HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (84)I Resaentiat E lndustrial E Commercial NO.EACH TOTALJOe aoox€ss31 to EAN-IA f€ UILLAGC 9R.D+
FIXTURESOWNER
Solr$tOWcr AS'SOC Stl6- Ot t O
PHONE
each plumbing lixture/kap \\5.00 55-
Dental Unit or Medical Gases 10.0033\ S .elrnuicr^l B.D
MAILING ADOHESS
SEWERCITYGC6-TA NtgA 'ifi''{,c-arc
Orm.r-&dl(br O.drtbn
I hereby attirm thal I am ermpl lrom the Conlracto/s Licmta Law lor ths ,ollowing ro8on (S€c.
7031 5, Businoss and Prol6sion3 Cod6. Any city or county which requires a p€rmit to conslrucl.
alter, amprovs. d€molbh. or rapair eny slruclure. prior to it3 isuanca. also roquireS lhe apdicant
,or such p€rmit to ,ile a sagnod slatemenl lhal h6 i3 licansod puBuant lo lhe prcvisiom ol lhe
Contractor's Licens Law (Chaplar I (commencing wilh S€ction 7@) ot Oivision 3 ot tho
Business and Pror6sions Crdo) or tMt he is sxompt th€ialrom end the b8is ,or tho alleged
exmpton Anyviolst,onotSoc{ionTO3l.5byanyappliclnllorapermitsbiocl!lheepplicanlto
t civil penalty o, not more than live hundr€d dollars (ts(x)):
E S*tion Zolll l. as flner ol the property. or myemplorr€swithwag€sas thoirsolecompon-
calion, wrll do lho mrt. and lhg strt clure is nol inlendod or orlared lor sale.
E S."tion 70448 l. as ownsr ot tha piop6ny, am erclusively conlrrcting with licansod
conlracto.s lo conslruct the prolel.
Oale
-
Owner (Srq.)
5.00
1st 100'+Conn.
Waler Heater - Electric or Gas
Ea. Add'l Conn.
MISCELLANEOUS
Ea. Add'| 100' or Fraction
Temporary Gas Service
Private Sewage Disp. System
PIPING
GAS SERVICE 1 to 4 Outlets
Ea. Add'l Outlet
Repair or Replace Gas
15.00
30.00
5.00
5.00
5.00
100.00
1.00
5.00
Conlrdoil t .. Only
CONTRACTOR
ln F CltAtA L kL SnLt ca.rl<ttl
PHONE
/ Lta -o1o1
lP-lfl AexteL Lv€
IAOORESS
CITY ltrr f Lst Ng'.€ cA ^ 42i9oSTATE/ZIP
I hereby alrirm that I 8m licensod undet
Conlrector
tnCode, and my license
,rac".*-erbnDct abn
I hereby slrrrm thSl I hgve rt€rlilr@te ol @nsenl to slf-rnsure, o,
subiecl to the Worker's Compenstion Laws ol
tlo0c. To ApP0c.tt:
ll6fter making lhis CtrtrricaleolExemplion. youshould b€comsubiEllo theWdk6/sComp€ft
sll|on provisrons ot the L8bor Code. y@ must lorthwith comply wlth such prfl6i6s d this
permit shell be dsmed r*oked
with the City
permil is issued. I shall nol employ any
ot Wo,ker's
p€Gon in any mnmr s 8!t
Calitornra
Oate
-
Appli6nt (Srg.)
Att. or Repair of Drainage - Vent Piping
l
I
10.00
10.00
8.00
10.00
4.00
5.00
10.00
1.00
6.00
5.00
10.00
10.00
8.00
3.00
5.00
Water Piping Ea. 100'
Water Service Ea. 100'
Rain Water Piping (buried) Ea. 100'
Over 2"
Water Soltner
Backflow Device 2" or Less
Oler5
Lawn Sprinkler
Vacuum Breakers 1-5
Rain System - Per Drain
Repair/Alt. Drainage or Vent
lnd.' Wbste lnterceptor
Deck Drain System - Per Drain
Pool Traps
Subtotal
TOTAL PERMIT FEE
Fenalty Fee (when applicable)
lssuance Fee
Violation Fee
Plan Check 65% of subtotal
#Receipt No.
