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I Resrdential : lnduslrial ! Commercral <br />| <br />," <br />I <br />EA.H I rorAL <br />Res. Hotels, Motels, Apt. Sq. Ft .03 <br />Gar. or Carports Sq. Ft..02 <br />Receptacles .50 <br />:^,13 o 5"**- .r,- y,-/-4r;,;!:, . <br />i,kk"* a4-44-t --L ,iyn- o//D <br />,p*3 t 5 7o"n-r-',*l *ro, <br />Od-Z- k-o,- A- ? at z 4-Switches .50 <br />Fixtures .50 <br />Air Conditioners <br />Each <br />20 00 <br />Approwd Factory Wired Unit <br />List <br />Busways, special raceways, under floor <br />duct, trolley or plug-in busways ea. 110'or <br />fraction thereol <br />500 <br />naling System. Mrnrmum lee <br />smoke or heat sensor <br />Fire Sig <br />Outlet. <br />10.00 <br />.50 <br />Lighting Standards with One Lamp <br />Each Add'l fixture on same slandard <br />s.00 <br />1.00 <br />C)wrret Briilclor Der:laratiorr <br />Maintenance Permit (annual)50.00 <br />Service Meters <br />Up to 400 amps, per meter <br />Over 400 amps, per meter <br />Oveil1200 amps, per meter <br />15.00 <br />35.00 <br />75.00 <br />Signs and high potential gas tube lighting 15.00 <br />2 35.00 7D. dO <br />Switchboard. motor control cenler 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 <br />,1ffi4 Gt2:x9o',:'"ontY ''^.y{z'*t,gffl -214 <br />#-+rz'z <br />,,rArL 1,' ?*z adw14J4z_ <br />I am llcenscrl [nder the provrsrons of Chapter 9, Drvrsron 3 of lhe <br />I <br />cl'T <br />"*'r):) <br />,,,affi/ olll glf)U?f,La"---' <br />o €o.?>c <br />I herebv al,rrm <br />Ca. <br />Temporary construction lighting <br />500 lamps or less <br />Over 500 lamps <br />2.O0 <br />4.00 <br />Time clock or photo electnc cell 3.00 <br />POWER APPARATUS: GeneTaIoTS, <br />motors, transformers, rectif iers, industrial <br />heating, cooking, or baking equipment <br />and other apparatus as follows: <br />Up to and including 1 HP, KW KVA <br />Over 1 and not over 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 />Over 500 HP, KW KVA <br />2.00 <br />5.00 <br />10.00 <br />20.00 <br />30.00 <br />40.00 <br />workors componsation o4bratio n / <br />I hereby aflrrm thal I have a cerlrlcale o, consenl to sell{nsure, or a certrficate ol Worker's Compen- <br />sanonlnsurance CertrfiedcopyislrledwrlhtheCitybuildrngrnspectondepartmenl <br />Notlco To Appllcant: <br />ll, alter makrng thrs Certrfrcate ol Exemptron, you should become sublecl lo the Worker's Compen <br />salron provrsrons ol the Labor Code. you must rorlhwilh comply wrth such provrsrons or lhrs permrt <br />shall be deerned revoked <br />nol employ any <br />aws oiCalrlornra <br />Apphcanl lSrg. )- <br />Subtotal >0.0o <br />Penalty Fee (when applicable) <br />Violation Fee (s0.00) <br />Plan Check 650/o of subtotat /fi { O (minimum 20.00) <br />Receipt No. b1 b I Pg* b-3 1 3 Date <br />Plan Check (Adlustmenr) ffr2t\Ulssyance Fee 10.00 <br />/roratPERMrr FEE (minimum $35.00)YiJ, tlD <br />Expir atiorl <br />Applicanl's Declaratiorl <br />oerc I /.2- g1 PERMIT NO.231lao <br />PERN,'llT ISSUED BY lSig.)- <br />lsl.m,/,5 tY) <br />tJ-67 <br />tt/@/g? s:sPil +1S <br />lti i,:,lit.5&9-!-\.,,,,1i,,rJ,,, yU* <br />VALIDATION IOFFICE USE ONLYI <br />(ACCOUNT fr r-413r <br />APPLICATION AND <br />ELECTRICAL PERMIT <br />(TYPTWRITE OR PRINT IN INK) <br />I o CITY OF SANTA ANA <br />206 W. 4th Sr. <br />667 -2738 r <br />APPLICANT FILL IN AREA BELOW <br />(D <br />C7ozo <br />oo,ma <br />Ns <br />P <br />t <br />Distribution: 1. lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy c s .613 <br />5.00