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10-0042 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 10-00000042 , Property Address: 78241 SCARLET CT APN: 604-024-072- - - Application description: REMODEL - RESIDENTIAL Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 5000 Applicant: Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT ----------------------------------- - --------------- LICENSED CONTRACTOR'S DECLARATION ' I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License Class: 'License No.: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter's (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: (_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself through his or her own employees, provided that the improvements are not intended or offered for sale. If, however; the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). (_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ( 1, I am exempt under Sec. , B.&P.C. for this reason Date: I f 0- Owner, !D' CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Lender's Name: Lender's Address: LQPERMIT Owner: MICHAEL.PLINSKE 78241 SCARLET COURT LA QUINTA, CA 92253 Contractor: Owner VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/15/10 D)_U JA1 15, 2 i� Ji CITYrF UA ;`.UiWTA ------------------ WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I hall forthwith comply with thosekrovisions. -Dater hk rl0.. Applicant: ftu,- � D. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COvE GEIS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection pur as , /d fY/J Date: �Signature (Applicant or Agent): Application Number . . . . 10-00000042 ------ Structure Information WINDOW REPLACEMENT ----- Other struct info . . . . . CODE EDITION ---------------------------------------------------------------------------- 2008ENERGY Permit BUILDING PERMIT Additional desc . Permit Fee 72.00 Plan'Check Fee". 46.80 Issue Date . . . . Valuation 5000 Expiration Date 7/14/10 Qty Unit Charge Per Extension BASE FEE 45.00 -- -`- -3.00 9.0000 -THOU BLDG 2,001-25,000 27.00 ---------------------------------------------------------------------------- Special Notes and Comments WINDOW REPLACEMENT - (6) WINDOWS AND (1) SLIDER. INSPECTOR TO VERIFY TEMPERED GLAZING.•2008 ENERGY CODE. January 15, 2010 12:57:16 PM AORTEGA ---------- ----------------------------------------------------------------- Other Fees . . . . . . . . BLDG STDS ADMIN.(SB1473) 1.00 ENERGY REVIEW FEE 4.68 Fee summary Charged Paid Credited ----------------------------------=------------ Due .• ------- Permit Fee Fee Total 72.00 .00 .00 72.00 Plan Check Total" 46.80 .00 .00 46.80 Other Fee Total 5.68 .00 .00 5.68 Grand Total 124.48 .00 .00 124.48 LQPERMIT 01/15/2010 12:37 9512961418 MILGARD. 1/15/10 11:56!04 milgard Manufacturing Irc. 2 -Display Energy Performance Values 5-Spcl Cfg Salta Order: 1113654 SI TF Total "Weighted Avezage" values': 100.71 sr RESIDENTIAL 101 290 .27.0 .460 Ln$ Se: Model Qty SgFt W/I GIT Gas Film Grd Glass U/V SHGC VT..T 1 97.40T HV 1 13.33 SSSS JLE1 ARG MXCL .29 .21 .48 2 8240T SH 1. 6.90 SSSS LEI ARG MXCL .29 .21 .48 3 8140T HV 1 26.45 SSSS LEI ARG MXCL .29 .21 .48 4 8240T SH 1 6.90 SSSS LEI ARG MXCL .29 .21 .48 5 8140T Hv 1 26.45 SSSS LE1 ARG tsiCL. .29' .21 .98. 6 8140T HV 1 20.74 SSSS LF.1 ARG MXCL .29 .21 -48 NG15 F3 -Exit F6-(Un)Fold FI -Find Better F10 -Export 14FRC F12 -Return F22-ExpNFRC.,Loc2 1 RAGE 01/02 k. 01/15/201'0 12:37 9512961418 MILGARD 1/15/i0 11:56:33 Milgard manufacturing Inc_ 2-DisplaY Energy Performance values 5-Spcl Cfq Sales Order: 11.13683 SI L•F Total "Weighted Average" values! 36.37 SF 280 .210 500 RESIDENTIAL 36 Ln# Ser Model Qty SgFt GO/I G1T Gas Film Grd Glass U/v SKGC vLT 1 5621 SD 1 36.37 DSDS LEI ARG TXCT .28 .21 .50 NG1S 13 -Exit F6-(Un)Fold F7 -Find Better F10 -Export NFRC F12-Retucr. F22-ExpNFRC>Loc2 PAGE 02/02 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 5 of 5 Project Name: Climate Zone # # of Stories HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealin & Testing HERS verification is required for this measure. ❑ YES It NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned space, the ducts are to be sealed per §152(b)1Dii and the newly installed ducts are to be insulated per §151(f)10. ❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ❑ YES %fNO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the ducts are to be sealed per §152(b)IDi. 13 YES it ducts YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be sealed per § 152(b)1 E. ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. ❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Refrigerant Charge -Split System HERS verification is required for this measure. ❑ YES if NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat exchanger) a refrigerant charge measurement shall be verified per § 152(b)l F. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of § 150(o) do not apply to existing residential homes. Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. ❑ YES SNO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is replaced, the airflow and fan watt draw shall be verified per 152(b)lCi to meet the requirements of § 151(07B. Documentation Author's Declaration Statement • I certify that this Certificate of Com lien a documentation is accurate and complete. Name:/� Signature: 'Dr Company: VKAAAIM— Date: Address: If Applicable ❑ CEA or ❑ CEPE (Certification #): City/State/Zip: Phone: Responsible Building Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. ' • I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts I and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this bui ing permit application. Name: e: Signature: ! Company: Date: Address: License: City/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 2 of 5 Project Name: Climate Zone # # of Stories Mass and Furring Strips Construction(footnotes) 1. Indicate the type ofassembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional assemblies can be found Reference Joint Appendix JA4. 