Plan Check
(50.00)
(minimum 20.00)gL
(o oate
ErpHdt
This p€rmit shall axpire by limatetim and b€come null and void it the rcrk authtrizod by this
permil is nol @mm€ncd within 180 days lrom lh6 date ol this pormit or il rcrk au0rtrizsd by this
p€rmil is suspend€d or rbandonod ,t any trmo arlr lho worl is cmmncod tor a FErbd ol 18[)
days. A nfl ptrm,t sholl be obtsinod tiBt b€tor6 such wort can be @mmncod.
I certiry that I hava r6d thr rpp,,-,ffi:;ffir*,
and
Oate Applicant oi Agent
I ag.e€ to
comply with ell city ordinancs and state lews to building
lhis city lo entsraulhorized
pu.pos6
BHAlli$" <?6 O ,,.,8Y PEBMIT ISSU€O BY (Sig
Au- fecs PD
,1 t-ata
Y)
11
inanca Copy i(
-
APPLICATION AND
PLUMBING PERMIT
(TYPEWRITE OR PRINT IN INK)
'}
o
CITY OF SANTA ANA
206 W. 4th Street
667-273a /W
APPLICANT FILL IN AREA BELOW
(!g-Izo
ool,
ma(t
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lo
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Oistribution l. ln3pector Copy 2. Fil6 Copy
cs-61 1
I t*
<e
I
(minimuq.l3!.00)
-Ss-
-@-
-roE-
tcos
looo-5
I )lIt
ffi
_/
o t
PLUMBING IN ON RECORDS
Rom!.kr
Ground Work (Soil)
Ground work (Waler)
Water Service (Ground)
Gas Service and Underground
Lawn Sprinklers
Wasle lnterceptor
Pool Traps
Sewer
Rool Drains
Water Healers
Waler Soltner
Renlal or Medical Gases
Rough Plumbing
Final Plumbing
Temporary Gas Service
*o'"' /zr/h - bLti@
I
O.t.ln.p.ctor Approv.l
(8lgneturc)
t'/./*1 //i.P.*
ilth 2-hrf
/t
/r,/q a.ud
a /
,6r*.-/htorr-
6/q/tu Ptf//
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APPLTCATION AND I
MECHANICAL PERMIT
(TYPEWRITE OR PRINT IN INK)
t CITY OF SANTA ANA
206 W. 4th Street
667-2738 W
APPLICANT FILL IN AREA BELOW
q,grIzo
oof,,
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Distflbution 1 lnspeclor Copy 2. File Copy 3 Finan€a Copy 4. Applicent Copy
3710 Santa Fe Vlll-age Dr., Unit D
JOB AODRESS
lower Associates
"^5'StfT"trview Rd.
"''[osta Mesa
Orn -!rr[d., O.clrtloo
I h€rsby altirm thrt I am srdnpt lrom tho Contrec'to/s Licons Law lorthe lollowing re.son (Sec.
7@l 5, Bu3in6s and Por6sims Codo. Any city or county which r€quiros I p€rmil lo construcl,
alter. improve. demolish. or ropair any struclura. prior to ils issuance. also roquires tho lpplicsnl
fo, such pormit lo lile a signod stltGmsnl lh8t ho b licmlod purluant lo th€ provi3ions o, lhc
Conlraclor's Licmse Lar (Chapl6r I (commencing with Soction 7m0) o, Oivirion 3 ot lh6
Business 8nd ProtGions Codo) or thal ho ir exempl tharelrom and lhe blsis ror lhe alog€d
oxemption. Any violetion o, S€clion 7031.5 by any applicant lor a pdmit subiecls the applicsnt to
s civil penalty of nol more lhan lave hundrod (bllers (3500):
ES""tion7(f4A l.asowndollheproparty,ormyemployswithwag€3esthearsolecompoft
3ation, will do the work, and tha 3lruclur6 is not intgnd€d or ottorod lor g6le.
E S*tion 70448 l, I owner ol the pop6rty. em exclusively conlr*ting wifh licsnled
@nlractors to conslrucl lhe prcjocl.
Dale
-
Owm. (Sig.)
ConlTatoil l..o Only
3180 Broken Arrow
CITY STATE/ZIP
9t760
CONTRACTOR
C
AOORESS
el T
I heroby alrirm that I am licensod under th€ provisions otCheptar g Oivi3ion 3oltheBugnesgri,
Prote3sions Cods. and my licanso is in lull ,orc6 and etfacl. .4Zb/
orrcll'tlfi conrraaor (s.s )
c20 0150127..J?./"90 5507 1 7",*"
EACH FURNACE INCL. OUCTS AND VENTS
Heat Pump Compressor less than 5 HP
EACH AIR HANDLING UNIT OR VAV BOX
Repai( Alt. or Add. lo any Heating/Cooling sys.
