ELEC (08-0854)54105 Avenida Madero
08-0854
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
08':000OPA 54.,
Property Address:
54105 AVENIDA MADERO
APN:
774-192-016-5 -000000-
Application description:
ELECTRICAL
Property Zoning:
COVE RESIDENTIAL
Application valuation:
1850
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 9 (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
a y applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).:
(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.).
( ) I am exempt under Sec. , B.&P.C. for this reason
te: 5' IJ ner:
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
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 5/15/08
Owner:
WILLIAM E. JOHNSTON
54105 AVENIDA MADERO
MORENO VALLEY, CA 92553
---------------------------------
Contractor:
Owner
----------------------- v ---qY 16
.08M
R
---------------------------------- -- --- ---
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
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 shall forthwith comply with those provisions.
te: 5 i 5 U plicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS 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 eXuponabove-mentionedproperty for inspection p rpos a te: 1 5 "Applicant or Agent):Q a
Application Number . . . . . 08-00000854
Permit . .
. ELEC-SERVICE
CHANGE
Additional desc .
.
Permit Fee . . .
. 33.50
Plan Check
Fee
.00
Issue Date . . .
.
Valuation
. . .
. 0
Expiration Date .
. 11/11/08
Qty Unit Charge
Per
Extension
BASE
FEE
15.00
1.00 18.5000
EA ELEC
SVC <=600V/<=200A
18.50
----------------------------------------------------------------------------
Special Notes and
Comments
UPGRADE ELECTRICAL
PANEL FROM 100
AMP TO
200 AMP
Fee summary
Charged
Paid Credited
Due
-----------------
Permit Fee Total
--------------------
33.50
----------
.00
----------
.00
33.50
Plan Check Total
.00
.00
.00
.00
Grand Total
33.50
.00
.00
33.50
LQPERMIT
WILLIAM E. JOHNSTON
54-105 AVENIDA MADERO
LA QUINTA, CALIFORNIA 92253
760.702.1555
May 15, 2008
To Whom It May Concern:
I have hired Mr. Edward Luna to repair and increase the electrical panel for my house
located at the address above. I am" authorizing Mr. Luna to obtain the necessary permits
in order to begin this project for my residence. The Deed of Trust has been recorded with
the County of Riverside Recorder's Office this morning and possession of the residence
has been completed. As proof of ownership I have attached a copy of my Settlement
Statement and Certificate of Insurance. If further verification is needed please contact the
Coachella Valley Water District as I have submitted an application for water service as
owner and resident of the subject Property (under perjury of law).
If you need to contact me for any reason please do not hesitate to all the number listed
above.
Regards,
William E. ohnston
-9513020470 DESERT SWST INS.BR
06:24:18 p.m. 05-14-2008 212.
E(MMIDD008
EVIDENCE OF PROPERTY INSURANCE r51'/
14/2ooe
THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE OF PROPERTY INSURANCE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES BELOW.
AGENCY I Pk Nu Eq., (951) 694-5200
COMPANY
Desert Southwest Insurance Brokers, Inc.
The Travelers Indemnity Company
License #0004828
25,125
32605 Temecula Parkway #301
Loss of Use
Temecula CA 92592
rN. Nn: (951) 302-0471 loDRIESS: brad@dswib. com
CODE: SUB CODE
CU TOMERIDN: 00001140
INSURED
LOAN NUMBER
POLICY NUMBER
WILLIAM EUGENE JOHNSTON
3769000335
9829597986331
54105 AVENIDA MADERO
EFFEcrnE DATE
EXPIRATION DATE
5/9/2008
5/9/2009EITERMWATEDIFCHECKED
CONTINUED UNTIL
LA QUINTA CA 92253
THIS REPLACES PRIOR EVIDENCE DATED: .
