HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (76)o t
APPLICATION AND
PLUMBING PERMIT
(TYPEWRITE OR PRINT IN INK)
CITY OF SANTA ANA
206 W. 4th Street
ffi7-27*f{{-
APPLICANT FILL IN AREA BELOW
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NO.EACH TOTAL@esidentialD lndustrial E CommercialJOB4
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I hereby arrrrm that I am erempt l,om the Contractor's Lrcense Law lor the lollowrng re6oo (S&
7031 5. Busrness and Prol6srons Code Any city or county whrch requrres a FErmtt lo conslruct.
aller, rmprove, demolish. or reparr any sl.ucture. pnor to rls rssuance. also requtres lh€ applicant
lor such peimrl lo lile a sgned statement thal he rs lrcensed pu.suant lo the provtsons ol lhe
Contraclor's Lrcense Law (Chapler 9 (commencrng wrth Sectron 7@0) ol Oivasron 3 ol lhe
Busrness and Prol6srons Code) or thal he rs exempt tt€refrom and the basts lor lhe alleged
exemplron Any vrolalron ol Sectron 703 1 5 by any applrcanl tor a permil subrects the apptucant lo
a crvrl penally ol nol mo.e than ive hundred dollars (S5OO)
E S*l,on 7044A l. as owner ol lhe properly. or my employes wrth wages as lheir sol€ compen-
salron wrll do the rcrk and the structure is nol rnlended or ollered lor sale
E S*t,on 70448 l, as owner ot the p.operly, am exclusrvely contracthg wrth lrcensod
contractors lo construct the proiet
Oale Owner (Srg )
Contlrbn lr.. Only
b7L1- D7D7
PHONE
"'" Xry',, f-hr),-, -STATE/ZIPq237 D
I heraby afi.m lhal I am lrcensad under lhe provisions of
Cods. md my lien* is in lull torce and
Contractor
Pro16srons
flfrp..
'.otc.
To APPllc-l:
ll alter makrng thrs Certrftcale ol Exemptron, you should become sub,trt to lhe Worke/s Compen-
salron provrsrons ol the Labor Code. you must lorlhwrth comply w(h such p,ovrsrons or lhts
permrl shall be demed revoked
of consenl lo
Dclmllon
of
California
this parmil is issuad, I shtll notemployany
to the Worker's Comp€nsalDn Lils ot
whrch
subjmt
copy is lil€d wiih the City
Dete
-
Applic8nt (Sag.)
pensatron lnsu,ance
I hereby atirm that I have
FIXTURES
each plumbing ftxture/trap 5.00
Dental Unit or Medical Gases 10.00
SEWER
1st '100' + Conn.15.00
Ea. Add'l Conn.5.00
Ea. Add'l 100' or Fraction 5.00
Private Sewage Disp. System 30.00
GAS PIPING
GAS SERVICE 1 to 4 Outlets 5.00
Ea. Add'l Outlet 1.00
Bepair or Replace Gas Piping 5.00
Gas Service 100.00
MISCELLANEOUS
Water Heater - Electric or Gas 5.00
Water Piping Ea. 100'10.00
Rain Water Piping Ea.100'8.00
Water Softner 4.00
Alt. or of - Vent 10.00
Lawn Sprinkler 6.00
Rain - Fer Drain 10.00
lnd. Waste lnterceptor 8.00
Pool Traps 5.00
Deck Drain System - Fer Drain 3.00
Repair/Alt.or Vent 10.00
Vacuum Breakers 1-5 5.00
Orcr 5 1.00
Backtlow Device 2" or Less 5.00
@er 2"10.00
Water Service Ea. 100'10.00
Subtotal
Penalty Fee (when applicable)
Violation Fee (50.00)
Plan Check 650/o of subtotal ,6.5O (minimum 20.00)
Receipt M.7C Pc#Date
Plan Check (Adjustment)
lssuance Fee 10.00
TOTAL PERMIT FEE
DATE -)7-
ErDarr0on
ThB permit shall oxpire by limitltim and beome null 8nd void il the mrk authorizod by this
permilisnotcomm€ncodwithin l8Odly3 lromlhodalsotthiEpermitorilwortsuthori26dbythis
parmil is 3uspended or abandonsd at 6ny lim6 Itld ths worl is commsncad tor a poriod ol 180
days. A nfr psmit shall be oblsined ,iBl b€rda sch wort can bo rscommn@d.
