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12-1454 (RER)TAW 4 P.O. BOX - 1504 VOICE (760) 777-7012, 78-495 CALLE TAMPICO s . ' FAX (760) 777-7011 LA QUINTA, CALIFORNIA'92253 BUILDING & SAFETY DEPARTMENT •INSPECTIONS (760) 777-7153 . • BUILDING PERMIT , + Date: 12/19/12 Application Number: 12-00001454 r Owner: c Property.Address: 52523 AVENIDA RAMIREZ NANCY KERR { r f'• APN: .- 773-291-025-1 -000000 52523 AVENIDA RAMIREZ Application description: 'REMODEL - RESIDENTIAL . LA QUINTA„ CA _92253 " - r Property Zoning: COVE RESIDENTIAL CiL-?hex' st'ruct info 1 Uc ' Application valuation: •' 100 • _ U G } Contractor: a Applicant: - Architect or Engineer: Owner r• ! _ - ..' C/9' �v��o �O� .DITZOat 301U. (`fit", ., - � • ." . P1 A IV IN �. 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 - Ihereby 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: - - r License No.: -y - for by Section 3700 of the Labor Code, for the performance of the work for which this permit is - 1 issued. - n-Date'm - `Contractor: • _ 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: r 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's State License law for the Carrier - - - - - - - - - - - - - - - - - - - - - - - Policy Number following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to / I certify 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 Contractor's 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 'tX 3700 of the Labor Code, I shall forthwithh ch I with tho provisions that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by _ 'l _�� ,. :. a y pplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (55001.: - ate: L. plicant:- ` ( ),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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL . • - 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 ($100,000). AN 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. y • 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.). - - s s APPLICANT ACKNOWLEDGEMENT ` • - _ (_ 1 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 •r _ • , 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 contractor(s) licensed 1 . Each person upon whose behalf this application is made, each person at whose request and for ' 1 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 ` S' - t 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 + r "• y . performed under or following issuance of this permit. .Hate: f �L�-` I-1 2 ner: - 2. Any permit issued as a result of this application becomes null and void if work is not commenced r" within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject .` • • - - CONSTRUCTION LENDING AGENCY , , permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the • _ . 1 certify that I have read this application and state that the above information is correct. I agree to comply with all -+ ,• r work for which this permit is issued (Sec. 3097, Civ. C.). ' - city -and county ordinances and state laws relating to building construction, and hereby authorize representatives + - • + 'r ' w - of this county to enter upon the above-mentioned property for inspection pur Lender's Name: ' l - ✓/ / _ " �; • • - « •[ ate: 12-: ignature (Applicant or Agent): • - Lender's Address: Ir LQPERMIT _ - - •' • - - Application Number 12-00001454 Permit BUILDING PERMIT INV FEE Additional desc . Permit .Fee 30.00 Plan Check Fee 9.75 Issue Date . . . . Valuation 100 Expiration Date 6/17/13 Qty Unit Charge Per Extension BASE FEE 30.00 Cranial Notes and rnmmPntG RELOCATE A/C, NEW 4' X 8' HEADER. APP. ST. 2010 CODES.INVESTIGATION FEE ASSESSED PER 1997 UNIFORM ADMINISTRATIVE CODE -§304.5 FOR WORK BEGUN WITHOUT BUILDING PERMIT. RESOLVES CODE CASE # 12-6310. -----------------_-----------.------------------------ Other Fees . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE .98 Fee summary ,Charged Paid Credited Due Permit Fee Total 30.00 .00 .00 30.00 Plan Check Total 9.75 .00 .00 9.75 Other Fee Total 1.98 .00 .00 1.98 Grand Total 41.73 .00 .00 41.73 Jr P.O. Box 1504 LA QUINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUiwmG & SAFETY DEPARTMENT PRO PER1'y O WNER' S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner-Bullders Applying for Construction Permits ffemI�IC1TfCB TO-ttOP�'Y Dear Property Owner; An. kation for a building perms has been Submitled is ieolpt+vvese MU spftified at Y name listing youndf as the builbex of the property We we pmViding YM to an Owner -Budder Aclono recapetnstbihties and Possible ride wlo�ant cad [B€otmntien VaifiEatieia Form m make you awaeo of your You may incur by haviag tints permit. issued m. your name as the Oi'neaBuilder, we 10 net ime a builidiDg.pmut pati! 7"esi � .have read, inklaled your. of. oadl Provision, wed' and returned this form to us at oar Official address indicated. An agent of the owner cannot cxectit+e this notice unless year, the property owner, obtain the prior approval of the permitting authority. L.t., Zr►, t Ai 1L understand a Gequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder' building 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 employers while woddng on my property. My homeowner's inswaeoc may not provide coverage for dose 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. 2. I understand building permits are not required to be signed by property owners unless they aresponsible for the construction re on and are not a Licensed Contractor to assume this responsibility. 11-1-,3. I understand as an "Owner -Builder" I am the responsible myself Gem respo party of record on the permit. I understand that 1 may protect Yse potential financial risk by hiring a licensed Contractor and having the permit filed in his or her none inst+eod of ml own. *t (Q- 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers o permits and contracts. 5. I understand if 1 employ or otherwise engage any persons, other than California licensed Contractors, and the total vat of m construction is at least five hundred dollars (5500) including labor and materials, I may be considered an "employe under state and federal lava. ' A6. 1 understand if I am considered an -employee, under state and federal law, 1 must register with the state and fedt g0ycrnmeut, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployro compensation for each "employee-" I also understand my faihue: to abide by these lays may subject me to serious finan risk. (�7. I understand under California Contractors' State License Law, an Owner-Buildbr who builds single-family reside structures cannot legally build them with the intent to offer them for sale unless all work is performed by lice subcontractors and the number of structures does not exceed four within any calenda_ year, or all of the work is perfoi under contract with a licensed general building Contractor. i L& I understands as an Owner -Builder if I sell the property for which this permit is issued, l may be held liable for any financial or personal_ i4arin stied by any subsequent owaer(s) that result from any latent construction defects. in the workmanship br materials. (5-9. 1 understand I may obtain more information regarding my obligations as an "omployW' from the Internam ROwenue Service, the United States Small Business Administration, the California Department of Benefit Payments. and tba California Division of Industrial Accidents_ I also understand I tray contact the California Contractors' State License Board (CSM l� at I - 800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. . t14, 0. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that l am the part' wally and dally responsible for proposed construction activity at the following address: agree that, as the party legally and ftnaticially responsible for this proposed constriction activity, [will abide by all applicable laws and regaireatents that govern Owner -Builders as well as employers. agree to notify the issuer of this form immediately of any additions; dddeons, or ca"ecs to any of the inf at 1 have providod on' this form Licensed contractors are regulated by laws designed to protect the public. If yair contract with someone who dose not have a li®oa9a, tiro Contractors' State License Board may be unable to asmist you with any &wnaial loss you may sustain as a result of a complaint Your only remedy against unliomed Contractors may be inviw7 count. It is also Impos tam for you to. undorataad that if an umlieaosed Coauvctor of catployce of that individual or fum is W*vd while WWVMg on your property. you may be heM liable for damages. If you obtain a pest as Owner -Buller and vn* to but CoafracWTS, you will be mVoct Vo for vu fYm vkcduer or not those Coffmwtom are p mpexiy fieeeowd sad the status of dew wovkc i owame ooveram Before a building permit can be issued, this form must be completed and signed by the property ovrner and retwrntd to the agency respwsMt for iss;M ft * s.prrmit. Note: A copy of tiler pr*VwV em's s AwnVat fwm rhea+ er other verification awe t4k to the icy is roq' .h -.d to be presented nehmen the ppssit is inua to vel the prop; owner's signaturt. _ . _ _. . Signature of property owner_ - v Date •� _ Note: 73re 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. A[)TEPRIZATION.(F AGENT TO ACT ON PROPERTY OWNWS' BERn Excluding the Notice to Property Owner, the exe cation of which I understand is my perirenal responsibility, I hereby authorize the following powu(s) to act as ray agents) to apply for,sign, and file the documents nezessary to obtain an Owner -Builder Permit for my project Scope.of Construction Project (or Description of Work): n ln. i;. vi��in Grp Project Location or Address: � Z J'2_ ? l�d aJ.; Q �vrn L 6Z Name of Authorized Agent: �te, p n /fid i -c Tel No 7,C /1 7 7 Address of Authorized Agent: �- 2 Z I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the a' information and certify its accuracy. Note: A copy of the owner's driver's ticense, form notarization, or other verification aoceivtable to the agency is iced to be p 7 edwhen the permit is issued to verify the property owner's signature. s Property Owner's Signature:. Date: Quote Back to Quote Date: 12/15/2012 Project #: 369704748 Customer Name: STEVE PFANNKUCHE Customer Phone: ( Customer Address: N/A LA QUINTA, CA 92253 USA Line Item Frame Size http://sstsrv.Iowes.com/m2o—at-mediumQuote.jsp?projectld= I 1... LOWE'S HIW, INC. #208 78-865 HIGHWAY 1 1 I , • LA QUINTA, CA 92253 USA (760) 771-5566 Description: ALUMINUM WINDOW Product Code Description 0001 Manufacturer: Betterbilt - Regalview Division: Millwork O Size = 72" W x 24" H Product: Windows Exact Size= 71 1/4" W x 23 Type: Sliding 1/4" H Series: Series 6A0 Fixed Glass Size= 34 7/8" Product Configuration : 2 -Lite W x 20" H Handing: OX Operable Glass Size = 34 Open Frame?: No 5/16" W x 20" H Frame Type: Fin Fin Setback: 1 3/8" Glazing : Insulated Exact Width: 71 1/4" Exact Height: 23 1/4" Rough Opening Size Width: 72" Rough Opening Size Height: 24" Vent Size: Equal Exterior Color: White Identical Glass Options :.Yes Glass Options: HPLow-E Tempered: No Argon Gas: Yes Grid Thickness : No Strip Fins : No Cam Lock: I Screen: WSI Label Instructions : None Lead Time: 12 Unit Price Quantity Total Price lJ-rG= � 40 $196.40 I of 2 12/15/2012 10:23 PM P. escri tive Certificate of Compliance: Residential CF -IR -ALT Residentla/ Afterallons a e 1 of Project Name: I Climate Zone tt I / of Storks General Information Site Address: Z Z3 Enforcement Agency: Date: Building Type E5 Single Family O Multi Family Circle the Front Orientation: N, E, S, W, or degroes Conditioned Floor Area (CFA): Project Type: ,O Alterations O Envelope O Fenestration O Roof O HVAC Repiwement or Change Out O Duct Rephcemeat O WaW Heater : Tbis orm b not to be used or NfwO Coeatnteted BNU&W or Addtdens Insulation Values For Opaque Surfaors (for Fwrieg use the Mass and Furring Strops Construction table belo*4 Assembly Alteration O Opening of framed cavity alone - Alterations thw b olve the opening of the framed cavity Of a wall, cYiltrhg or flow:urate: install the mandatory minimum inrdadon vahar per §/SO for the altered assembly. Fill in Columns A -C and eater nu adotary kadation valor in Column N. O Replacement of cadre assembly - ReplacenwN of an entire wall, ceiling, orJloor assembly requires the innalation of Componeng Package- D kndation vales in Table I S I -C. Fill in Columns A - J. Opaque Surfak a Details For ere tarred of Mass Walls see Farriat Suips Constnedoe Table bdww. A B C I D E F C I ■ I 1 I J P On NekStandard Values From JA4 Table Ta�/ ID Assanbiy Name or T ' Framing Thickness, Framed Coassinthotn JA4 Propoaod Material Spacing, U- JA4 Table Cavity Inmr;ation Assembly Aisembl�r and Siu2 or Other' factor' Numbers R -values R-\W%ats Cell Value U-6ctor Asseenbh Name a 1A4 Table a T h Number' < > Note: For firred assemmex awonwtivfor Cahrimuorr /mutation R-vahre. see Pop JAI -3 awd Egw6on 4-1. For cdcWaaing fined anis hese d N A/ms ad Farrurg Cmatru wn table below. I. For Tag/!D indicate the identifuntion surest that matches the building plans. 