LOCATION/DESCRIPTION
54105 Avenida Madero, La Quinta, CA 92253
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OR ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS
SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I.VVCKAbC InrVKMAIIVPI
COVERAGEIPERILSWORMS
AMOUNT OF INSURANCE
DEDUCTIBLE
Dwelling - Replacement Cost
$251,250
$1,000
Personal Property
175,875
AUTHORIZE
Other Structures
25,125
Loss of Use
125,625
Liability
300,000
Medical Payments
1,000
Annual Premium $774.00
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO
MAIL DAYS WRITTEN NOTICE TO THE ADDITIONAL INTEREST NAMED BELOW, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO.OBLIGATION
OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AnnITInFJAI INTFRFST
.Sunrise Community Bank
41990 Cook Street Suite 701
MORTGAGEE
LOSSPAYEE
X
ADDITIONAL WSURED
Llenholder
LOAN
Palm Desert, CA 92211
376900033
AUTHORIZE
M%.Vnu a (cyvvrv,r WA%;UKU UVKPVKAIIUN 7993-2006. A11 right$ reserved.
INS0.27 (=607)a The ACORD name and logo are registered marks of ACORD
US Department of Housing and Urban Development OMB No. 2502-0265
A. Settlement Statement
B. Tvoe of Loan
1. _ FHA 2. _ FMHA 3. _ Conv. Unins.
4. _ VA 5. 1L Conv. Ins.
6. File Number
1584963-01
7. Loan Number
70270
8 Mortgage Insurance Case Number
C. Note: This forth IS famished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked '(p.o.C.)' were paid
outside of dosing; they are shown here for infomhation purposes and are not Included in t he totals. WARNING: It is a crime to knowingly make false statements to the
United States on this or any other form. Penalties upon conviction can include a fire and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section
1010.
D. NAME OF BORROWER: WILLIAM EUGENE JOHNSTON
ADDRESS: 54105 AVENIDA MADERO, LA QUINTA, CA 92253-3632
E. NAME OF SELLER. WASHINGTON MUTUAL BANK, FA
ADDRESS: 7255 BAYMEADOWS WAY JACKSONVILLE FL 32256
F. NAME OF LENDER: SUNRISE COMMUNITY BANK
ADDRESS: ., ., MI 48381
G. PROPERTY ADDRESS: 54105 AVENIDA MADERO LA QUINTA, CA 92253-3632
H. SETTLEMENT AGENT: SERVICE UNK
PLACE OF SETTLEMENT:
1. SETTLEMENT DATE: 05/14/2008
DISBURSEMENT DATE: 05/142008
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION:
100. GROSS AMOUNT DUE FROM BORROWER
400. GROSS AMOUNT DUE TO SELLER
101. CONTRACT SALES PRICE
$180,214.00 401. CONTRACT SALES PRICE
$180,214.00
102. PERSONALPROPERTY
402. PERSONALPROPERTY
103. SETTLEMENT CHARGES TO BORROWER (LINE 1400)
$5,606.69 403
I
104.
404.
-1
105.
405.
ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE
106. CITY/TOWN TAXES
406. CITY/TOWN TAXES
107. COUNTY TAXES 51142008 TO 07/012008
$501.26 407. COUNTY TAXES (05/142008 TO 0710120081
$501.26
108. SCHOOL TAXES
408. SCHOOL TAXES
109.
409.
J
110.
410.
111.
411.
J
112.
412.
120. GROSS AMOUNT DUE FROM BORROWER
1 $186,523-951420. GROSS AMOUNT DUE TO SELLER
$180,715.26
200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER
500. REDUCTIONS IN AMOUNT DUE TO SELLER
201. DEPOSIT OR EARNEST MONEY
$3,600.00 501. EXCESS DEPOSIT SEE INSTRUCTIONS
202. PRINCIPAL AMOUNT OF NEW LOANS
$144,000.00 502. SETTLEMENT CHARGES TO SELLER (UNE 1400)
$12,391.84
203. EXISTING LOAN(S) TAKEN SUBJECT TO
503. EXISTING LOAN(S) TAKEN SUBJECT TO
204. PRINCIPAL AMOUNT OF SECOND NEW LOAN
$18,000.00 504.
205. SELLER CREDIT FOR BUYER'S CLOSING COSTS
$5,000.00 505, SELLER CREDIT FOR BUYERS CLOSING COSTS
$5,000.00
206.
207.
208.
506
507.
rte.
209.
509
ADJUSTMENTS FOR ITEMS UNPAID BY SELLER ADJUSTMENTS FOR ITEMS UNPAID BY SELLER
210. CITY/TOWN TAXES
510. CITY/TOWN TAXES
211. COUNTYTAXES
511. COUNTYTAXES
J
212. SCHOOL TAXES
512. SCHOOL TAXES
213.
