PLBG (10-0896)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253.
Application Number: c10`00060_1 9aO
t Property Address: 77550 CALLE MONTEREY
APN: 774-051-023-12 -000000=
Application description: PLUMBING
Property Zoning: COVE RESIDENTIAL
Application valuation: 600
T-�� 4 4 Q"
BUILDING & SAFETY DEPARTMENT-
BUILDING
EPARTMENTBUILDING PERMIT
Owner:
MUNOZ NORMA
77550 CALLE MONTEREY
LA QUINTA, CA 92253
(760)564-7854
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/13/10
Contractor:
Applicant: Architect or Engineer: ECOWIZE INC --
�� ^ , 73081 FRED WARNING DRIVE D 0
PALM DESERT, CA 92260 I +
(760)898-2655 i
Lic. No.: B SEP 14 2010
CITY OF LA QUINTA
FWANCE DEPT.
LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: ..
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
License Class: 945713 License No.: B for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
1 � � issued.
�t��Lc �.a ccs. \ C�4�
!Date: Contractor: h� 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
OWNER -BUILDER DECLARATION insurance carrier and policy number are:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier DELOS Policy Number 01DKRM2228906
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to _ Icertify that, in the performance of the work for which this permit is issued, I shall not employ any
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become subject to the workers' compensation laws of California.
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors State and agree that, if I should become subject to the workers' compensation provisions of Section
• License Law (Chapter 9 -(commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3700 of the Labor Code, I spall forthwith comply with tho a provisions.
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).: Date:'`�(1,. ICY I!7 Appy licant:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and—Y�'''1'® _
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL', Q
Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP. TO ONE HUNDRED THOUSAND
and who does the work himself or herself through his or her own employees, provided that the DOLLARS 1$100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
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.). APPLICANT ACKNOWLEDGEMENT
(_ I I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
- 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application.
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed - 1 . Each person upon whose behalf this application is made, each person at whose request and for
pursuant.to the Contractors' State License Law.). whose benefit work is performed under or pursuant to any permit issued as a result of this application,
(_ I I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
Date:
Owner:
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
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 couuntlly to enter upon the above-mentioned property
for. inspection
/purposes.
Aw
IDa- • l I � ynature-IApplicanf or Agent!:
r
Application Number . . . 10-00000896
Permit PLUMBING
Additional desc
Permit Fee 22.50
Plan Check
Fee
5.63''
. Issue Date
Valuation
.
. 0
Expiration Date 3/12/11
Qty Unit Charge Per
Extension
BASE
FEE
15.00•
1.00 .7 5000 EA PL WATER HEATER/VENT
7.50
Special.Notes and Comments
ELECTRIC WATER HEATER CHANGE OUT
40
GALLON.
- ------------------------ ---------------------------------------------------.
Other Fees . . • • BLDG STDS ADMIN (SB1473)
1.00
Fee summary Charged .,Paid
Credited
Due'
Permit Fee Total 22.50
.00
.00
22.50
Plan Check Total 5•.63
.00
.00.
5.63
Other Fee Total ` 1.00
.00
.00
1.00
Grand Total 29.13
.00
.00
29.13
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations
age I of
Project Name: 1
AD
Climate Zone H
N of Stories
General Information
Site Address: 1-1$190 &&
Enforcement Agency
Date:
Building Type USinggle Family O Multi Family
Circle the Front Orientation: N, E, S, W, or degrees
Conditioned Floor Area (CFA):
Project Type: O Alterations O Envelope O Fenestration O Roof O HVAC
Ta�/
ID
-ItyplacementorChange-Out I3-Dnct cement 0—Water—lir
NOTF: This form is not to be Used of New(Y Constructed
Buildings or Addldohts
Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration
O Opening of framed cavity alone- Alterations that irrvolve the apening of the framed cavity ofa wall, ceiling or floor must install the
mandatory minimum insulation value per §1 S0 for the altered assembly. Fill in Columns A -C and enter mandatory insulation value in Column H.
