HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (78)a oAPPLICATION AND
PLUMBING PERMIT
(TYPEWRITE OR PRINT IN INK)
CITY OF SANTA ANA
206 W. 4th Street
667-273€N
APPLICANT FILL IN AREA BELOW
@
E-9zo
ool,
m(,(,
s
JOB ADDRESS /! lndustrial E Commercial NO.EACH TOTAL
5.00
'10.00
each plumbing fixture/trap
Dental Unit or Medical Gases
MAILING
STATE/ZIP )G SEWER
Oun r-Buald.r D.drlba
I hereby sltirm lhst I am exompl lrom tho Contracto/s Lrcens Law ,or the lollowing reasm 1Se.
7031 5, Businss and Pror6sions Codo. Any city or county which requires a p€rmit lo construct.
alier. rmprcw. demolish, or reparr any slructura, prid to rls isuanc6, alsrequiresthe applicanl
lor such permil to ,ile a 3igo€d stetemenl lhal he is licensed puBuant to lh€ provitiom ot lhe
Conlractor's Licens Lil (Chepter 9 (commoncing with Seclion 7m0) o, Oivisaon 3 ol th€
Eu3iness and Proro3sims Cods) or thst he is oxempl lhsrolrom 8nd tho balb tor lhe sllegod
exomption. Any violrtion ol Saction 7@1.5 by any applicanl tor a pormil subiect3 the applicant lo
I ciyil penalty ot nol mo.o then tivs hundrod (bll86 (3500):
E S*tionZOal l,asown6rollheproperty.ormyemployGswrthwsgaraslhsirsolocomp€n-
salion, wall do lhs mrt. and lhe 3truclur€ as rcl antandod or otleed ,or sale.
El S*tion 7(x4B l. a3 owner ol the proporly. m oxclusivoly conlreling wilh licffrod
conlracloG lo conslruct the prolftl
Oate
-
Owrer (Sig )
ConlrEton t,.. otily
tfn /,j1d,",r;-L Allt rrT^;-,SONTRACTOR t7/- /7a7PHONE
I
CITY A .
X, y', f y'n r- -u r-,
STATE/ZIP
^qr33es
I he,eby allirm lhsl I 8m licensd undar the provBions ol
ilo(lc To ApellGal:
ll aller makrng lhrs Cfrtrftcaleol Exemplron. you should becomesubtel lo lhe Wdker'sCompen-
satron provisrons ot lhe Labor Code. you must torthwilh comply w[h such provisions or this
permrl shall be dtrmed revoked
Erpardo.r
ThE pormit shall expiro by limilslim and b*omo null and void il tr€ work authoriz€d by lhig
pormit is not commencod wilhin 180 dlyE lrom lhe deto o, lhis p€rmil d il rcrk authorizod by this
permil is suspendod or sblndonod al rny tim erts tho work is cmmnc€d ,or a p€riod ol 180
dey3. A ner pormil shsll bc oblained ,iBl b€rqo $ch wort cln b€ ocommoncad.
AFlc.all D.drilqr
I corliiy lhsl I havo rood lhi! applicalion rnd strls lhal lh€ rbova
3ol lhe
Vlo
Contr8clor (Sig.)
ol Works's
I agrs to
and
ryfr";*
Lfdnse No
Oate
Oate
Expirei
lhis parmil is issued, I shall nol employany
to the Worker's Compenstion Laws ol
which
sub,trt
Applicanl or Agenl
Applicant
Code, and my licens is in lull lorce end
D*lr.tlon
ol consent lo
pensation lnsu.ance Cgtrlied
I hereby allirm that I have a
rn lhe performencoot th€
in any manrer so rs to
Calrlornra
comply with all and stale 186 relaling to
this city to ontar upon the
Dats
-
Applicant (Sig.)
the clty
aulhorized
purpos6
Alt. or Repair of Drainage - Vent Piping
Plan Checi< 65% of subtotal L S - (minimum 20.00)
5-
,/o
10.00
/
/
Subtotal
I -,
lst 100'+Conn.
Wbter Service Ea. 100'
Ea. Add'l Conn.