513.
214.
514.
J
215.
515.
216.
516.
217.
517.
I
218.
518.
219.
519.
FJ
220. TOTAL PAID BYIFOR BORROWER
$170,600.00 520. TOTAL REDUCTION AMOUNT DUE SELLER
$17,391.84
300. CASH AT SETTLEMENT FROM OR TO BORROWER
600. CASH AT SETTLEMENT FROM OR TO SELLER
301. GROSS AMOUNT DUE FROM BORROWER (UNE 120)
$186,523.95 601. GROSS AMOUNT DUE TO SELLER (UNE 420)$180,715.26
302. LESS AMOUNTS PAID BYlFOR BORROWER (UNE 2201
$170,600.00 602. LESS REDUCTION AMOUNT DUE SELLER (UNE 520)
$17,391.84
303. CASH FROM BORROWER
$15,923.95 603. CASH TO SELLER
$163,323.42
cmcrw r : m rhe mror auon contained West IS important tax Information and is being famished to the Internal Revenue Service. It you ate
required to file a return, a negligence penality or other sanction will be Imposed on you 8 this item is required to be reported and the IRS determines Mat it has not been reported. The
Contract Sales Price described on fine 401 above constitutes the Gross Proceeds of this transaction. -
SELLERS INSTRUCTIONS: If this real estate was your principal residence, file Form 2119, Sales or Exchange of Principal Residence, for any gain, with your Income tax return; for
other transactions, complete the applicable parts of Form 4797, Form 6252 andfor Schedule D (Form 1040).
You are required by taw to provide the settlement agent (Fed. Tax ID No: 1 with your current taxpayer identification number. If you do not provide your
correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by law. Under penalties of perjury, I certify that the number shown on this statement Is
my torted taxpayer identification number.
TIN: ! SELLER(S) SIGNATURES:
SELLER(S) NEW MAILING ADDRESS:
SELLER(S) PHONE NUMBERS: (H)
(W)
Service Unk Printed 05/14/2008 at 12:12 PM by thdlkrtt REV. HUD -1 (3/86)
US Department of Housing and Urban Development OMB No. 2502-0265
SETTLEMENT STATEMENT FILE NUMBER: 1584963-01 PAGE 2 OF 3
L SETTLEMENT CHARGES
PAID FROM
BORROWER'S
FUNDS AT
SETTLEMENT
PAID FROM
SELLER'S FUNDS AT
SETTLEMENT
700. TOTAL SALES/BROKER'S COMMISSION BASED ON PRICE $180,214.00@0.00=$8.740.70
DIVISION OF COMMISSION LINE 700 AS FOLLOWS:
701. $2,447.40 TO AFFORDABLE HOME LOANS & REALTY
702. $5,244.42 TO KELLER WILLIAMS
703. $1,048.88 TOASSETLINK
704. COMMISSION PAID AT SETTLEMENT
$8,740.70
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. LOAN ORIGINATION FEE - 0.8750% - SUNRISE COMMUNITY BANK $1,260.00
802. LOAN DISCOUNT
803. APPRAISAL FEE TO RESIDENTIAL APPRAISAL GROUP POC BY BORROWER: $400.00
804. CREDIT REPORT TO LANDSAFE $9.45
805. TAX SERVICE CONTRACT
806. APPLICATION FEE
807. FLOOD CERTIFICATION FEE
808. UNDERWRITING FEE
609. YIELD SPREAD PREMIUM TO AMERA MORTGAGE POC BY SUNRISE COMMUNITY BANK $1,260.00
810. TRANSFER FEE TO AMERA MORTGAGE $650.00
811. PROCESSING FEE TO AMERA MORTGAGE $295.00
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. INTEREST FROM 05/142008 TO 06/01/2008: $21.7000/DAY FOR 18 DAYS $390.60
902. MORTGAGE INSURANCE PREMIUM FOR
903. HAZARD INSURANCE PREMIUM FOR TO DESERT SOUTHWEST INSURANCE BROKERS POUCYO=959798- $774.00
633-1
1000. RESERVES DEPOSITED WITH LENDER FOR
1001. HAZARD INSURANCE - 2 MO. AT $64.50/MO $129,00
1OD2. MORTGAGE INSURANCE
1003. CITY PROPERTY TAXES
1004. COUNTY PROPERTY TAXES - 6 MO. AT $311.16/MO $1,866.96
1005. SCHOOL TAXES
1009. AGGREGATE ANALYSIS ADJUSTMENT TO AMERA MORTGAGE ($516.07)1 $0.00
1100. TITLE CHARGES
1101. SETTLEMENT OR CLOSING FEE TO SERVICELINK $700.00
1102. ABSTRACT OR TITLE SEARCH
1103. MORTGAGE UPDATE FEE
1104. SIGNING FEE TO SERVICELINK $150,00
1105. DOCUMENT PREPARATION TO SERVICELINK $150.001 1
1106. NOTARY FEES
1107. ATTORNEY'S FEES
1108. TITLE INSURANCE TO SERVICELINK $297,75 $863A0
1109. LENDER'S POLICY $0.00 - $297.75 LOAN AMOUNT - $144,000.00
1110. OWNER'S POLICY $0.00 - $8M.00 LOAN AMOUNT - $180214.00
1111. SURVEY
1112. See addendurn page for details $25.00 $000