O Replacement of entire assembly - Replacement of an entire wall, ceiling, or floor assembly requires the installation ofComponent
Package- D insulation values in Table 151-C Fill in Calvmnr A - J
Opaque Surface Details For the furred portioned
A B C
of Mass Wails see Furring Strips
D E F
Coustracdon Table below.
G I H I I
J
P' oposed 5W Neft
Standard
Values From JA4 Table
Ta�/
ID
Assembly Name
or T m
Framing
Material
and size,
Thidmess,
Spacing, U- JA4 Table
or Other' factor' Number'
Framed Continuous JA4
Cavity Insulation Assembly
R-value6 R -Value Cell Veluel
Proposed
AssemblZ
U -factor
Noce: For furred assemblies, aaomoeing for Contimrous Imulation R-vatue, see Page JA4-3 and Equation 4-1. For calculating flared walb sae doeAlae and
FumiW Conravaion table below.
-. - r -_d--- -- -W «+cn.91u..rvn name rnat matches the building plans.
2. Indiciale the Assembly Name or type: RooflCetling, Walls, Floors, Slabs, C.1 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 passible frame type assemblies.
3. Enter the thiabtess for mass in inches or Spacing between framing members enter; 16 "or 24 -0C. or Other for all other assembly description
such as Conmie Sandwich Panel, Span&el Panel, Logs, Straw Bale Panel and etc....
4. Based on the Climate Zone; enter the Standard U factor from Table 13 1-B. C or D for each different assembly Name or type.
S. 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 lnsulation 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
9.7)r- Proposed Assembly U factor, Column J, must be equal to or less than the Standard U -tactor in Column E to comatv-
Furring Strips Construction Table for Mass Wails Onl
A B C I D E
F I G H I J I K L M
Proposed Properties of Masonry and Concrete
Walls From Reference
A radix Table 43.5 4.3.6 4.3.7
Added Interior or Exterior Insulation
in Furring Space from Reference
Joint Appendix Table 43.13
�
Final
$ " xg ° �' -- Assembl
x 8 C a > U-factot Comment
rJoint
Thicktuass'
Assemb h
Name or
T '
u
_
JA4 Table �'
Number' < >
Registration Number: Registration Date:Time: HERS Provider:
2008 Residential Compliance Forms
August 2009
Prescriptive Certificate of Compliance: Residential CF -IR -ALT
Residential Alterations Page 4 of S
Project Name: -7
w Climate Zone fl N of Stories
HVAC SYSTEMS - HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
Heating Equipment
Type and Capacity 1•2-3
Minimum
Efficiency Distribution
AFUE or HSPF Type and Location
Duct or Piping
Insulation
R -Value
Configuration
Thermostat (Central, Split,
Type Space, Package or H dronic
External Tank
Water Heater Type/Fuel
Distribution Type
Number In
Tank
1. Indicate Heating Type (Central Furnace, Wall Furnace, Heat pump, Boiler, Electric Resistance, etc.)
2. Electric resistance heating s allowed only in Component Package C, or except where electric heating is supplemental (i.e., if total capacity
< 2 KW or 7,000 Btu/hr.electric heating is controlled by a time -limiting device not exceeding. 30 minutes). See f 15l(b)3 exception.
T Refer lathe HERS Verification section on Page 4 of the CF -JR -ALT Form for additional requirements and check applicable boxes.
4. Indicate 7jpe or Location (Ducts. Ifydr•onic in Floor, Radiators, etc.)
HVAC SYSTEMS- COOLING
System-CapacityThermal
Minimum
R -Value'
Cooling Equipment
Type and CaMity'-Z
Efficiency
(SEER/EER or Distribution
COP) Type and Location'
Duct or Piping
Insulation
R -Value
Thermostat
Type'
Configuration
(Central, Split,
Space, Package or H dronic
1. Indicate Type (Storage Gas. Heat Pump. Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The 'Prescriptive requirements do
not allow the installation of a recirculating water heating system for single dwelling units.