AFfcarll H.rdqr
I corlity that I havc rdd this applicalim 6nd sllte that th€ !b@s
Applic8nl or Agent
corrocl. I 80r€o_
andcomply wth all city and state l8m releting lo
thi3 city toauthorized
purpos6
PERMTT TSSUEO BY (Sig.)n0-Bgltii$. 5rU2 j u, ,,i,",n,
-2r-- ^----!, hvt /t4-2?7o y'Wm. S.t*$
vALroATroN (oFFrcE usE oNLY)
(ACCOUNT r11-4r2)
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,
Oistnbutron lnspeclor 2 Ftle Copy 3 Frnance Copy 4 Applicanl Copy
cs-61 1
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Oate
Erprres Verified
Applrcant
lhe
I t
PLUMBING I NSPECTION RECORDS
Ramark!
Ground Work (Soil)
Ground Work (Wator)
Waler Servic€ (Ground)
Gas Service and Underground
Lawn Sprinklers
Waste lnterceptor
Pool Traps
Sewer
Rool Drains
Waler Healers
Water Soltner
Eental or Medical Gases
Rough Plumbing
Final Plumbing
Temporary Gas Service
Noles
1.
D!t.ln.p.ctor Approvrl
(Slgnrturc)
,44n 2"lrl.+
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JOB AOORESS
3708 Santa Fe Vl11age Dr., Unit B
Ehesidential !lndustrial ECommercial NO.EACH TOTAL
EACH FURNACE INCL. DUCTS AND VENTS
OWNERSunflower Associates
PHONE
714-546-0rLO Up to 100,000 BTU 15.00
MAILING AOOR€SS3315 Fairvlew Rd.Owr 100,000 BTU 20.00
EACH ABSORPTION SYSTEMCITYCosta Mesa
STATE/ZIPcA 92626 100,000 BTU to 1,000,000 BTU 25.00
Our-lufl.bt D.dtilil
I htroby sltirm lhat I sm sxgmpl lrom tha Contracto/t Licffs6 Law lor tho tollowing raaon (Soc.
7(x}1.5. Busim md Pror6sions Code. Any city or county which toquiro! 8 pormit to construcl,
all€r. improvo, d,gmoligh. or ropeir any 3truclurs. prior to itg isurnco. also r€quirss the sgplicanl
tor $ch pdmit to tila I signod alat6m6nt that ho is licons€d puBuanl lo tho provisiom ol lhs
ContTaclor's Licffle Law (Chepler I (@mmencing with Soction 7@0) ot DivBion 3 ot th€
Busins 8nd Prolasions Code) or that ha is orempt thot€lrom end the b83B tor th€ slleged
exomption. Any violetion ol Saction 7031.5 by 8ny 8pplicant tor a p€rmil ilbjecB the applicsnt to
a civil psnelty ot nol more than tivo hundrod dollaB ($sm)l
E S""tion zOga l. as ownor ol th6 proporty, or my omployoe3 with wag€s a3 thsirsolacompan-
salion. will do th6 wo.t, and th€ 3tructuro B nol inlmdsd or ollerod for !ale.