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. RECORDING FEES - MORTGAGE: $51.00 $51,00
1202. CITY/COUNTY TAX/STAMPS
1
1203. STATE TAX/STAMPS
1204. GRANT DEED TO AR SERVICELINK $13.00
1205. GRANT DEED TO AR SERVICELINK $13.00
1300. ADDITIONAL SETTLEMENT CHARGES
1301. SERVICING FEE TO ASSET LINK $1,748.14
1302. See addendum page for detaas $250.001 $340.00
1400. TOTAL SETTLEMENT CHARGES $5,808.691 $12,391.841
nuu CERTIFICATION OF BUYER AND SELLER
I have carefully reviewed the HUD -1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on
my account or by me In this transaction. I further oenify that I have reoehod a copy of the HUD -1 Settlement Statement. I agree to further a4usbnents in the event of errors or
omissions and indemnify and hold hamtless Settlement Agent against such errors or omissions.
WILLIAM EUGENE JOHNSTON
000-00-0000
WASHINGTON MUTUAL BANK, FA
00.0000000
WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO The HUD -1 Settlement Statement which I have prepared is a true and accurate account of
THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON this transaction. I have caused or will cause the funds to be disbursed in accordance with
CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS this statement.
SEE TITLE 18: U.S. CODE SECTION 1001 AND SECTION 1010.
By:
. DATE
Service Unk Printed 05/14/2008 at 12:12 PM by helliott - REV. HUD -1 (3/86)
TELEPHONE (760) 777-7012 FAX (760) 777-7011
OWNER/BUILDER INFORMATION
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.
For your protection you should be aware that as "Owner/Builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the City or County. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be
aware of the following information for your benefit and protection.
If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200.00 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
If you are an employer, you must register with the State and Federal Government as an employer and you are subject
to several obligations include State and Federal income tax withholding, federal social security taxes, worker's
compensation insurance, disability insurance costs and unemployment compensation contributions.
There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with
respect to worker's compensation insurance.
For more specific information about your obligations under Federal Law, contact the Internal Revenue Service (and, if
you wish, the U.S. Small Business Administration). For more specific information about your obligations under State
Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "Owner/Builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally.
Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N. Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of
these matters. The building permit will not be issued until the verification is returned.
Very truly yours,
CITY OF LA QUINTA
DEPT. OF BUILDING AND SAFETY
78-495 Calle Tampico
La Quinta, CA 92253
(760) 777-7012
FAX: (760) 777-7011
GL, L &
Q_—
OWNER'S SIGNATURE/DATE
5 y - Iys f v ►c1 L e,ry
PROPERTY ADDRESS
oeasq
PERMIT NUMBER(S)
Bin #
City of La Quints
Building & Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit # w( •
`
Project Address:
Owner's Name: W't11 CZ
A. P. Number:
Legal Description:
ontractor:
Address:
Address: 5CA . d S n 1cj0. Ag Q)
City, ST, Zip:`
S 3
Telephone:
Project Description:
City, ST, Zip:
Telephone:
3O O
State Lic. # : City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic.-#:
Name of Contact Person:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project 60
APPLICANT:
DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Rec'd
TRACKING.
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading. plan
2nd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
" Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees