HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (70)APPLICATION AND
ELECTRICAL PERMIT
ITYPEWRITE OR PRINT IN INK)
I o CITY OF SANTA ANA
206 W. 4th Sr.
667-2738
4 tu
APPLICANT FILL IN AREA BELOW
@g-ozo
oa,m
X
XResidentral lndustnal Commeroal NO.EACH TOTAL
Res. Hotels, Motels, Apt. Sq. Ft. I I I l0 .03 33, Vo
Gar. or Carports Sq. Ft +77 .02 I'7t
Receptacles .50STATE/ZlPc* ?zlzeCD-'fr-W,z--n-
7ag7
t H
JOB ADDBESS
73tr
CIT Y
Swilches .50
Fixtures .50
Air Conditioners
Each /20 00 al.0-a
Factory Wired Unit fi,ltApproved
LiSt 4 5.00 Vo,n
Busways, special raceways. under floor
duct, trolley or plug-in busways ea. 110' or
fraction thereot
500
Fire Sionalino Svstem. Minimum fee
Outle[ 66taor heat sensor /10.00
.50 ,9 IH
Lighting Standards with One Lamp
Each Add'l fixture on same standard
s.00
1.00
Owner-Bulldcr D.cle?ctlon
I hereby allrrm thar I am ex€mpt from the Contractor's Lrcensc Law lor lhe lollowrng reason (Sec
7O3l 5, Business and Prolessrons Code Any crty or county whrch requtres a permrt lo construct,
aller, rmprove, demolish, or repaI any structure. plor to rls rssuance, also requrres lhe appIcanl tor
such permrt lo file a srgned stalemenl that he rs hcensed pursuanl to the provrsrons ol the Conrac-
tor's Lrcense Law lChapler I (commenc,ng wrth Soctron 7000) ol Drvrs,on 3 of the Busrness and
ProlessronsCodelorlhalhersexempilherelromandthebasrslorlheallegedexemptron Anyvrola-
ton o, Secton 7O3l 5 by any apphcanl lor a permrt sublects the apphcant lo a ovil penally o, nol
more lhan frve hundred dollars I S 50Ol
n S"",,on7O44A l,asowneroflhepropertv,ormyemployeeswrlhwagesaslhe[solecom'
pen$lron, wll do the work, and lhe structure rs nol rntended or ollered lor sale
D Secrron 70448 l, as owner ol the properly, am exctusrvely contractrng wrth lrcensed con-
l€clors lo conSlruct lhe paolecl
Dale - Owner (Srg l--
-
Marntenance Permit (annual)50.00
Service Meters
Up to 400 amps, per meter
Over 400 amps, per meter
Over 1200 amps, per meter
I 15.00
35.00
75.00
/f,d
Signs and high potential gas tube lighting 15.00
Swimming pools, lountains, spas 35.00
motor control center o@)Switchboard.@Eacn
(15.00 /fifr
Temporary construction meter service
pole
Eqph distribution pole
25.00
5.00
-/mpoary construclion lighting
500 lamps or less
Over 500 lamps
2.00
400
Time clock or photo electric cell 3.00
POWER APPARATUS: Generalors,
motgrs. transtormers, rectifiers. industrral
lyzting, cooking, or baking equipmenttnd other apparatus as follows:
Up to and including 1 HP, KW KVA
Over 1 and not over 10 HP, KW KVA
y'Over 10 and not over 50 HP. KW KVA,/ Over 50 and not over 100 HP, KW KVA
Over 100 and not over 500 HP KW KVA
Over 500 HP, KW KVA
2.OO
5.00
10.00
20.00
30.00
40.00
€/L&L 6t6'3t'/3
I hereby affrrm thal I am lcenscd uhder the provrsrons ol Chapter 9, Drvrsron 3 of the Buyness and
I herebv atllrm thal I have a cerlrficale of consenl lo sell-rnsure, or a ceilrlcale ol Worker's Compen
satron lnsurance Cert(red copy rs lrled wrlh the City burldrng rnspectron department.
lf, alter makrng lhis Certrficale ot Exemptron, you should become subjecl lo the Worker's Compen
satron provrsrons ol the Labo. Code, you must lorthwrth compiy wrth such provrsrons or lhrs permrt
shall be d@med revoked
Contractor Use Only
rlrsr
PHON E
/
44/r'L-
lhe
E
0/z/
eftec rf,fLrcsnseCrly
By lSrg
Applicant (Srg )
CONTRACIOR
lhrs
ker's
nol employ any
Laws of Cal
Workors Componsation
Notice To
I ce.lifv lhal rn lhe psrlormance ol the work
'&" )r7dr
Date
Dat€.
:"",a%ryn:,,"":";
Subtotal
/2.?,54Penally Fee (when applicable)
(50.00)Violation Fee
Plan Check 650/o of subtolal 726f (minimum 20.00)
ReceiptNo e.7L7 ec*(o7)3 Date
Plan Check (Adjustmenl)
lssuany' Fee 10.OO -, )
;W6t PERMIT FEE (minimum $35.00)t12 2J
Expiration
Applicant's Declaration
r' '. , I r,i. i i I rl, 'r rl ', rl,'!'rr"r:,i r rl,'r':
(ze represenlatrves ol lhrs 0ty lo enler upon lhe above.menlroned properly for
" ",. *l l+ fff,,,,,,.,,,.,. oo,,.,,, fihrufl
purposes
D^rE ,//-2 - ?7 PERMIT NO.
{(da-3 VEFIFIED BY {Srg )PERMIT ISSUED BY {Srg I
fzY)
71b-4*ay
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VALIDATION (OFFICE USE ONLYI
(ACCOUIIT flt'4131
Distribution: 1 . lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy cs.5r3
,
Date lnspector Approval
(Signature)
3,z.ea .€,rz,art
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ere?nrcAL rNSPEcnoN necfros
Remarks
I
Fir(itory Wrrc{j Urrtt
l-lu,r DU(.t
, N,4rrtor Cor)tr(,1 Crrnter
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T,'n)fJ()r.rry I rqlrtrng
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