3. The external water heating tank andpipes steal! be insulated to meet the requirements o 150 ' .
I. Indicate Cooling Type (AiC, Heat pump, Evap. Cooling, etc)
2. Refer to the HERS Verification section on Page 4 of the CF -I R -ALT Form for additional requirements and check applicable boxes.
3. Indicate Tmv or Location Ducts, onic in Floor, Radiators, etc.
WATER HEATING
List water heaters and boilers for both domestic hot water (DHW) heaters and hydronic space heating. Individual dwelling DHW heaters must be
gas or propane fired and may not exceed 50 gallons. Hot water pipe insulation from the DHW heater to the -kitchen(s) and on all underground
hot waterpipes is required in all aomponentpackages in all climate zones.
External Tank
Water Heater Type/Fuel
Distribution Type
Number In
Tank
Energy Factor or
Insulation
T
Standard, Recirculatin 2
System-CapacityThermal
Efficient
R -Value'
1. Indicate Type (Storage Gas. Heat Pump. Instantaneous, etc.)
2. Recirculating systems serving multiple dwelling units shall meet the recirculation requirements of §150(n). The 'Prescriptive requirements do
not allow the installation of a recirculating water heating system for single dwelling units.
3. The external water heating tank andpipes steal! be insulated to meet the requirements o 150 ' .
SPECIAL FEATURES The enforcement agency should pay special attention to the Special Features specified in this checklist below.
These items may require written iustification and documentation and special verification.
NEW ROOF ASSEMBLY - Radiant Barrier
The radiant barrier requirement of § 15 I(f)2 does not apply to roof alterations.
Slab Edge (Perimeter) Insulation O YES O NO
YES: In Climate Zone 16 in Component Packages D, R-7 insulation is required.
Heated Slab Insulation O YES 0 NO
YES: Slab edge insulation required for all heated slabs in all Climate Zones.. See details in Table 118-A of the standards.
Raised Slab Insulation O YES 0 NO
YES: In Climate Zones 1 2, 11, 13, 14 & 16, R-8 insulation is required; in Climate Zones 12 & 15, R-4 is required under component Package D. '
Thermal Mass
To obtain Compliance Credit for the installation of thermal mass, use the Performance Awroach.
Registration ikumber- Registration Date,Time:
2008 Residential Compliance Forms
HERS Provider:
August 2009
Pivscri Live Certificate of Compliance: Residential CF-tR-ALT
Residential Alterations (Page 5 of,5
Project Name: N of Stories
�� � -�� ►."
Climate Zone N
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 Sealing,& Testing HERS verification is required for this measure.
13 YES 13 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; theducts are -to be sealed peT §1-52(b)1'Dii and the newly instatted-ducts are to beinsulated-per-"ff)10,.
O EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos.
13 YES O NO 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) l Di. .
O YES 13 NO YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handier,
outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are to be
seated per §152(b)IE.
O 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.
0 EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space.
13 EXCEPTION: Existingducts ems constructed insulated or sealed with asbestos.
Refrigerant Charge - Split System HERS verification is required for this measure.
O YES O NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air
handy, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, .or the furnace heat
ex a refrigerant charge measurement shall be verified per § 152(b) 1 F.
Central Fan Integrated (CFn Ventilation System and Fan Watt Draw
The -ventilation requirements of § l o do not apply to existing residential homes.
Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure.
E3 YES D NO 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 7B.
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete,
Name:
Signature:
Company:
Date:
Address:
if Applicable O CEA or O CEPE
(Certification N):
City/State/Zip:
Phone:
Responsible Building Designer's Declaration Statement
• 1 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.
• 1 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 building it application.
c:�,,.__J
Name:ature:
snd
Company:
lZ \ h
Date:
Address:7_±_�
License:
City/State/Zip. ZZ�
�\W1
Phone:
I I
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300.
Registration Number:
2008 Residential Compliance Forms
Registration Date?ime: HERS Provider:
August 2005
Bin #
City of La Quinta
Building 8z Safety Dh4slon
P.O. Box 1504, 78-495 Calle Tampico
La Quanta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:
Al CIE er, s Name: r�'i1 Y-,0
A. P. Number: Address:
Legal Description: City, IT,Zip: �Q
Contractor:/o
C��7 �� • �_ Telephone: �0
Address:J"S0� 1 Project Description:
City, ST, Zip: 4` V, Qk (O
Telephone.(p
State Lic. #: C City Lic. C
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:.
State Lic. #: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person \ Sq. FL: # Stories: # Units:
Telephone # of Contact Person: too -01—)(0 Z�L)Estimated Value of Project: �
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cales.
Reviewed, ready for corrections
Plan Check Deposit
Truss Calca.
Called Contact Person
Plan Check Balance
Title 24 Calcs
Plans picked up
Construction
Flood plata plea
Plans resubmitted
Mechanical
Grading plan
2'' Review, ready for correctioriMssue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''d Review, 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
x
V.
A.
•4.4 QuAt
't
P.O. BOX 1504
Building 77--5rJd Calle Monterey LA QUINTA8-105 CCAL CALIFORNIA 92253
Address
Owner
Har tlilov
Mailing
Address "ie
City Zip
..La Quanta .92253
Contractor
EcoftO SeWer
Addres
rs0. BOX 192
Desert FP 92261
State Lic.
& Classif.
Arch., Engr.,
Designer
Address
City
Cod 4809631
BUILDING: TYPE CONST
A.P. Number
Tel.
Legal Description
Project Description
346-2793
City
Lic. # 342
el.
Zip(State
Lic. #
CONTRACTOR'S DECLARATION -
under provisions of Chapter 9 (commencing with Section
and Professions Code, and my license is in full force and
I OWNER -BUILDER DECLARATION
I hereby affirm'that I am exempt from the Contractors License Law for the following.
reason: (Sec. 7031.5,Business and Professions Code: Any city - or county which requires a
Permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that.he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he 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).
❑ I, 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, Buisness and
Professions Code: The Contractor's License Law does, not apply to an owner, of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such 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 did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does notapply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
Thereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
Lel Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'. COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
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-
Date—L--Owner
alifornia
Date . Owner
NOTICE TO APPLICANT: If, after making this certificate of Exemption you should become
subject to the Workers' Compensation provisions o% the Labor Code, you must, forthwith
comply with such provisions or this permit shall be deemed revoked '
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
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 city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 1.1130
e jb it
OCC: GRP.-
Sewer Hook Up
ZONE
BY:
Minimum Setback
Distances:
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ -Demolition ❑
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Estimated Valuation
600.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal..
Const.
Mech.
'Electrical -
Plumbing
30.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
.. Y
TOTAL
30.00
REMARKS
ZONE
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
v
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING'a.tS
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMSOJO
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD ,
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
IKITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOa HP
POLE, TEMIPERM
LAVATORY
r
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
t
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR'
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL, AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMSOJO
EWER
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIFEWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION-
NSPECTION
CERT.
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL
7
Received From:
/%%tel INC V,, / G / VD/ tre-. �G/ 2.lBs�f/ 1 r' ^ �G+ —Date _
Address:/ V!% I—A vCf� .2 A
Account No. 0� �2 i IV �� 'Lot(s) ' �� Tract � L;;ie, 2.2.0
Service Address % St� C� L %110 �� �� G.A. Code
❑ Meter(s) $
❑ Service(s)
❑ Backflow(s)
❑ House Laterals)
❑ Detector Check (s)
❑r Surcharge
Sanitation Capacity Charge 9V
❑ W.S.B.F.C.
l7 Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ Inspection Fee -Tract -
Fee -
❑ Plan Check Fees Water / Sewer -
Tract -
❑ Bond Payment - A.D. - Bond
Assort.
❑ Customer Deposit
❑ Other
/ TOTAL $ -J asS
Remarks: Cl,�STO/n Q2 uJl L' L l �� /�L% lmeo a I
❑Copy to:
Cash.
Check
Money
Order
Water Service
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Cash'
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CVWD-4 (11/89)