HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (51)KQesidentiat E lndustrial E Commercial NO.EACH TOTAL'TTB'," ,le.^to-Lo Vit-l4r/- oe-
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STATE/ZIP"'lL.b}lr^*(_
I 5FIXTURES
MISCELLANEOUS
each plumbing lixture/trap
Temporary Gas Service
Dental Unit or Medical Gases
SEWER
1st 100'+Conn.
Ea. Add'l Conn.
Ea. Add'l 10O' or Fraction
Private Sewage Disp. System
PIPING
GAS SERVICE 1 to 4 Outlets
Ea. Add'l Outlet
Gas PipingRepair or
5.00
10.00
15.00
30.00
5.00
5.00
5.00
100.00
'r.00
5.00
Our.r-Au[&? Oadralbn
I heraby sltrrm lhal I am erempl trom lho Contraclor's License Law loi tha lollowing rcBon (Sec
7031.5. Busine$ and Prorossions Cod€. Any city or county which roquirs 8 pormil to construcl,
aller, improve. domolilh. or repair any slructure. prior lo its assuance. also Taquiras th6 applicant
tor such pormit to ,il€ a signed statemonl ttlat he is licensod pursuent lo ths provirions ot tho
Contrrclo.s Lrcons Lru (Chapls I (commencing with S€ction 7m0) ot Oivision 3 ot the
Eusrns3s and Prote$ims Code) or lhat he is orempl theratrom and tha besis lor the alleg€d
€xgmption AnyviolationolSoction7@1.5byanyapplicrntlorap€rmitsubiectslh€applicsnlto
a civil penalty ot nol more than rive hundrod (bllsr3 (1500):
E SrectionTO44A l.ssowneroltheprop€ny,ormyemF,loyoerwithwag€saslhoirsolocompsn-
salion. will do th6 nort. and tho strGturs is ml intmded or otlerad ,or sal6.
E S*tion 7(N48 l. as omor ot th€ propeny. tm oxclusivoly cmtrrciing wilh lic.nrad
conlracloB lo construct thg proiecl.
Date Owner (Sig )
/5.00 5-
Conlrrclon t !c Only
10.00
L7Y- d7 6 7
PHONE
8.00Wtrfi^;,-L Llllinb*,;
Water Heater - Electric or Gas
Rain Whter Piping (buried) Ea. 100'
Water Softner
Water Piping Ea. 100'
4.00AOORESS
Alt. or Repair of Drainage - Vent Piping 10.00STATE/ZIPq233a Lawn Sprinkler I 6.00
Rain System - Per Drain 10.00
lnd. Whste lnterceptor 8.00
Pool Traps 5.00
I hereby aflirm lhal I am lac€n$d under lhe provisions ol Chapler 3orth€
Wt::
Contractot
Code, and my license rs in lull lorca and etlect.
Deck Drain System - Per Drain 3.00
Repair/Alt. Drainage or Vent 10.00
Vacuum Breakers 1-5 1 5.00
1.00
1 5.00
10.00
/10.00
3ubiact to the Workg/s Comp€Nlion Lr3 ol
Lo0c. To Appllcil:
ll atier makrng lhrs Cerlricate ol €xemption. you should become sublel lo lhe Worker's Compen-
provrsrons ol lhe Labor Code. you must torlhwrlh comply wrlh such provrsrons or this
shall be demed revoked
ol Wo.i(a. s Com-
the
Verilied By
Applicanl (S,9.)
Dale Applicant (Srg )
I hergby alfirm thal I have
pensatron lnsuTance
this parmit rs issuod, I shall nol smploy any
Oclfrtlon
of consonl to $lt-insure, or
copy is tiled wilh the City
in eny mnner so as to
Calrfo.nra
Oate
Exprres
Plan Check 65o/o of subtotal ("
Owr5
Device 2" or Less
Over 2"
Water Service Ea. 100'
Subtotal
Penalty Fee (when applicable)
Violation Fee
Pc#Receipt No.
Check (Adlustment)
(s0.00)
Date
(minimum 20.00)
lssuance Fee
TOTAL PERMIT FEE
Erplr.don
This permrt shall oxpir€ by limitatio and bocome null and void it the work authdized by lhis
rs nol commenc€d within 180 days lmm lho dato ot this permil d il work authorizod by this
is susp€nded or sbandoned at any time stler lhe work is commncod tor a p€riod ol l8O
A nor pormit shell ba obtrincd ,i6t bgloro such wort can bo rEcommoncsd.
ArDlcd'. O.drdor
I corlity lhsl I have rs6d lhis rpplicalim 8nd thal the lbove
Applrcant or Agent
lo
towrth all and stste
of this city to ents '10.00
o4
?i*3,is.5%17 (Sig 1 ^b PERMIT ISSUEO 8Y
(ht- k7 7a 7 7 O-/tosptt-a-!J-(ACCOUNT r-41 2)
e oAPPLICATION AND
PLUMBING PERMIT
(TYPEWRITE OR PRINT IN INK)
CITY OF SANTA ANA
206 W. 4th Street
667-273€f?--
APPLICANT FILL IN AREA BELOW
trg-ozo
oo
f,
ma
Dist,ibutaon 'l lnspector Copy 2 Frle Copy 3 Finance Copy 4 Applicant Copy
CS-61 1
//<-
z
5-
E(minimum $il5.00)
I
o I
PLUMBING INSPECTION RECORDS
Ramrrk!
Ground Work (Soil)
Ground'Wori (Wated
Water Service (Ground)
Gas Service'arid Underground
Lawn Sprinklers
Waste lnterceptor
Poot Traps
Sewer
Rool Drains
Waler Healers
Water Softner
Bental or Medical Gas€s
Rough Plumbing
Final Plumbing
Temporary Gas Service
Noles lbb tut*.{Q
\-.\.t
D.t.lnapactor Approvrl
(Slgneturo)
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