpn 7ctr|1.5 by any applicant lor a permit subi€cts th6 applicenl to
8 civil p€nalty ot nol more lhan livo hundr€d (bllsr3 (t500):
E S""tion Zolll l, as owner ol the property, or myemployoes with wages B theirBolecompon-
sation. will do the work. and lh€ structure is not inlend€d or otlsed tor sale.
E S*tion 70448 l, 6 owns ol lhe property, am exclusavely contrrting wnh licms€d
@ntracloB to construcl lhe p,oist
Date Owner (Sig.)
Cont Eton t.l. Only
-720
STATE/ZIP ,7/75/
PHONE
cr
I her€by allirm thel I am lcms€d under the provlsom ol Chapter 9.
ProlGsrons Code, ild mv hconso rs(,il("!*.@Lz- c,*"
oa'f*.iU-$. contracror
andOrvisionPol tFusin6s
in full lorce and gtlst.
(sig )
Range Hood with Duct and Fan (Type l)
I
2
n
15.00 7o.oo
10.00
10.00
10.00
Each Vent Fan Connecled to a Ducl
Air less than 2,000 CFM
2,000 CFM to 10,000 CFM
Over 10,000 CFM
MISCELLANEOUS
Outdoor Dual Healing or Cooling
Floor Furnace
Heater: Suspended, Wall or Unit
Com'l Dryer Vents
Decorati\re Fireplace (Wood or Gas)
Repair, Alt. or Add. to any SYS,
25.00
15.00
15.00
15.00
15.00
10.00
15.00
20, e'o
/arttt
tvoilm Coi?.rlalbn Oaclralbn
I hereby alllrm that I hav6 a cortiticato ol @nsent to $ll-insurs. or I cerlilicetool Worktr's Com-
I certaty that rn the fErlormance ollhe work lor which this
person in tny manner $ s to be@me subloct to the Worke/s Comp€nsation Laws ot
Califo.nis
l{oto To Appll6l:
ll attq maktng thts Certiftcale ol Eremptton. you should become subltrt to lhe Worker's Compen-
Satron provrsrons Ol lhe Labor COde, yOU musl lorthwtth comply w[h such provrstons Or thrs
permrt shall be deemed revoled
t
Oate Applicant (Sig.)
building inspection deparlmant
I shall not employ any
Hmd with Ducl and Fan fl'ype ll)15.00
(50.00)
Fan Coil lnstallation
Fire Extinguishing System
Each Evaporative Cooler
lncidental Gas Piping
Fire Damper lnstallation
by
20.00
15.00
15.00
10.00
15.00
Subtotal
Violation Fee
Penalty Fee (when applicable)
Plan Check 65% ot subtotal rtr 6n (minimum 20.0O)
Receipt No.Pc#Date7
Plan Check (Adjustment)6 i{'o
lssuance Fee 10.00
TOTAL PERMIT FEE (minimum $35.00)+
Erpkdon
This p€rmit shall oxpire by limitation and bo@ma nult end void it the work authorizod by this
parmat B nol commenc€d withln 180 days ,rom the dsto ol this permit or i, work 8uthorized by this
p€rmil is suspad€d or abendongd al any timo alls tha work is commonc€d ,or a poriod ol 180
days. A nd pdmil shall b€ obtained ti6t berora such work can b€ recommsncsd.
AD9{cma'. D.drdcr
I certity thal I hsve read this rpplicatim and st8t6 thlt tho aboe inlormstbn is correct. I aoroe to
@mply with all city ordinanG and stete laB rglsting to buitding constuc{bn. and heroby
authori2ed .oprosentstbn o, thi! city to ents upon tha eboFmmtioned pop€ity t6 iBp6ction
lzaq frz**Applicant or Agenl (Sig )
purpos6
Dale o rE / 2- 7fifl PERMTT No.
ByA.,li$" 5_1bl b u,^,,,,o ",)PERMIT ISSUEO BY (S'9 )
CL d,
Ul fi* f*"U <-4-/or/r TL-:27=nVVALIOATION (OFFICE USE ONLY)
(ACCOUNT t11-412)
eppr-icAnoN AND e
MECHANICAL PERMIT
(TYPEWRITE OR PRINT IN INK)
o CITY OF SANTA ANA
206 W. 4th Street
667-2738
4?,*
APPLICANT FILL IN AREA BELOW
(!q-oza
ooI
m
<n
U)
\
Oislrabution: t lnspector Copy 2. File Copy 3 Fiobnce Copy 4 Applrcant Copy
cs-618
filed
(S€ )
NO.EACH TOTAL
15.00
20.00
25.00
30.00
/25.00 tlm
15.OO
\
MEctNrcAL rNsPEcroN *=.t*
Remarkg
Forced Air Furnace
Wall Heater
Floor Furnace
Suspended Heaters
Air Handlers
Heat Pump
Plenum and Ducts
Compressor
Boiler
Outdoor Dual Package Unit
Decorative FirePlace
Bange Hood - Duct and Fan
Fan and Duct
Appliance Vent Through Roof
Evaporative Cooler
Repair, Alteration, Ducts
Fan Coil lnslallatron
Gas PiPing
Fire Damper
Rough lnspection
Final lnspection
Date lnspcctor Approvrl
(Signaturol
Wq,/zgl/la,^,
6fr/u h*
Notes