34674 (GRD)-APPLICANT NAME (L, F, MI)
f6I Q Ci3ijbIT. Q.
RESS -
78520 HWY 111
CITYICOMMMUNIITTYISTATEIZIP
�w p� �r �y R {�
LA UINTA CA 922530000
JOB ADpDDRESSISPACE
4 'SITE
�} 1 q
.-l..O,i.520 HWY III
CITYIICOMppM�UUN��I��TTpYpIS,TAA�TEEIqIZIP
4
[ ems •� IL M 11 5�
n.'922530000
LA QUINTA CIA . TIG2530000
BOK PAG
PRC
C
T{W^.N
RNG�%
SE
S
Js wqy
613 41
�qy
013
OTiIf
Y@���
/yam
A f
TRACT LOT
MOD
SS
000000
011
I
TRACT NAME
OWNER NAME
PHONE#
nq� O
e((LL,F,MI)I)�q COUNTRY
LA QUIN 0 A COUN R i A��4!
"
CONTRACTOR.FIRM NAME
LICNC #
ADDRESS
CITY/COMMUNITYISTATEIZI P
PHONE# BLDG.
INSPECTOR
FINAL DATE
ARCIENG FIRM NAME
LICNC #
ADDRESS
CITY/CDM M U N ITY ISTATEIZI P
PLAN # PLAN
AMI
APPR VE D TE V
2/
USE OF PERMIT -
PLAN G . ..
ItS C.
BL
ZON FSB
SSB
SSB
RSB
OFC
01
CPS 010
010
010
010
17
LOT SZ
END
PP53NEnR0#
97 1OOS00
APPL/PRMT p PB I DATE
CONSTRUCTION FEE
34674 46
$0.000
PLUMBING
S6. et►0
$$8,00,
(F�.�i!L+� �
ELECTRICAL FEE
.p8 1 0 CIPS
1'IEC.HANICAL, FEE
$4!! a50
PLAN CHANGE 2 HR
$30.00
Pit
l
SMI FEE
$0.00
TOTAL .
FEE�(�,00
CA
I CK
I NC
C NjER B.I. !
COUNTER L.U.T.
ly
T R U G T U R :A L. { BUILDING �
TOTAL PERMIT COST . is $96.00
r
MECHANICAL FEE COMPUTATIONS * Permit Fee (if applicable)
, VEN'C%;i-Fans t 02 Eva ' cooler r o Ho ori t 00 hisc t 00
COMPR SSOR--0-�3 HF O >3•" 15 03 > 1 rm30 )15-3000 )30-50100 >50 t 00
Pi�"ATING SYS EM= u100 y�0 BTUs03 100,001 or More i1J:p0
C<�.t>,C:`�RIC.;AL FE COM �UTA'� I N �: Perml t Feer (if app�.i aG e)
No of Units 3 Set -vice Voltst 0
PLUMBING -FEE COMPUTATIONS % Permit Fee (if applicable)
FIXTURES—Bar Sinki J Dri,nkin Fntn t 0 F8 Drains 0
Kitchen Sirtk r 0 L,aunr ry Tray t 0 Dr�inal t 1 Wtr lomat : 1
Lavatory r 1 Shower t 0 Tubi 0 Dide+t t 0 Other t 0
REPATR AL.TERATION•- Drainage, vent, Water Piping/Treatment: i.
SM n allation of Water Piping and/or WaterTreafinent Egatip:l
PLAN CHANCE 2 HR
FEE"i
FE» i
FEE:
FEEL
FEE t
FEE:t '
FEE:
F[Et
F .Er
FEET
$3.00
$4.00
$22 . 50
2.00
3. 00
$3.00
$4.00
$7.50
$2.50
$2 91,10,
�0.
$30100
P E
A
Pit
l
T
'-CONSTRUC:i`ION F�T1MA�"f~ {�lOTE_t blot to beusedate property valuation)
Description FCC: Croup. Type Sq Ft date Valuation
PRIMARY MISC; M M 0 $10.00 $0
-4 onstrurtion Fee based on Total Actual Valu4lion of $0 iat $0.00
MECHANICAL FEE COMPUTATIONS * Permit Fee (if applicable)
, VEN'C%;i-Fans t 02 Eva ' cooler r o Ho ori t 00 hisc t 00
COMPR SSOR--0-�3 HF O >3•" 15 03 > 1 rm30 )15-3000 )30-50100 >50 t 00
Pi�"ATING SYS EM= u100 y�0 BTUs03 100,001 or More i1J:p0
C<�.t>,C:`�RIC.;AL FE COM �UTA'� I N �: Perml t Feer (if app�.i aG e)
No of Units 3 Set -vice Voltst 0
PLUMBING -FEE COMPUTATIONS % Permit Fee (if applicable)
FIXTURES—Bar Sinki J Dri,nkin Fntn t 0 F8 Drains 0
Kitchen Sirtk r 0 L,aunr ry Tray t 0 Dr�inal t 1 Wtr lomat : 1
Lavatory r 1 Shower t 0 Tubi 0 Dide+t t 0 Other t 0
REPATR AL.TERATION•- Drainage, vent, Water Piping/Treatment: i.
SM n allation of Water Piping and/or WaterTreafinent Egatip:l
PLAN CHANCE 2 HR
FEE"i
FE» i
FEE:
FEEL
FEE t
FEE:t '
FEE:
F[Et
F .Er
FEET
$3.00
$4.00
$22 . 50
2.00
3. 00
$3.00
$4.00
$7.50
$2.50
$2 91,10,
�0.
$30100
FORM. 284.208 (11.81)
INSPECTOR
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Figs 8 Frms
34
Plenums 8 Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets 8 Outlets
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
43
Final
10A
Fireplace T.O.
No
ADDITIONAL INFORMATION
'
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Loth
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit L.Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
PSL
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME