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Residentral tnOustnalr{Commercral NO.EACH TOTAL
<br />Res. Hotels, Motels, Apt. Sq. Ft..03
<br />Gar. or Carports Sq. Ft..02
<br />Receptacles 7 50 u. oo
<br />/Jp 7* l/rlzr'- P
<br />Oz*u-I"* ,rfL- or / ct
<br />V;^-;, fr--J-Yn"--"- il"il *o > p
<br />JOB ADDRESS37oe
<br />LING
<br />q,i /
<br />B
<br />ESS
<br />U-'f"-Switches 50
<br />Fixtures rq .50 2z.oa
<br />Air Conditioners
<br />Each
<br />20.00
<br />Approved Faclory Wired Unil
<br />List 5.00
<br />Busways, special raceways, under floor
<br />duct, kolley or plug-in busways ea. 1 1 0' or
<br />fraction thereot --
<br />Fire Signaling System. Minimum lee
<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 />Owner Builder Declaration
<br />ll'
<br />:i
<br />Maintenance 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 />/5 00
<br />Signs and high potential gas tube lighling 15.00
<br />Swimming pools, fountains, spas 35.00
<br />Switchboard, motor conlrol center or g@
<br />Dangl5-Eacn I
<br />15.00 /5o o
<br />Gmporary construction meter service
<br />pole
<br />Each distribution pole
<br />25.00
<br />5.00
<br />ksbenn 4 L El6c/6"ntracror use ontv fi'fL '3s1,
<br />ttrrt, Qt,),T'Tlawr
<br />#: //oo
<br />(tr- //)L/ 7
<br />ADDRESS
<br />{,,7 o 't /14'4 A,!---L
<br />_e*4
<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 I 3.00 3.o n
<br />POWER APPARATUS: Generators,
<br />motors, lransformers, rectifiers, industrial
<br />heating, cooking, or baking equipment
<br />and other apparatus as tollows:
<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 />I hereby affirm thal I have a cerirlcale of consenl to selfrnsure, or a ceilrfrcate of Worker's Compen-
<br />sation lnsurance Certrfredcopyrs liledwrth theCily building
<br />person rn any manner so as to become subpcl to the wo,ker's compensalton Laws of caltfornra
<br />Dat6__-- Applcant(Srg.)-
<br />NotlccTo Apy'lcant:
<br />ll. after making lhrs Certrlrcate ol Exemptron, you should become sublect lo the Worker's Compen
<br />stron provrsrons ol lhe Labor Code, you musl lorthwrth comply wrth such provisrons or lhrs permrl
<br />shall b€ d€emed revoked
<br />U
<br />Workers Compensation D6claralion
<br />Venled 8y (Srg
<br />Applrcanl (Srg
<br />mance o, lhe work lorI certrty that rn the
<br />Date Expr
<br />departmenl
<br />permrt rs shall not employ any
<br />Subtotal L4-oo
<br />Penalty Fee (when applicable)
<br />Violation Fee (s0.00)
<br />Plan Check 650/o of subtotal 4 t, U O (minimum 20.00)
<br />ReceiptNo. bl t 7 Pc# L j -sa Date
<br />Plan Check (Adiustment)
<br />lssuance Fee 10.00
<br />./rOtat pERMtT FEE (minimum $3s.oo)ryt/,0-3
<br />Expir.tlon
<br />This permil shall exprre by hmrtatron and become null and vord rl the work authoilzed bv thrs permrl rs
<br />nol commenced wrlhrn 180 days from the date ol rhrs p€rmrt or rf [,ork authoflzed by lhrs permrt rs
<br />suspendedorabandcnedatanytrmeallerlheworkrscommencedloraperrodollS0days Anew
<br />permlt shall be obtarned lrrsl belore such work can be recommenced
<br />Applicant's Declaratiorr
<br />,",,1 PD :{1App, can, cr asen,,s,s,
<br />(re represenlattvesol thrscrty toenter upon the proparty loJ rnspeclron pu.poses
<br />DATE l,l -) -tr7 PERMIT No. 236'4L
<br />Js,tt
<br />t PEBMIT ISSUED BY (SIg )Q,
<br />t74.00
<br />llnUrlL frvr"^^r'q Ith
<br />lL/ww 3:55Pil 413
<br />}ii:iliii 3'/(a3 uo u,n,,,,,,,,,n,
<br />VALIDATION (OFFICE USE ONLY)
<br />rACCOUNT rll.4l3l
<br />APPLICATION AND
<br />ELECTRICAL PERMIT
<br />TTYPIWBITE OR PRINT tN INK)
<br />O hb,tse Frr*
<br />BbG--1-
<br />CITY OF SANTA ANA
<br />206 W. 4th Sr.
<br />667 -2738
<br />e
<br />to/
<br />Yufu_ APPLICANT Fl IN AREA BELOW
<br />@c
<br />=ozo
<br />oo
<br />S
<br />N
<br />Distribution: l.lnspectorCopy 2. FileCopy 3. FinanceCopy 4. ApplicantCopy c s -613
<br />5.00
<br />lrcensd under lhe provrsrons ol Chapter 9, Drvrsron 3 ol
<br />Crrv
<br />my hcens! rs rn ot
<br />Date
<br />Classb
<br />Contraclor lSrg
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