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<br />l* l,o",i rorAL/Resrdentral lndustflal Commercral
<br />Res. Hotels, Motels, Apt. Sq.r{2.fb 03 72a*
<br />Gar. or Carports Sq. Ft 4{f .02 ,. ?d
<br />Receptacles .50
<br />Switches .50
<br />Owner Builtler Declardtiorl Fixtures 50
<br />Air Conditioners
<br />Each I 20 00 20,oo
<br />Approved Factory Wired Unil . D t+)
<br />_List Dp Hoad
<br />Busways, special raceways, under floor
<br />duct, trolley or plug-in busways ea. 110' or
<br />lraction thereol
<br />7 5.00 3-f,oo
<br />5.00
<br />Fire Signaling System. Minimum fee
<br />Outlet, smoke or heat sensor I 10.00
<br />.50 fo
<br />Lrghting Standards with One Lamp
<br />Each Add'l fixture on same slandard
<br />5.00
<br />1.00
<br />Maintenance Permit (annual)50.00
<br />2VO 9o.
<br />gr2Uryyo"tY,,,{;,fr9*i ?"
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<br />I hereby ali nYr that I sed ilnder lhe provrsrons ol Chap!er I
<br />ce and ef,
<br />STATETZIPT ?)&
<br />[) v s or :] ol IlI U ],i,r,:i\,rirLl
<br />o / 2/,rrdC-t 0
<br />Cr
<br />Workers Compensation
<br />I herebv alfrrm that I have a cerlrfrcale of consent lo sell.rnsure, or a cerlr|cate of Worker's Compefl-
<br />satron lnsu.aice Certrfred copy rs trled wrth the Crty burldrng rnspectron department
<br />Notice To Applicant:
<br />'rrl
<br />Service Meters
<br />Up to 400 amps, per meter
<br />Owr 400 amps, per meter
<br />Over 1200 amps, per meter
<br />/15.00
<br />35.00
<br />75.00
<br />tCo o
<br />Signs and high potential gas tube lighting 15.00
<br />Swimming pools, founlains, spas 35.00
<br />W"o'
<br />motor conlrol center oooo.15.00 tf,oo
<br />Temporary clnstruction meter service
<br />pole
<br />Fach distribution pole
<br />25.00
<br />5.00
<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: Generalors,
<br />motors, transformers, rectifiers, industrial
<br />hegting, cooking, or baking equipment
<br />-arfd other apparatus as follows:
<br />Up to and includrng 1 HP, KW, KVA
<br />Over 1 and notover 10 HP, KW KVA
<br />Over '10 and not over 50 HP, KW KVA
<br />Orcr 50 and nol 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 />Subtotal / 3l .LL
<br />Explratlon
<br />Thrs permrl shall exprre by Imrtalron and become null and vord rl the work aulhonzed by lhrs permrl rs
<br />nol commenced wrthrn l80 days lrom the date ol lhrs permrl or ri u,ork authon2ed bv lhrs permrt rs
<br />sugpeodod or abandcned at anv lrmealler lhe work rscommenced lor a penod ol lS0 days A new
<br />permrt shall be oblarned lrrsl before such work can be recotrrmenc€d
<br />scrty loenter upon the
<br />Applrcant or Agenl I
<br />Applicant's Declaration
<br />|1:
<br />I certrly that I have read t
<br />comply wilh all crty ordrn
<br />rrze repre*nlalrves ol lhr!
<br />,",,' ll'2-t 1
<br />Penalty Fee (when applicable)
<br />Vtelalioo-Eeo-(50 00)
<br />Plan Check 650lo of subtotal * q.SG (minimum 2O.OO)
<br />ReceiprNo. C7U,7 Pc# $ jyloate
<br />Plan Check (Adjustment)Az+
<br />lssuance Fee 10.00
<br />I foTAL PERMTT FEE (minimum $35.00)bl ,fu
<br />oA[E //-2. 31 PERMIT NO,
<br />',',i',',',li,';i:; 1f / I 0 / \r,*,r r) L,\,,,,.,, Wl,U
<br />VALIDATION {OFFICE USE ONtY
<br />(ACCOUNT flr-4r31
<br />I
<br />,l5tY 1
<br />PERMIT ISSUED BY (Sig.l lb sn
<br />tt/@,/w 3;sPil +13 |t+1.65
<br />APPLICATION AND
<br />ELECTRICAL PERMIT
<br />(TYPFWRITE OR PRINI IN INK)
<br />o o CITY OF SANTA ANA
<br />206 W. 4th St.
<br />667 -2738
<br />APPLICANT FILL !N AREA BELOW p
<br />(Dc-Iz
<br />6)
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<br />Distribution: '1. lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy C S 61:l
<br />D"r"Erp,,"l&#-.ver,t,edBytS,o,--- /-
<br />:""(#:#:'":::^:::: . %lcertfy lhat rn the per6rmarrc| ot rhe work lor whrch thrs q9 't rs rssued.
<br />peason rn 6ny manner so as to become sublecl lo lhe Workct s Compensalron Laws of Cahlornra
<br />Date --- Applrcanl{Srg)-
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