2. Indicate the Assembly Name or type: RoWxilintg. Walls. F4eors. &6bu. G o"i Spme. Dom 1vnde&--hs&we the Frame type adSite: For Wood Meld, Metal Buildings. Mass, enter 2x4. 2x6. or etc... see JAI for other possible finnre type assemblies. 3. Enter the thickness for mass in inches or Spacirg between framing member: enter: 16 "or 24 "0C. or Other for all other asm mbly description such as Concrete Sandwich Panel. Spamdrel Panel. Logs. Straw Bale Panel and etc.... 4. Baud on the Climate Zone: anter the Siawb rd U factor from Table 15 I -A C or D for each different assetably Name or type. S. Enter the Table number that closely resembles tlhe proposed assembly. 6. Enter the R - value tuns 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 f utor value bated on Column F Table Number and aver tut Assembly -U-f= or in Column J 9. The Proposed Assembly U factor. Column J. must be equal to or less than the Standard U -factor in Colmer E to cotmoly. Furring Strips Construction Table -for Mass Walls Oral A B C D E F G H 1 J I K L M Proposed Properties of Masonry and Coac-mte Walls From Reference Joint radix Table 4.3.5,43.6.4-k7 Added Interior or Exterior Insulation in Furring Space from Reference Joit A radix Table43.13 Final y S �'+ Assembly I < > ' U-facto:7 Comment Mess Thickness' Asseenbh Name a 1A4 Table a T h Number' < > Registration Number: Registration Date:Time: 2008 Residential Compliance Forms :HERS Provider: August 2009 'Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 2 of Project Name: Climate Zone # 0 of Stories and 1. Indicate the type ofassembly to inhale; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid ConcreteWalls. Eac. Additional assemblies can loud Reference Joint Appendix JA4. 2. This is the U -Factor based on the thickness of the assembly in indw 3. lite 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. -6. The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA 4. The equation is the inverse of Col added to Column l. Column Kis 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 Cl(Replaeing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of 1Component Package D in 7461e 1 S/ -C The Total Fenestration and West jacingArea 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 151-0. Adding more than 50f11 ofwindow 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 a Tabh- on P ge 2 of the CF -IR -ALT Orientation Fenestration Type and Frame (North, East, PropsedAroa radon Glass Door or Skylight) Soutk West flo Maximum Maximum U -factor 7 SHGr, 3.4 NFRC or Default Values D Lio 3' Z F G CFA of Allowed Existing Allowed Entire 1. Fenestration area is the area of total glazed product (i.e. glass plus fine). Exception: When a door is less than S0'9 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 thou that specified on the CF -IR ALT Fora: . 4. Submit a completed WS -3R Form if a reduced SHGC is calculated with exterior shading. 5.Yapplicable at this stage enter "NFRC" or NFRC Certified windows or are CEC "Default " valuesfound in Table 116-A or B. ALTERED FENESTRATION ALLOWED -AREAS (Co e1e i nrore than S offenestration Is addee') A B C D E F G CFA of Allowed Existing Allowed Entire % of, Fenestration Area. Fenestration Asea Proposed Area• 4 Dwelling CFA; r Area Removed' Area Added' A x B D+ C Total Fenestration Area ft West Fenestration Area (Required In CZ's 2, 4dt7-15 1. The Proposed West Fenestration Area includes West -sloping skylight area and any other skylight area with a pitch less than 1:12. 2. Enter 20•/ when no West orientation restriction or 15% when West fenestration is being installed in Climate Zones 2, 4, do 7-15. Note that the maximum allowed fenestration can only be S% of the CFA as indicated in Column F. Column G must be equal to or less than Column F. 3. In climate zones 2. 