2. This is the U -Factor based on the thickness of the assembly in inches. 3. The R -value of the insulation to be added on the interior or exterior of the assembly. 4. The Calculated R- Value is the R -value of the furred out section of the assembly. 5.-6. The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix J44. The equation is the inverse of Column added to Column I. Column K is the inverse from column J. 7. Insert the calculated U- actor value on to the Opaque Sur ace Details in Column J FENESTRATION PROPOSED AREAS Replacing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package D in able 151-C. The Total Fenestration and West facing Area requirements are not applicable. ❑ Adding 50ft' or less of window area —Newly installed windows shall meet the U -Factor and SHGC Value requirements of Component Package D in Table 151-C. ❑ Adding more than 50ft2 of window area — Newly installed windows shall meet the U -Factor and SHGC Value and the Fenestration Area requirements of Component Package D in Table 151-C. Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF -IR -ALT Orientation Fenestration Type and Frame (North, East, PropsedArea' Maximum Window, Glass Door or Skylight) South, West) (ft' U -factor'' Maximum NFRC or Default SHGC''''' Values G Allowed Existing Fenestration Total Area !. Fenestration area is the area of total glazed product (i.e. glass plus frame). Exception: When a door is less than 50% glass, the fenestration area may be the glass area plus a "2 inch frame " around the glass. 2. Enter value from Component Package D Requirements in Table 151-C. 3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower U factor and/or a lower SHGC value than that specified on the. CF -IR ALT Form. 4. Submit a completed WS -31? Form if a reduced SHGC is calculated with exterior shading. 5.tfapplicable at this stage enter "NFRC" or NFRC Certified windows or are CEC "Default " valuesfound in Table 116-A or B. ALTERED FENESTRATION ALLOWED AREAS (Complete if more than 50ft' of fenestration is added) A B C D E F G Allowed Existing Fenestration Total Area CFA of Entire % of Fenestration Area Fenestration Allowed Proposed Area Dwelling CFA Area Removed Area Added A x B) (E -D) + C Total Fenestration Area 20 West Fenestration Area (Required In .05 >_ CZ's 2,4&7-15 1. West Fenestration Area includes west -sloping skylights and any skylights with a pitch less than 1:12. 2. West facing glazing area removed cannot be "counted" twice. " In order to distribute the west glazing area removed to the other orientations, input the west glazing area removed in the Total Fenestration Area row, column D. 3. Include the Proposed Area othg,.., st facing fenestration in both Area columns below. 4. To meet com Bance, the Pro oserea must be less than orequal to the Total Allowed Area or BOTH the Total and West Fenestration Areas. i Registr6tion Number: i Registration Date/Time: HERS Provider: 2008 Residential Vornpliance FonMN ­�,;s August 2009 U 1 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations (Page 1 of 5 Project Name: n J.Climate Zone # # of Stories Lae& r� e�✓ 1 15 General Information Site Address: '�ga (� S Qr�P e 1 Enforcement Agency: Date: %S , Building TypexSingle Family ❑ Multi Family Circle the Front Orientation: N, E, S, W, or degrees Conditioned Floor Area (CFA): Project Type: Iterations ❑ Envelope ❑ Fenestration ❑ Roof ❑ HVAC [D' or T pel and Size or Other; factor Numbers R-value6 R -Value? Replacement or Change Out ❑ Duct Replacement ❑ Water Heater NOTE: This form is not to be used for Newly Constructed Buildings or Additions Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration ❑ Opening of framed cavity alone— Alterations that involve the opening of the framed cavity of a wall, ceiling, or floor must install the mandatory minimum insulation value per x/50 for the altered assembly. Fill in Columns A —C and enter mandatory insulation value in Column H. ❑ Replacement of entire assembly— Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component Package- D insulation values in Table 151-C. Fill in Columns A —J. Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. A B I C D E F G I H I I J Proposed SeeO1e Standard Values From JA4 Table Framing Thickness, Framed Continuous JA4 Proposed Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly [D' or T pel and Size or Other; factor Numbers R-value6 R -Value? Cell ValueB U-factor9 K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Note: For furred assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and Furring Construction table below. 1. For Tag/1D indicate the identification name that matches the building plans. 2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc... Indicate the Frame type and Size: For Wood, Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16 "or 24 "OC; or Other for all other assembly description such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc.... 4. Based on the Climate Zone; enter the Standard U factor from Table 151-B, C or D for each different assembly Name or type. 5. Enter the Table number that closely resembles the proposed assembly. 