E S*tion 70448 l. as ownor ot the property, am oxclusively conlreling with licenssd
@ntracloG to conslTuct thg pro,et
Oate Owner (Sig )
1,000,001 BTU to 2,000,000 BTU 30.00
EACH COMPRESSOR, BOILER,PUMP
Heat Pump Compressor less than 5 HP 25.00 25 .00
5HPto30HP 25.00
3t to 50 HP 30.00
Over 50 HP 40.00
EACH AIR HANDLING UNIT OR VAV BOX
Air Handling less than 2,000 CFM 10.00
2,000 CFM to 10,000 CFM 10.00
Or,er 10,000 CFM 10.00
MISCELLANEOUS
Outdoor Dual Packaged Healing or Cooling 25.00
Floor Furnace 15.00
Heater; Suspended, Wall or Unit 15.00
Com'l Dryer Vents 15.00
Decorative Fireplace (Wood or Gas)15.00
Repair, Alt. or Add. to any Heating/Cooling sys.10.00
Range Hood with Duct and Fan (Type l)15.00
Each Vent Fan Connecled to a Duct 3 15.00 45.00
ConlrElo[ t,.. olrly
CONTRACTORSteel T A/C
AODRESS
3180 Broken Arrow
STATE/ZIP
9t760
I h€reby attirm thal I am licensed under ths provisions o, Chtpter 9. Division 3 ol thq8usinBs 8nd
ProlB3rons Corre, md my liense rs in tull lore and alt6cl. -l-O-'
.-."12*/nP o_l! 9 L I 7",*"c20 015012
o*" rttl -X? conrrscror (sie
Y
tlod(.rt Comgrmalbn Ordrlbn
I hereby affirm that I have a cerlrricate ol @nsent lo *ll-rnsu.e, or a certilicale ol Works s Com-
pensalron lnsurance Certa,ied copy is fil6d wrth lhe City building inspetion department
which lhis mployany
pe'3on in any mannsr !o !3 to b€come subiocl to the
Calilomh
Compensation Lils ol
Dale Applicant (Sig.)
l{otlc. To Appllcil:
ll alls makrng thrs Certrtrcale ol Exemplron, you should become subltrt to lhe Worker's Compen-
Salron provrsrons ot the Labor COde. you must lorlhwrth comply with such provisrons or thrs
permal shall be deemed revoked
Fan Coil lnstallation
Fire Extinguishing System
Each Euaporative Cooler
lncidental Gas Piping
Fire Damper lnstallation
Each Appliance or Equipmonl B€gulated by
this Code but not sp€cilically lisled abo€
Hood with Duct and Fan (Type ll)
Subtotal
1 20.00 20.00
15.00
15.00
10.00
15.00
15.O0
15.00
90.00
Penalty Fee (when applicable)
Erp.rdoa
ThE permit shall expire by limilalim and b@me null end voad il the work &rhorizod by this
pormit E not commanced within 180 days rrom tha dste ot thb parmil or il work suthoriz€d by thi3
permit ,s Suspendsd or abandoned al any limo alt€r the work ig comrn€ncad ror a poriod ot 180
deys. A nfl psmil ghtll be obtained tiBt boloro $ch work can be recommonced.
A9olbmat O.drifon
I certity that I hava rBd this spplacatiof, and stats that the abds inlormetion B correct. I aoree to
comply with all city ordinanc€a and state laws r€lsting to building con3tuc{ion.8nd h€reby
for iiltpstionaulhorired
purpos6.
.epr6enlstion of lhis city to enler upOn the abovlmentioned
o^";.''''L7'9 Applicant or Agent (Sig
Violation Fee (50.00)
Plan Check 65% of subtotal 58.50 (minimum 20.00)
Receipt No.Pc# 69L7 Date 213
Plan Check (Adjustment)Credit 3.25
lssuance Fee 10.00
TOTAL PERMIT FEE (minimum $35.00)-0-
oArE / A -2A.91 PERMrrNo. 1 3 7 60
eurr-orHco f {ba}ERTFTED By (sie.)PERMTT rssuEo BY (s,q ) - Vlz- >q eL,
APPLICATION AND .a CITY OF SANTA ANA
206 W. 4th Street
667-2738MECHANICAL PERMIT
(TYPEWRITE OR PRINT IN INK)&*APPLICANT FILL IN AREA BELOW
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Oislribulion '1. lnspmtorCopy 2 FileCopy 3 FinancoCopy 4 AppticantCopy
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PIIONE
279-3200
CITY
Nnrnn
Oale
Expirs Vtrilied By (Sig.)
Date Applicant
I ceniry th8t
ALL FEES PAID ON M10865
-2
ol
MECHANICAL INSPECTION RECORDS
Rcmarl<s
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 Root
Evaporative Cooler
Repair, Alteration, Ducts
Fan Coil lnstallation
Gas Piping
Flre Damper
Rough lnspection
Final lnspection
Date lnapcctor Approval
lSlgnatur.,
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Notes