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APPLTCATTON AND o <br />ELECTRICAL PERMIT <br />YPFtnrii TF ltit PUrNI ,_ \(l <br />CITY OF SANTA ANA <br />206 W 4rh Sr. <br />667 -2738 fbl <br />o <br />APPLICANT FILL IN AREA BELOW <br />e <br />(, <br />za <br />aau <br />Ut <br />TOTALNO <br />03 <br />EACH <br />Hotels, Motels, Apt. Sq. Ft. <br />I I lndustrial iCommerod <br />-6-ar. or carports sq. Ft a2 <br />Receptacles 50 <br />JOBADO9ESS <br />s/x- bt74 <br />"V')7oG'Y-/a-,/4-a-?/L2- <br />Sw(ches 50 <br />Fixtures 50 <br />Arr Condiloners <br />Each <br />20.00 t{ <br />500 <br />Appro\€d Faclory Wired Unil <br />Busways, special raceways, under lloor <br />duct, trolley or plug-in busways ea. 1 10' or <br />fraction thereol <br />500 <br />Fire Signahng Syslem Mnrmum lee <br />Outlet. smoke or heat sensor <br />10 00 <br />50 <br />Lighling Standards with One Lamp <br />Each Add'l luture on same standard <br />00 <br />00 <br />5 <br />1 <br />Owner Au lder Declaralion <br />;,",1/2,ff' <br />rnrandedor oller€d lor ere <br />l-.' <br />Maintenance Permil (annual)50.00 <br />Service Meters <br />Up lo 400 amps. per meter <br />Over 4O0 amps. per meler <br />Over 1200 amps, per meter <br />15.00 <br />35.00 <br />75.00 <br />Signs and high potenlial gas lube lighting 15.00 <br />Swmming pools. fountarns, spas 35.00 <br />r5.00 <br />Tempf rary construclion meter setuice <br />pole <br />Each distribution pole <br />25.00 <br />5.00 <br />Temporary constructjon lighling <br />500 lamps or less <br />O\er 500 lamps <br />2.t)o <br />4.00 <br />Time clock or photo eleclric cell 3.00 <br />POWER APPARATUS: Generalors. <br />molors. transformeas, rectifiers, industrial <br />heating, cooking, or bakng equrpmenl <br />and other apparalus as follows: <br />Up lo and including 1 HE KW KVA <br />Over 1 and nol oler 10 HP, KW KVA <br />Over 10 and not over 50 HP, KW KVA <br />Over 50 and nol over 100 HP KW KVA <br />Over 100 and not o!€r 500 He KW KVA <br />Over 500 HP, KW, KVA <br />2.@ <br />5.00 <br />r 0.00 <br />20.00 <br />30.00 <br />40.00 <br />lherebya,l'rm thal l.m lce.sF.l,rnderrhe provsonsol Chapter9. D'v's,on 3 o, lhe B!s'ness and <br />Proiesso,sCod€, and mv lrc€n* s 'n l!11 lor.e and etls.l <br />Workers Compensarron Declararion <br />1,, atre, m.t,nq rh'sCerril'care oi Eremp!on, you should become suble.l ro lhe Worker sCompeo. <br />el on p'ov eonsol ihe Labor code, yo! mu$ lorrhw rh compry wrh such p.ov's'onsor lhrs pe.m'l <br />shall be deemed revoked <br />Conrracror use Only <br />ADDR!SS <br />CIIY <br />\+xJ.--,Subtola <br />Penalty Fee (when applicable) <br />(s0.00)Violation Fee <br />Plan Check 65./" of subtotal (minimum 20.00) <br />Receipt No Pc#Date <br />flan Check (Adjustmen0 <br />lssuance Fee 10 00 <br />TOTAL PERMIT FEE (minimum S35.00),J-- <br />Erpirrrton <br />Applicanl's Oeclaralion <br />c6rv wm a clly ordn.nces and slale laws rslatno to b <br />)ze.ep,e*^6nv6sot th6cryroenrer Lpo.lheabove <br />//ftfi <br />oarc //-2-2 -PERMIT NO,99 <br />5/, FAf*,,,o"",,,n <br />OSTS <br />T4-PEBMII TSSLIED BY {SE I ,\Y <br />ttS.mll/gyB9 11:51flt 413 <br />VALIDAIION (OFFICE USE ONLYI <br />Distribulion: l.lnspectorCopy 2 FileCopy 3. FinanceCopy 4. Applicant Copy c s .613 <br />n <br />Swilchboard. motor conlrcl center or sub- <br />panels <br />Each <br />r;r 1, , !,r.,,1?,:r <br />;t,qt: 'ru/u/