HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (79)o oAPPLICATION AND
PLUMBING PERMIT
(TYPEWRITE OR PRINT IN INK)
CITY OF SANTA ANA
206 W. 4th Street
667-2738
APPLICANT FILL IN AREA BELOW 4
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STATE/ZIP2bz a
PHONE
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MAILI
CITY
il 5.00
10.00
NO.EACH TOTAL
5
D lndustrial ll Commercial
each plumbing fixture/trap
Dental Unit or Medical Gases
15.00
30.00
5.00
5.00
SEWER
1 st 1 00' + Conn.
Ea. Add'l Conn.
Ea. Add'l 100'or Fraction
Private Sewage Disp. System
PIPING
GAS SERVICE 1 to 4 Outlets 5.00 s-
Ea. Add'l Outlet 1.00
Repair or Replace Gas Piping 5.00
Orn r-Butld.r D.drdbil
I harsby Itlirm that I !m sxempl lrom lhe Conlractor's Licen3o Law lor the rollowing rgason (Sac.
7qjl.5. Busrness end Proressaons Code. Any caty or county which roquirss a pormil lo conslruct.
aller. improve. d€moliEh. or replir lny 3lrucluro. prior lo rts r$uance. allo roquirag lh€ applicanl
tor sch pormil lo ,lle a signod 3tllamoil thal hs B licon3ed pursuant to lho provisions ot lho
Contrscttr's Licens Law (Chlplor 9 (commencing with Saction 7CD0) ot DivBion 3 ot lho
8u3inN and ProlesEron3 Code) or lhst ho is axmpl thererrom and the basis ,or lho dbgod
exmplion. Any yiolalion ol S€cllon 7031.5 by any applicrnl tor 6 pormit 3ubiecB tho lgplicanl to
8 civil pemlty ol nol more lhan five hundrod dollaB (t5@):
E SoctionTO44A l,r!o*n6rorlheproporly.dmyemplol€Bwilhwag€saslheir3olacompon-
3ation, wrll do the wort. and tho strrclure is nol rntend€d or ottorod lq s!le.
E S."fion 7Oa4B l, as owner o, lhe proporly. am axclusivoly conlrrcting with licsnsad
conlracloB lo con3lruct th€ proisct.
Oaie Owrer (Sig )
Cont?rto[ t rc Only
W)) -,' Lz /1J,(t Lzafi-,,-.t 67/-oza7
PHONE
ADDRESS
STATE/ZIP
I he.6by altirm that I am licensad undor lhe provisDns of Chapld 9,3of the
Code and etlecl.Probssrons
Vfl,A"
Conlractor (Sig )
license is
Class
Notc. To Appllcrl:
ll atler makrng lhrs Cefirficate of Eremplron. you should become subl6t to the Wo.ke/s Compen-
salron provrsrons ot ll€ Labor Code. you must lorthwrth comply wrth such provisions or this
permrt shall be deemed revoked
Brlrdoi
This permit shall expiro by limitltion rnd bocome null and void il the wort eulhorizcd by thi3
pormit is not commonced within 'lE0 d8ys lrom th€ dato ot thi! parmit or il work aultro(i2€d by this
permit i3 3uSponded o abandoned at any time attei tha wort is cornmnced lor a poriod ot 18O
A nw psmit shall be obtain€d tict b€rore such work can bo ncommonced
Aplcrnlt Dodrdor
I csniry thal I het/€ read lhB spplicalion snd !i.to thel the sbov6 intomdiql
ol Worker's
I 89r* to
tn
Applicent or Agonl
O8te Applicant (Sig )
Oclrallon
subisct
Applicsnt (SiO.)
