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SITE NAME SITE ADDRESS Specification and Requirements are available at www.anaheim.net/hms Please review prior to permit application submittal. Make checks payable to: CITY OF ANAHEIM PLAN CHECK INFORMATION CONTRACTOR INFORMATION COMPANY NAME COMPANY NAME ADDRESS ADDRESS CITY, STATE ZIP CITY, STATE ZIP PHONE NUMBER ( ) PHONE NUMBER ( ) EMAIL EMAIL PLAN CHECK CONTACT JOB SITE CONTACT CSLB LICENSE Underground Storage Tank (UST) Permits UST Modification UST Installation $506.00 for up to four hours $1012.00 for up to eight hours Public Works AND Planning Review Required Public Works AND Planning Review Required UST Removal UST Temporary Closure $759.00 for up to six hours $506.00 for up to four hours Public Works AND Planning Review Required Public Works AND Planning Review Required UST Abandonment-in-Place Remove flammable/combustible liquids or $506.00 for up to four hours change contents in UST Public Works AND Planning Review Required $126.50 for up to one hour Hazardous Materials Permits Facility Closure $253.00 per facility for up to two hours Other Services Additional Plan Check Hours Laserfiche Fee Plan check and inspection activities that require Only for plans over 8 ½ x 11. Actual cost charged by outside additional time will be assessed at $126.50 per hour, which vendor will be assessed at the completion of the project. will be assessed at the completion of the project. Expedited Plan Check $253.00 for review within two business days of submittal Applicant’s Name (please print) Applicant’s Signature Date: OFFICE USE ONLY Amount Received: Date Approved By: Credit Card Check No. Approval Date: Rev/7/2019 FEA# ANAHEIM FIRE & RESCUE Hazardous Materials Section 201 S. Anaheim Blvd., Suite 300 Anaheim, CA 92805 (714) 765-4040 www.anaheim.net/hms PERMIT APPLICATION