Over 2"
Ea. Add'l 100'or Frac'tion
Backflow Device 2" or Less
Private Sewage Disp. System
Orer 5
GAS PIPING
Vacuum Breakers 1-5
GAS SERVICE 1 to 4 Outlets
Bepair/All. Drainage or Vent
Ea. Add'l Outlet
Repair or Replace Gas Piping
Temporary Gas Service
MISCELLANEOUS
Water Heater - Electric or Gas
Water Piping Ea. 100'
Rain Water Piping (buried) Ea. 100'
Water Softner
Rain System - Per Drain
lnd. Waste lnterceptor
fool Traps
Deck Drain - &r Drain
15.00
30.00
5.00
s.00
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
s.00
6.00
10.00
10.00
3.00
8.00
5.00
Fee (when applicable)
Violation Fee (50.00)
DatePc#Receipt No.
Plan Check (Adjustment)
lssuance Fee
TOTAL PERMIT FEE (minimum
PERMIT
Lawn Sprinkler
il-Y /toroA- 'o'PERMIT ISSUED BY (Sig.)\x-BUILOING
PERMIT No.(srg IVERI
J*-*- -,,--/ kn.l/1q7o )AiA- Stkt?fl -1-
vALTDATTON (OFFTCE USE ONLY)
(ACCOUNT
'1
1-412)
Drstflbulron I 2. File Cogy 3 Finance Copy 4 Applrcant Copy
cs-61 1
FIXTURES
il
4
/a=o -
Z9-'-
5Y!a
a,
o o
PLUMBING INSPECTION RECORDS
Remarkr
Ground Work (Soil)
Ground Work (Water)
Waler Servic€ (Ground)
Gas Service and Underground
Lawn Sprinklers
Wasle lnterceptor
Pool Traps
Sewer
Rool Drains
Water Heaters
Water Sortner
Bental or Medical Gases
Rough Plumbing
Final Plumbing
Temporary Gas Service
Notes
\'
lnapoctor Appiov!l
(Slgneturo)O!t.
t-liln rr'* Arrl-
u//n //, lrlfI
rfua 2r*P{t
(&zful^lo-
I?4/ro H),^-/
%z/cy,
J.Ar,n,-
-
i L.
APPLTcATToN AND a
MECHANICAL PERMIT
(TYPEWRITE OR PRINT IN INK)
o CITY OF SANTA ANA
206 W. 4th Street
667-2738
APPLICANT FILL IN AREA BELOW 4rL.
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JOA AOOBESS
3708 Santa Fe Village Dr., Unit D
E Residential E lndustrial E Commercial NO.EACH TOTAL
EACH FURNACE INCL. DUCTS AND VENTS
Up to 100,000 BTU 15.00
Orcr 100,000 BTU 20.00
EACH ABSORPTION SYSTEM
100,000 BTU to 1,000,000 BTU 25.00
1,000,001 BTU to 2,000,000 BTU 30.00
EACH COMPRESSOB, BOILER,
OWNER
Sunflower Associates
PHONE
7 t4 I s46-Ort0
MAILING AODRESS
3315 Fairview Rd.c''[osta Mesa
STATE/ZIPcA 92626
Olltt{ulld.t O.dtabo
I hersby Itlirm that I am orffipt lrom the Contracto/s Liconse Lew ,o, tha ,ollowing r8m (Se.
78t.5. Busins3s and Pror6sions Code. Any cily or county which requarB s p€rmit lo cmrltucl.
alter, improve, demolBh. oi ropsii any struclure, prior to ils i33uance. al3o roquire3 lha lpplicant
lor such ptrmil to lilo a sign€d 3trtemonl that he b liconssd purEuant lo lha provi3bns ol lh€
Conlractor's Licms Lrr, (Chepts 9 (@mmoncing with Selion 7mO) ol Oivision 3 ot tho
Busins and Prot€3sions Cod6) or lhet he i3 oxmpl therolrom and the barB ,or lh€ allooed
exemption AnyviolationorS€clionT03l.5bysnyepplicanllorapormilsbisclslhaapplicanlto
I civil p€n8lly ot not more lhan live hundrad dollaB (35m):
E S""f,on 7Ol4A l. as own6r ol the properly. or myemployss with wa96 a thoir solecompen-
sation, will do tho wod(. and lh€ 3lructur6 is nol inlendod or olltrod tor sale.