ofthe
in eny manner I a to
Calilornra
wrth all and slate building
lhethrs ciy lo
I hereby attrrm thel I hsva I ol consont to selt-insure-
pensatron lnsurance.copy rs liled with lh€ City
Verilied
this pormil rs issued. I shsll notemployany
to the Worker's Comp€nsalion Lils ol
Oate
Exprres
Ah. or Repair of Drainage - Vent Piping
Temporary Gas Service 100.00
10.00
Subtotal
Water Heater - Electric or Gas
We[er Service Ea. 100'
Water Piping Ea. 100'
Rain Water Piping (buried) Ea. 100'
Backtlow Device 2" or Less
Water Softner
Over 5
Vacuum Breakers 1-5
Lawn Sprinkler
Rain System - Per Drain
lnd. Waste lnlerceptor
Pool Traps
Deck Drain System - Fer Drain
Repair/Alt.or Vent
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
Fee (when applicable)
Violation Fee
Plan Check 650/o of subtotal
Pc#Receipt No
Plan Check (Adjustment)
lssuance Fee
TOTAL PERMIT FEE
(s0.00)
Date
(minimum 20.00)
(minimum
PERMIT
Over 2
DATE S'/ 7.
)l,0r-BUILOING
PERMIT No ilhaC (srg )PERMIT ISSUED BY (Sig.)
L-- -.-,)-2 d-vt. tuil?7.> 1l10/tL .<.ll.ggdJj -
,vALroATroN (oFFrcE usE oNLY)
(ACCOUNT rr r-4r2)
O'st 'tl Copy 2 Frle Copy 3 Frnance Copy 4 Applrcanl Copy
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PLUMBING INSPECTION RECORDS
Rom!rk!
Ground Work (Soil)
Ground Work (Waleo
Water Service (Ground)
Gas Service and Underground
Lawn Sprinklers
Waste lnl€rceptor
Pool Traps
Sewer
Rool Drains
Water Heal€rs
Waler Soltner
Rental or Medical Gases
Rough Plumbing
Final Plumbing
Temporary Gas Service
Notes
Ortc Intp.ctoi App.ov.l
(Sl0nrturc)
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APPLICATION AND a o CITY OF SANTA ANA
206 w. 4th Street
667-2738MECHANICAL PERMIT
(TYPEWRITE OR PRINT IN INK)
APPLICANT FILL IN AREA BELOW h,-
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)P Residential E lndustrial D Commercial NO.EACH TOTAL
3708 Santa Fe Vlllage Dr., Unlt E
JOB ADDFESS
EACH FURNACE INCL. DUCTS ANO VENTS
Up to 100,000 BTU 15.00
Over 100,000 BTU 20.00
EACH ABSORPTION SYSTEM
Sunfl-ower Associates 7 14 I s46-OLr
MAILING ADORESS
STATE/ZIPcA 92626
OWNER PHONE
3315 Fairview Rd.
Costa Mesa 100,000 BTU to 1,000,000 BTU 25.00
1,000,001 BTU to 2,000,000 BTU 30.00
EACH COMPRESSOR, BOILER,HEAT
Oiln atrtld.?D.drtbr
I hereby attirm lhat I am oxompt lrom th€ Cdlraclo/s Lic6ns Law lor ths lollowing roaon (S€c.
708 1 . 5. EusinB and Prot6sions Code Any cily or @unly which roquir6 8 pormil to conEtruc-|,
aller. improva. dgmolbh, or rgpair any strucluro. prior lo its isulnce. also roquireS lha appllcanl
fo. such permil lo tile a sign€d slatamont that he is licmlod puBuanl to tho provisions ot th€
Contractor's Licmle Le (Chaplor 0 (commencing wilh S€clion 7@0) ol DivEion 3 ot lha
Eusan6s and Protcaim3 Codo) or lhal he is exompl lharetrom and the basis lor tha allsgod
exmption. Any violslion of S€ction 7001.5 by lny spplicrnt lor a rErmil subjecls tho appliclnt to
8 civil panally ol not mor6 then five hundred dollac (35m)i
E Section zoga l, a8 ownor ot the proparly, or myomployGwith wsgB Glheirsole compor
sstion. will do the wort. and the 3tructure is not intsndad or oltsed tor sale.
E S*tion 70448 l. a owns o, lhe prcperty. m 6xclusiv6ly contr&ting with licansad
contractors to construct the proirct.
Date Ownor (Sig I
Cmlilclon t,.. Only
CONTRACTOR
Steel- T. A/C 279-3200
PHONE
Heat Pump Compressor less than 5 HP
EACH AIR HANDLING UNIT OR VAV BOX
Outdoor Dual Packaged Healing or Cooling
Repair, Alt. or Add. to any Heating/Cooling sys.