4, 7-15, no more than S% of the CFA is allowed for west facing glazing. 4. Existing Fenestration area must be counted toward the maximum allowed 15% or 20•/ of the whole building and calculated in Column G. The Proposed Area must be less than or equal to Column F. S. Enter the fenestration removed as part of the alteration if any in column D. 6. Enter the Fenestration area that is being added as part o the alteration. 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Compliance- Residential CF -IR -ALT Residential Alterations a e 5 of Project Name: Climate Zone # # of Stories HERS VERIFICATION SUMMARY 77ne enforcement agency should pay special attention to the HERS Measures specified in this checklist belaw. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector beforefinal inspection Duct Sealing & Testing HERS verification is required for this measwe. ❑ YES Q 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. 0 EXCEPTION: Existing duct systems that are extended, which are constructed, inWated or sealed with asbestos. OYES ONO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the duds are to be sealed per § 152(b)1 Di. OYES 13NO 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 beating coil, or the furnace heat exchanger) the duds are to be sealed per § 152(b)l 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. 0 EXCEPTION: Duet systems with less than 40 linear feet in unconditioned space. EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Refrigerant Charge -Split System HERS verification is requiredfor this measure. 0 YES 0 NO YFS: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replaoement of the air handler, outdoor condensing unit of a split system.A/C or heat pump, 000ling or heating coil, or the fiance heat ex a re ' erant dwge measumment shall be verified per § i S 1 F. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of § 1 o do not apply existim . residential homes. Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. 13 -YES ONO 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 § 15 1 Ci to meet the mcimiremients of § 151 7B. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and com tete. Name: Signature: Company: Cate: ._ 12 - 2 ZAddress: Address: -::1 If Applicable CEA or CEPE (Certifrcatian #): City/State/Zip: Phone: u �2Z376 0 7 7 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 agencyfor approval with this building rmit application. Name: Signature: Company: Date: Address: License: City/State/Zip: Phone: for assistance or quesnons regarding the Energy Standards, contact the Energy HotUne at. 1-800-772-3300. 2008 Residential Compliance Forms March 2010 VV.� Zt7�-q YDPp A? &V �� vn�T users Bin -# City of La Quina Building & Safety Division P.O. Box 1504,78-495 Caffe Tampico La.Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit #•` `'A ��" Project Address: ^Z Z 3 / e,h ,%^r .Z Owner's Name:. 1%acyl L(i A. P. Number. Address: Legal Description: Contractor. City, ST, Zip: (11 L la 1 2 3 UI Nle Telephone: Address: Project Description: A G City, ST, Zip: q)4 Telephone: State Lic. #: City Lic. M. ' Arch., Engr., Designer. r Address: City., ST, Zip: Telephone: State Lic. #:/ : "� ,„�.,z,,,, %»„� Name of Contact Person: S. ��. 14",o k Construction Type: , Occupaacy: Project type (circle one): New Add'n Alter Repair Demo _1 Sq. Ft.: # Stories: #U nits: Telephone # of Contact Person: 47 k0 %' G' Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACMNG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cafes. Reviewed, ready for corrections Plan Check Depcsit. . 'Russ Cafes. Called Contact Person Plan Check Bala ace. Title 24 Calci. Plans picked up Construction % Flood plain plao Plans resubmitted Mechanical Grading plan 2iQ Review, ready for correctionsfissue Electrical Subeontactor List Called Contact Person Plumbing Grant Deed Pians picked up S.M.I. ILO.A. Approval Plans resubmitted Grading IN HOUSE:- ''' Review; ready for correctionsfissue Developer Impret Fee Planning Approval . Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Foes