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='')')'^ saJ,-h.- /?4 4r. B <br />''r r(rr.l (zr9 <br />-Atq<,. .r/c-otto <br />OWNER <br />4a-r.t-'-<-^) <br />7tn4r- <br />13rf(,r Il er-a-A- / .7t *L <br />,(Z <br />STATE i ZIP <br />XResrdentral lnduslrial Commercrat <br />i <br />-" i,o", I rorAL <br />Res. Hotels, Motels, Apt. Sq. Ft | | 17-1 <br />I <br />I <br />03 39.3o <br />Gar. or Carports Sq. Ft.43'02 y.7 E <br />Receptacles 50 <br />Switches 50 <br />Ow.rrer Bu ilcler Decla raltion Fixtures 50 <br />Air Conditioners <br />Each I 20.00 )b, oo <br />Approved <br />LiSI <br />Factory Wired Unft D. A.D P lFood 7 5.00 3.1. o o <br />Busways, special raceways, under floor <br />duct. trolley or plug-in busways ea. 110'or <br />traction thereof /5.00 <br />..5-'D <br />Fire Signaling System. Minimum fee <br />Outlel, smoke or heal sensor <br />10.00 <br />.50 <br />Lighting Standards wilh One Lamp <br />Each Add'l trxlure on same standard <br />5.00 <br />1.00 <br />Maintenance Permit (annual)50.00 <br />CON TB AC TOR <br />,'jt c -/o <br />15.00 <br />35.00 <br />75.00ffi7 <br />Service Meters <br />Up to 400 amps, per meter <br />Over 400 amps, per meter <br />Over 1200 amps, per meter <br />Signs and high potential tube lighting <br />Swimming pools, tountains, spas <br />Switchboard. motor control center <br />Temporary custruction meter service <br />pole <br />Each distribution pole <br />Time clock or photo electric cell <br />POWER APPARATUS: Generators, <br />motors, transformers, rectiriers, 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 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 />Over 500 HP, KW KVA <br />Subtotal <br />Penalty Fee (when applicable) <br />Volalrcn*ee _tc <br />Plan Check 65"/o of subtotal <br />Receipt No Pc#32 Date <br />Plan Check (Adjustment) <br />lssuance Fee <br />TOTAL PERMIT FEE <br />15.00 <br />35.00 <br />15.00 <br />/.f,oo <br />/S-o o <br />CIT <br />I hereby alfrrm that I am licensed r <br />Lrcense <br />o/>t52t*z-74, <br />&511) <br />#o-ffi ( <br />rnder the provrsrons ol Chapter 9, Drvrsron 3 ol the Business and <br />and mV hcen$ rs in lull lorce and sllect 25.00 <br />5.00 <br />3.00 <br />2.OO <br />5.00 <br />10.00 <br />20.00 <br />30,00 <br />40,00 <br />Crly Licensea <br />Conuacro. (Srg ) <br />Workers Compensation <br />Temporary construction lighting <br />500 lamps or less <br />Over 500 lamps <br />2.00 <br />4.00 <br />I hereby alltrm that I have a ce.tilEate ol congnt lo sell-insure, or a certrtcale ol Worker's Compen- <br />t^e Crty burldrn deparlmenl <br />I certrly thal rn the perlormance ot lhe work tor whrch shall not emoloy any <br />#:'" ^" <br />t r l-(--?a,//_tt7 / ,.r <br />Notice To Applicant <br />,: <br />E x pirat iorl <br />Applicant's Oeclaration <br />jil,.. <br />,,l...rr,,rtrr,ttl,lrijllrr'l <br />(50.00) <br />(minimum 20.00) <br />(minimum $35.00) <br />PERMIT NO. <br />10.00 <br />,",.1 l' 2- f,cl ooou."", ", onu",,, <br />BUILDING <br />PERMIT No dhtof vrB,rrDBY sq -\(- <br />VALIDATION IOFFICI USE ONtY <br />(ACCOUNT lll 413) <br />PEBtvllT ISSUED BY lSrg ) <br />yLbsT <br />|rlm/8P trt5941 tl$ tlv.58 <br />APPLICATION AND <br />ELECTRICAL PERMIT <br />(I YPEWRITE OR PRINT IN INK) <br />e O CITY OF SANTA ANA <br />206 W 4rh St. <br />667 -2738 \v <br />APPLICANT FILL IN AREA BELOW <br />@Iroz <br />6) <br />oollmaa <br />s <br />F <br />I <br />ir <br />t <br />Distribution: 1. lnspector Copy 2. File Copy 3. Finance Copy 4. Applicant Copy c s 613 <br />/ <br />/27 ly <br />;Prrtd, <br />o^rE //- Z- f ?23! <br />I