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Kidenriar I lnduslrial I Commercaal NO.EACH TOTAL
<br />Res. Hotels, Motels, Apt. Sq. Ft..03
<br />Gar. or Carports Sq. Ft 02
<br />Receptacles .50
<br />J btLT--JOB AODRESS?700
<br />OWNFFa/
<br />[,4AILING ADDRESS/a/
<br />o/
<br />Ce,7+qA /
<br />CITY
<br />frcL ' +/g -6
<br />Switches .50
<br />Fixtures .50
<br />Air Conditioners
<br />Each
<br />20.00
<br />Approved Factory Wired Unit
<br />LiSI 5.00
<br />Busways, special raceways, under lloor
<br />duct, trolley or plug-in busways ea. 1 10' or
<br />lraction thereof
<br />5.00
<br />Fire Signaling System. Minimum fee
<br />Outlet, smoke or heat sensor
<br />10.00
<br />.50
<br />Lighting Standards with One Lamp
<br />Each Add l fixture on same standard
<br />5.00
<br />1.00
<br />I
<br />0wner dJilcler Declaration
<br />Mainlenance Permit (annual)50.00
<br />Service Meters
<br />Up to 400 amps, per meter
<br />Over 400 amps, per meter
<br />Over 1200 amps, per meter
<br />15.00
<br />35.00
<br />75.00
<br />Signs and high polential gas tube lighting 15.00
<br />Swimming pools, fountains, spas 35.00 I I
<br />Switchboard. motor control center or sub-
<br />panels
<br />Each
<br />15.00
<br />Temporary construction meter service
<br />pole
<br />Each distribution pole
<br />25.00
<br />5.00 4S
<br />Temporary construction lighting
<br />500 lamps or less
<br />Over 500 lamps
<br />2 .00
<br />4 .00
<br />Time clock or photo electric cell 3.00
<br />POWER APPARATUS: Generators,
<br />motors, transformers, reclifiers, industrial
<br />heating, cooking, or baking equipment
<br />and other apparatus as follows:
<br />Up to and including 1 HR KW KVA
<br />Over 1 and notover 10 HP, KW KVA
<br />Over 10 and not over 50 HP, KW KVA
<br />Over 50 and not over 100 HP, KW KVA
<br />Over 100 and not over 500 HP, KW KVA
<br />Orcr 500 HP, KW KVA
<br />2.00
<br />5.00
<br />10.00
<br />20.00
<br />30.00
<br />40.00
<br />v,',r,,,iR! tsa)il-r t'rrrrtto .,tr'f,furo/ M-
<br />I hsreby alfrrm lhat I am lEensd onde, the provisions of Chapter 9, Orvrsion 3 ol lhe Business and
<br />Workers Compensation Doclaration
<br />cerlricate ol consent lo sell-rnsure. or a certr{rcatr ol Worker's Compen
<br />copy rs Irled wrlh lhe Crly bu,ldrng rnspectron deparlftlenl
<br />Notice -fo Apl)lica,rtl
<br />Contractor Use Only
<br />Iprclrrt
<br />L1A-/Eq7
<br />STA T t rZlP
<br />72BoG
<br />,""^"o_o_/_2_s_hg_ilv@_
<br />Prolcssror,s Code
<br />"{s3,
<br />-t
<br />o"," tL16
<br />ri lurS force effecrd
<br />oo3y7I.!,,"
<br />Contrac or I1
<br />a,
<br />{Stg
<br />I h|rrir\ ,rll ,,,r rl,Jl I tr.,!,r.1
<br />srlr()rr lr ,ilr., '( (. Cr'rl1l ed
<br />r)rr.r .r,r,. ///Sq
<br />,,_ L1_rg,trl
<br />Subtotal
<br />Penalty Fee (when applicable)
<br />(s0 00)Violation Fee
<br />Plan Check 65"/o of subtotal (minimum 20.00)
<br />Receipt No Pc#Date
<br />Plan Check (AdJustment)
<br />lssuance Fee 10.00
<br />TOTAL PERMIT FEE (minimum $35.00)3 s-_-
<br />Expiration
<br />Applicant's Declaration
<br />, ,t., ,,, ,1.
<br />I 1' i:' ' r'r i I I i '" I rr rl' 'I'
<br />t(48<(Applrcant or Agenr (Dale
<br />PERMIT NO.398DATE / -p -a?
<br />VERIFIED BY {Srg )PERMIT ISSUED BY lsrs )Y&.>j
<br />+ru
<br />\G--BUILDING
<br />PERMIT No 96q
<br />VALIDATION (OFFICE USE ONLY)
<br />IACCOUNT #11-413t
<br />APPLICATION AND
<br />ELECTRICAL PERMIT
<br />(IYPIWRITF OR PRIN I IN INK)
<br />o e CITY OF SANTA ANA
<br />206 W. 4th St.
<br />667 -2738 trfu
<br />APPLICANT FILL IN AREA BELOW
<br />oCFozo
<br />oo
<br />Distribution: 1, lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy av4$CE
<br />CITY
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<br />2s-
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