Range Hood with Duct and Fan (Type l)
20.00
NO.EACH TOTAL
1
Up to 100,000 BTU
Otaer 100,000 BTU
EACH ABSORPTION SYSTEM
'100,000 BTU to 1,000,000 BTU
1,000,001 BTU to 2,000,000 BTU
EACH COMPRESSOR, BOILER,
5HPto30HP
31 to 50 HP
Over 50 HP
Air Handling less than 2,000 CFM
2,000 CFM to 10,000 CFM
Owr 10,000 CFM
MISCELLANEOUS
Outdoor Dual Packaged Healing or
Floor Furnace
Heater; Suspended, Wall or Unit
Com'l Dryer Vents
Decoratile Fireplace (Wood or Gas)
Each Vent Fan Connec.ted to a Duct
Fan Coil lnstallation
15.00
20.00
25.00
30.00
25.00
40.00
25.00
30.00
10.00
10.00
10.00
25.00
20.00
15.00
15.00
15.00
15.00
15.00
10.00
15.00
Residsntial !lndustrial nCommercial
105 .00
tlo*.n CorD.lrdbn O.clrtbo
I hareby arlirm lhal I have a cortiliota o, @nsmt to self-insuro. or 8 certiticato ol Workr'9 Com-
pensation lnsurenc€ Cstified @py is lil€d with ths City brrilding inspection dcpsrtmont.
I certity thal in lhe fprlormanco of the work rorwhich this
peBon in any manner so rs lo bocomg subioct to tho
Calitomia
tlolb. To Appilcnl:
lt 6fttr m8king this C€rtiticatgolExomption. you Bhoutd b€come3ubisct to theWdke/sCompor
aalion provisions ol th€ Lrbor Code. you mBt lorthwith comply wilh such pr@isions o, thi8
permil shsll b€ deemad ravokod.
orr" t7414 Applicanl
Oate
-
Appticsnt (Sig.)
3i;?". 4/90 veriried By (sis )
Hood with Ducl and Fan (Type ll)15.00
by
abow
Fire System
Each Evaporatiw Cooler
lncidental Gas Piping
Fire Damper lnstallation
or
but nol
15.00
15.00
15.00
10.00
Subtotal
Penalty Fee (when applicable)
Violation Fee (s0.00)
Plan Check 65% ot subtotal 68. 25 (minimum ZO.OO)
Receipt No.pc # 6917 Date 2l I
Plan Check (Adjustment)Credit 13.00
lssuance Fee 10.00
TOTAL PERMIT FEE \1]ninimu]n $3s.oo)-0-
Erpl?.tbn
This pormit shall erpiro by limitetion and b€come null end void it the work 8uthdi26d by this
parmat b not commonc.d *ilhin 1@days trom the dats ol thls p€rmit or it work authoriz€d by this
fErmil is susp€ndod or abandoned at any tim6 atls lh€ work is commnced tor a period o, IEO
deys A nfl pormit shall be obl8insd li6t b€toro such wdk can bo rsommof,cod.
ApDllc.nl'. D.dribn
I certity thal I hsve read this application 8nd stste that the above inlormation is correct. I agroa to
comply with all city ordinancss and stete taws,eletino to buitding cmstuclion. and heroby
.uthorized reprmtstbn ot lhis cily to enl6r upon thG
purpoS€3.
o"6t24?-$- Appri*nr or Ae€nr (sis.)
inslElionabov*mmtoned property lor
."Jr -tDATE NO.
BUILOING
PERMIT No FIEO BY (Sig,)r-!r,YtPERMIT ISSUEO BY (SIg )
USE ONLY)
(ACCOUNT ALL FEES PAID ON M 108651-4'2l
cs-6r8
l"1T[/sao-or rc
l"tff'9'zozo
I Z). UU
4 bU. UU
15.OO
MEctNrcAL rNSPEcroN *r.t*
Remerks
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, Alleration, Ducts
Fan Coil lnstallation
Gas Piping
Fire Damper
Rough lnspection
Final lnspection
Dsto lnrpcctor Approval
lSlgnaturel
4b-
t/vlq ^luY
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