25 .00125.00
40.00
25.00
30.00
5HPto30HP
31 to 50 HP
Over 50 HP
Air Handling less than 2,000 CFM
2,000 CFM to 10,000 CFM
Over 10,000 CFM
MISCELLANEOUS
Floor Furnace
Heater; Suspended, Wall or Unit
Com'l Dryer Vents
Decoratiw Fireplace (Wood or Gas)
Hood with Duct and Fan (Type l)
10.00
10.00
25.00
15.00
15.00
10.00
15.00
15.00
15.00
I hereby alrirm lhal I 8m licensed under tho provEions of Chrpter 9. Oivision 3
Prol6sions Code, md mv hcgnse rs
.,"*3#o---i5oil u,*,
onrll:L? 8? conrra,or
Broken Arrow
Norco
AODRESS
3 180
CITY
in lull force and etl6ct.
orthe Bu3ir3and./L6'-
STATE/ZIP
9r760
Each Vent Fan Connected to a Duct 4 15.00 60.00
1 20.00 20.00
15.00
10.00
15.00
15.O0
15.00
Fire Extinguishing System
Each Evaporatile Cooler
Firc Damper lnstallation
Each Appliance or Equipmenl Ragulatad by
!!!q Code but not specifically lisled abore
Hood with Ducl and Fan (Type ll)
Subtotal
Fan Coil lnstallation
lncidental Gas Piping
105.00
Uo.f m Con?.mtbn Oaarrdbo
I hdaby attirm thal I have a corliliots ol consl to sell-insure. or a cerlilacrlo ol Wortd's Com-
p€ruation lnsurance. Co,lilisd @py is liled with the Cily building inspaction deprrlmonl.
peBon an any manner so as lo becoma subiecl to the Worker's Compensation Lils ol
Calilornia
t{otlc. Yo A9pllcnl:
ll alts makrng lhrs Cerlricaleof Exemptron, you should becomesubjet to the Worke/s Comper
salaon provrsrons ol the Labor Code, you must tonhw[h comply with such provisions or thrs
permrl shall be demed revoked
o^"iZ:U-fr Appricanr
I cerlity thal in lho p€rlormancoortha
(si9.
work lor which this
Dale Applicant (Si9.)
I shall rcl amploy any
Pil?", -{90 venried By (s,s )
Penalty Fee (when applicable)
Violation Fee (s0.0o)
Plan Check 650/o of subtotal 68.25 (minimum 20.00)
Receipt No.Pc * 6917 Date 213
Plan Check (Adjustment)Credit Ii-00
lssuance Fee 10.00
TOTAL PERMIT FEE (minimum $35.00)-0-
Erpkibn
This permit shall expiio by limitatim and bsome null and void i, th6 wort authorizod by thig
permit is rcl @mmsncod within lSOdey3lrom the dale ol thi3 permit or ilwork authorited by this
tBrmit is suspendod or absdonad et any timo atts the work is cmmncod tor a p€riod ot 180
days. A nfl ptrmit shtll bo obtainod lirst bolore such wqk can bo reommgncod.
ArglcJrl'. Mrdo.r
I cartity that I havo road this applicslion and stste thal ths above inlormation i8 corr€cl. I 4re to
comply with all cily ordimnc€s and state laws retating to buitding cmstuc'tbn, and heroby
reprGenlaton of this city to enttr utDn lhe abovFmfftion6d
r12J+Oale Applacant or Agenl (Sig.)
lor insp*timaulhorized
purpos6
DArErA.>-q-81 PERMIT NO.13763
831.,?i$.51
q ) k",,,. o ",,,,n,o,+^>.ly S-qPERMIT ISSUEO BY (Srg )
USE ONLY)
1-412)ALL FEE oN M 10865ID
Drstnbulron 1 lnspector Copy 2 File Copy 3 Frnance Copy 4 Applrcant Copy
10.00
15.00
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
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
Date lnspcctor Approval
(Signaturel
{z/ro
f/"7-frl,ttzu-/
Notes
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