E S*,ion 70448 l. as ownsr ol tho prcpsny. em exclusryely cmtrrting with lacensod
contreclors to conslrucl lhe proisct.
Oate Owner (Sr9 )
Contrrlon l,!. Only
PHONESteel T. AlC 279-3200
AOORESS
3180 Broken Arrow
CITYNorco 'H76',o
Heat Rrmp Compressor less than 5 HP I 25.00 2s.00
5HPto30HP 25.00
31 to 50 HP 30.00
Orcr 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
Owr 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 r)15.00
I hareby allirm lhat I am liceosed under the provisions r
Pror6sions Cod6. and my lrcense 6 rn tull lde snd
.,"*3(?o-trgztz c,o. c2o
ol Chapltr 9. Orvrsion 3orthe Bujrnqsandleltsc,r. .fLa-
0150127
Each Vent Fan Connected to a Duct 4 15.00 60.00
tlo.tart Coipfi dbo Oadrlbo
I haraby attirm lhst I hevo I cortilicate ot cons6nt to sll-insure. or a erlirieleot Wb.ttr's Com-
ponsation lnsurance. Certiried @py is tilgd wilh the City building departmenl.
Osle 4 90Expires Verified By (Sig.)
Dale f?-2?-*7 Applicsnt
I certify thal rn the pertormanceol tha work lor which this I shell not employ eny
pe6on an any manner I es to be@me subiect to the
Cali,ornaa
Compensation Laws of
Oate Applicanl (Sig.)
ttlollc. To Apdlcit:
ll atltr makrng thrs CertrlcateolEremptron. you sh@ld beomesub,ettotheWorker'sComper
salion provrsrons of the Labor Code. y@ must fonhwilh comply wtth such provistons or thas
Permrl shall be deemed revoked
Fan Coil lnstallation 1 20.00 20.00
Fire System 15.00
Each Evaporative Cooler 15.00
lncidental Gas Piping 10.00
Fire Damper lnstallation 15.00
or by
bul not aboE 15.00
Hood with Duct and Fan (Type ll)15.00
Subtotal
Penalty Fee (when applicable)
Violation Fee (s0.00)
Plan Check 650/0 of subtotal 68.25 (minimum 20.00)
Receipt l.lo.Pc # 69L7 Date 2 3
105.00
Erpkdon
This p€rmil shall sxpire by limitalion 6nd b€come null aod void it th€ work suthori:od by thi3
permit 6 not commGnctd wilhin l@ dsys trom the dato o, thi3 pormil or il work 8uthorized by this
permil is suspond€d or rbendonod Et any timo arls lhe worh is cmmncod lor a poriod o, rA)
drys. A nil permil shall be obtainod li'8t baloro such work cln be racommenced.
ADoLcfral D.Crdo.r
o","12@fl Applrcant or Agent
Plan Check (Adiustment)Credit 13.00
lssuance Fee 10.00
' rorAL PERMTT FEE (minimum $35.00)-0-
DATE
'
a.4 - Eq PERMTT No. 1,37 62
PERMIT ISSUED 8Y (Srg )'/t^/h
VALIDATION (OFFICE USE ONLY)
(ACCOUNT rl r-4r2)ALL FEES PAID ON M10865 :n12-
Orslribulion I lnspectoi Copy 2. Ftle Copy 3. Financo Copy 4. Applicant Copy
cs-618
o"r"l7Z8:fl conrracror (sie
I certrty
comply
thsl I have roed this Epplicalion and slale that the abova inttrmalion is corr61. I
authorized repr6entstion ol thig cily lo 6ntd upon
purpos6.
inspelion
gg$,lm 5t/ af,{F,F,ED By (sig )c,+,-
MEctNrcAL rNSPEcroN *=.to,
Remarks
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 Roof
Evaporative Cooler
Repair, Alteration, Ducts
Fan Coil lnstallation
Gas Piping
Fire Damper
Rough lnspection
Final lnspection
Dato lnspector Approval
(Signaturcl
/%_
lrA
q.
4q4vrr
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Notes