6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0". 7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter "0 ". 8. Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U -factor in Column J 9. The Proposed Assembly U -factor, Column J, must be equal to or less than the Standard U factor in Column E to comply. Furring Strips Construction Table for Mass Walls Onl A I B I C D I E F I G H I J K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference Joint Appendix Table 4.3.5, 4.3.6, 4.3.7 Joint Appendix Table 4.3.13 v U N ^] v "> U Assembly j G ° g F V °' " Final Mass Name or JA4 Table $8.2 Assembl Thickness' Type' Number' Q > x ° ' ¢ > 7 U-factorbY Comment im in c r% Registration Number: Registration Date/Time: 2008 Residential Compliance Forms KERS Provider 0 BY Augtust 2009 P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits WTORT'.4 M NOTICE TO MFERTY OWNER Dear Property Owner. An. application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. 'MM'S AC"RELEDUKENT AND VEIIMCATION OF INFO A`l1� _N DfRECUONS: Read and initial each statement below to signify you understand or verify this information - I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" �Suilding permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. 'My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 'k`. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. &3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. �4. I understand Contractors are required by law to be licensed and bonded in California and to list thew license numbers on permits and contracts. frl,p-5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 0 6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide woikers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. �7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot .legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any inancial orersonal ` ' P . tn�tu-res sustained. by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenge ervice, the United States SmallBusiness Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand.I may contact the California Contractors' State License Board (CSLB) at 1- 800-321-CSLB (2752) or www.csib.ca.gov for more information.about licensed contractors. 10. I am aware of and consent to an. Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible .. for proposed construction activity at the following address: A nVl 1. I agree that,, as the party legally and financially responsible for this proposed construction activity, .I will abide by all ap plicable laws and requirements that govern Owner -Builders as 'well as employers. 2. I agree to notify the issuer of thisform immediately ofany additions;deletionsbr changRs:to a_ny of the information I pro vided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with -someone who does not have a license,. the Contractors' State License Board may be unable to assist you with any financial loss You may sustain as a result of a complaint Your only remedy against unlicensed Contractors may be in°civil court. It is also important for you to: understand that if an urdimnsed.Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, YOU will be responsible for verifying whether: or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this .form must be completed and signed by the property owner and returned to the agency responsible for issuing; the.:permit. Note: A copy of the property owner's Qiriver.'s licensmf form notadcadon; or other veriftcadon acceptable to the agency is _required to be presented when the pemrit is issued to verify the property owner's signature. Signature of property owner Its �d%1� Date: Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to -apply-for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACTON PROPERTY OWNER'S BEHALF Excluding.the Notice to Property Owner, the execution of which I understandis my personal responsibility, I hereby authorize the following person(s) to act as. my agent(s) to apply for, sign, and file the documents necessary. to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjurythat I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature.. Property Owner's Signature: Date: 16. Bin # City of La Quinta Building 8t Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Project Address: g2 P Sc it Owner's Name- ame A. A. P. Number: k)0q -Mq - v 1q.. Address: Legal Description: City, ST, Zip: Contractor . �� Telephone:`' .. Address: Project Description: W �N001� City, ST, Zip: Y� Telephone: State Lic.# : - City Lia #; Arch., Engr., Designs . Address: City., ST, Zip: Telephone: State Lic. #: n Name of Contact Person: t Crl/9e� ' Dr P�I �SkA Construction Type: Occupancy: Project type (circle one): New Add'n Alta Repair Demo Sq. Ft : # Stories: # Units: Telephone # of Contact Person: 0 • p p . Sl (o t96 1i ma Estimated Value of Project: �j DOb APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Plan Sets Req'd Rec'd TRACEM4G PERMIT FEES Plan Check submitted Item Amount Structural Cala. Reviewed, ready for corrections Plan Check Deposit Truss Cala. Called Contact Person Pian Check Balance Tlde 24 Cala. Pians picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2' Review, ready for corrections/issue Electrical Subeoutactor List Called Contact Person Plumbing Grant Deed Pians picked cap S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''' Reyiew, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees