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11-0147 (RER)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number.lc •1-00000147-) Property Address: 53836 AVENIDA NAVARRO APN: 774-175-004-19 -000000- Application description: REMODEL - 'RESIDENTIAL Property Zoning: COVE RESIDENTIAL App eatlon Valuation: 1 U U U TAt!t 4 ��. BUILDING & SAFETY DEPARTMENT BUILDING PERMIT. Applicant: Architect or En i�ee ---------------------------------------------------- LICENSED CONTRACTOR'S DECLARATION'S - 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 hereby affirm under penalty of perjury that) 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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 155001.: . 1 �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 CONSTRUCTION WDING 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: ZAMORA VICENTE 3758 WILD OATS LN LA QUINTA, CA 92253 (619)472-1178 VOICE (760) 777-7012 FAX '(760) 777-7011 INSPECTIONS (160) 7774153 Dater 2/11/11 Contractor: FEBOwner F�' 1 201q 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. 1 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 Co hall forthwith comply with those provisions. Date:_2` �� APAppl�can: ,, WARNING: FAILURE TO SECURE WORKERS' COM ATION 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 LaQuinta, 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 propert f r spection purposes. Date: -!_&& Signature-IAppl�--- cantor Agent): Application Number 11-00000147 Permit . . . BUILDING PERMIT Additional desc. Permit.Fee 45.00 Plan Check Fee 29.25 Issue Date Valuation 2000 ' Expiration Date 8/10/1I Qty Unit Charge Per Extension BASE FEE 15.00 15.00 2.0000 HND- BLDG 501-2,000 30.00 r+Y Special Notes and Comments REPLACE OLD SINGLE PANE WINDOWS WITH NEW ENERGY EFFICIENT ONES (7) WINDOWS PER APPROVED PLANS & A.J. ------------------------------------------------------------------------ Other Fees . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 ENERGY REVIEW FEE 2..93 Fee summary Charged Paid Credited Due Permit Fee Total 45.00 .00 :00 45.00 Plan Check Total 29.25 .00 .00 29.25 Other Fee Total 3.93 .00 .00 3.93 Grand Total 78.18 .00 .00 78.18 - LQPERMIT . T 0 �> l+ �> l+ < !� I Z -Al I U Ln 1 N i Z I< -L. a t v N 3 , � o n a � sE--� C,� m ' J Prescriptive Certificate of Compliance: Residential CF -IR -ALT. Residential Alterations a e 1 of Project Name: Climate Zone N N of Stories I General Information Site Address: 5-38,-�A AIAVA Enforcement Agency: Date: Z -10-1 Building Type Single Family O Multi Family Circle the Front Orientation: N, E, S,:W)or degrees Conditioned Floor Area (CFA): Project Type: D Alterations ❑ Envelope O -enestration O Roof O HVAC H 1 •t J I K Replacement or Change Out ❑ Duct Replacement ❑ Water Heater L1/OTE: 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 O Opening of framed cavity alone -Alterations that involve the opening of the framed cavity of a wall, ceiling, or floor must install the mandatory mtntmum insulation value per §1 S0 for the altered assembly. Fill in Columns A -C and enter mawdatory insulation value in Column H. O Replacement of entire assembly Replacement - of an entire wall, ceiling, or floor assembly requires the ,installation of Component Package- D insulation values in Table 131-C. Fill in Cnlu/nnr .t - i Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Tabk below. A B C D E F G H [ J Pro Standard Values From JA4 Table Framing Thickness. Framed C•3ntinuous JA4 Proposed Ta�/ Assembly Name Material Spacing, U- JA4 Table Cavity 1-isulation Assembly Assembl I or T and Size' or Odle? factor' Numbers R-value6 R -Value' Cell Value U-faaor Note: For furred assemblies, accounim for Contimeous Insulation R -value. see Page JAi-3 and Egtarion I-!. For calc�dati�rg fwred walls ase the Alas and Frrri Con-vaion table below. L For Tag,'11) 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. -Medicate the Frame type and Size: For Wood, Metal, Metal Buildings. Mass, enter 2x4, 2.x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the thicknessfor mass in inches or Spacing between framing members enter; 16 "or 24 VC: or other for all other assembly description such as Concrete Sandwich Panel. Sparub-el Parol, Logs. Straw Bale Panel and etc.... 4. Based on the Climate Zone: enter the Standard U factor from Table 151-8, C or D for each different assembly Name or W. 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 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 Ufaclor in Column J 9. The Proposed Assembly U factor, Column J. must be eaual to or /vac thn» t;- ct»»A».a u_r t -„t..».» F t„ .,n» 1. Furrin,g Stfi s Construction Table for Mass Walls Only AI B C I D I E F G I H 1 •t J I K L M Proposed Properties of Masonry and Concrete Walls From Reference Joint A Mudix Table 4 3.5 4.3.6 4.3.7 Added o o c K 2 Interior in Furring Joint A L a E L' or Exterior Insulation Space from Reference udix Table 4.3.13 a ' $ a , a b ce <> Final Assemb� U -factor ' Comment Mass Thickness' V Assembly U_C Name or JA4 Table'0 Type' Number' <> Registration Number: Registration Date.Time: 2008 Residential Compliance Forms HERS Provider: August 2005 -Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alteratiotis Page 2 of 5 Project Name: Climate Zone # # of Stories Mass and Furring Strips Construction ootnotes 1. Indicate the type of assembly to include: Hollow Unit .Masonry Walls, Solid Unit Masonry. Solid Concrete Walls. Etc. Additional assemblies can befound 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 - I slue is the R -value of the furred out section of the assembly. -6. The Final Assembly is calculated using Equation 4-1 or Equation 4-4of the Reference Joint Appendix JV. The equation is the inverse of Colum added to Column 1. Column K is the inverse from column J. 7. Insert the calculated U- actor value on to the Opaque Surface Details in Column J FENESTRATION PROPOSED AREAS 19 Replacing window alone - Replacement windows shall meet the U -Factor and SHGC Value requirements ojComponent Package D in Table 151-C. The Total Fenestration and West facing Area requirements are not applicable. O 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. O Adding more than 50ft2 of window area - Newly installed windows shall meet the U -Factor and . HGC Value and the Fenestration Area requirements of Component Package Din Table 151-C. Complete the Altered Fenestration Allowed A. -ea Table on Page 2 of the CF -IR -ALT Orientation Fenestration Type and Frame (North. East, PropsedArea' Maximum Maximum NFRC or Default (Window, Glass Door or Skylight) South, West) ft2 U-factor2- } SHGC2• 1. ` Value5 L SuoC2 �'�ti F w'� 2-535 30 Dc)f-'lL 6LAZ.C- Loy, F_ CALA5 nv 'aL 6L/Q-6 L et -v E L- LA,;.,� 2--5-koLf: 00ji (a vINIL raAMEtI)vNt(a c' EAST; 50. IC 32 ZL I. Fenestration area is the area of total glazed product (i.e. glass plus frame). Exception: When a door is !:>ss than 50016 glass, the fenestration area may be the glass area plus a ''2 inch frame " around the glass. 1. Enter value from Component Package D Requirements in Table 151-C. 3. Actual fenestration products installed and as indicated in CF -6R -ENI' Form shall be equivalent to or ho-je a lower U factor and/or a lower SHGC value than that specified on the CF -I R ALT Form. 4. Submit a completed WS -31? Form if a reduced SHGC is calculated with exterior shading. 5.1f applicable at this stage enter "NFRC" or NFRC Certified windows or are CEC "Default " values found in Table 116-A or B. ALTERED FENESTRATION ALLOWED AREAS (Complete if more than SOjir of enestrationis 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 anv skylights with a pitch less than 1: 12. 1. West facing glazing area removed cannot be... counted"twice. •. In order to distribute the west glazing Brea removed to the other orientations. input the west glazing area removed in the Total Fenestration Area row, column D. 3. Include the Proposed Area of the West facing fenestration in both Area columns below. 4. To meet compliance. the Proposed Area must be less than or equal to the Total Allowed Area for BOTH the Total and West Fenestration Areas.. Registration Number. _ _ Registration Date Time: _ HERS Provider: — 2008 Residential Compliance Forms August 200 'Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations Page 5 of 5 Project Name: ��" Climate Zore # # of Stories h> 0 3 f 6 c v (`A1 I b'1 ��titf�'��2C� l S IHERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF -41? 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. ❑ YES ❑ 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 §1.52(b)I Dii and the newly installed ducts ar- to be insulated per §151(f)10. ❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ❑ YES ❑ 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 §I52(b)IDi. ❑ YES ❑ NO YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (inclucing the replacement of the air handler, outdoor condensing unit of a split system. cooling or heating coil. or the furnace beat exchanger) the ducts are to be sealed per § 152(b) I E. ❑ EXCEPTION: Duct systems that are documented to have been previously seiled confirmed through HERS verification in accordance with procedures in the Reference Residential Apprndix RA3. ❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. ❑ EXCEPTION: Existing ducts stems constructed, insulated or sealed with as restos. Refrigerant Charge -Split System HERS verification is required for this measure. ❑ YES ❑ NO YES: In Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (i-icluding 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 reftieerant charee measurement shall be verified cer 6152(b)IF. ICentral Fan Integrated (CFI) Ventilation System and Fan Watt Draw I The ventilation requirements of Q 150(o) do not aooly to existine residential homes. Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is regt_ired for this measure. ❑ YES ❑ NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (®VAC equipment and ducting) is replaced, the airflow and fan watt draw shall be verified Der 6152(b) lCi to meet rthe requirements of 151(f)7B. Documentation Author's Declaration Statement • l certify that this Certificate of Compliance documentation is accurate and complete. Name:Signature: �,�i CcNTt_ �i��v1 v2l� Company: Dae: Address: if Applicable ❑ CEA or ❑ CEPE 37 5 E- wE i t. o 0A -C 5 W (Certification #): City/State/Zip: Phone: I GfL 9 i G'Z ((� 2 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 -.his 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 specifiations submitted to the enforcement agency fora roval with this building pen -nit application. Name: Signature: Company: Date: Address: Li sense: City/State/Zip: PF -one: 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 Time: HERS Provider: August 200 P.O. BOX 1504 LA QUINTA, CALIFORNIA -92247- 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDINC & SAFETY DEPARTMENT PROPERTY OWNER'S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for Owner -Builders Applying for Construction Permits IW!GIRTANTt NOTICE TO PROPERTY OWNER Dear Property Owner. An. application .for a building permit has been submitted rn ' 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 thispermit•issoed in your name as the Owner -Builder. We will not issue a building permit until you: 4ave read, initialed your. understanding of each`provision, signed, and returned this form to us at our official address indicated. An agent of the owr�r cannot execute this -notice unless you, the property owner, obtain the prior approval of the permitting authority. 5 Read and initial eachstatement below to`signify you this i*rmation. VZ 1.4 understand a frequent 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 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 c•jverage for injuries to workers on my. property. \1 Z 2. I understand building permits are not required to 'be signed by property owners unle�;s they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility.. \/-Z. 3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. [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. V.LL4:I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. V -Z. 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 "employee' under state and federal law. V,- 6. 1. 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 workers' compensation disability insurance, aid' contribute to .unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to seriou§ financial risk. \J. -I. 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 pe'rformed 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. V, 7- 8. I undersiand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal. igjuries sustainedby any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. \1,Z.9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business 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 (CS -LB) at 1- 800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors. 4,11. 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: V,Z.I I- I agree that, as the party legally and financially responsible for this proposed construction activity,.i will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. V,2 , 12.1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information 1 have provided 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'eivil court_ Itis also important for you to understand that if an unlicensed 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 isstung,the permit. Note: A copy of the property owner's Mver's-licfasei form notanc"iOn; or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. .. Signature of property owner �� Dam: 2-10 — // 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 ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is 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 perjury that 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: Bin # Qty Of ra Q uin to ' Building a Safety Division P.O. Box 1504, 78-495 Calle Tampico UQuinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address:s"'j 36 AVA) OOA I V A v lck (Z(LO. Owner's Name: V I C 15 N M A. P. Number: Address: -2 -7 ej I L Q AT"5 L 0 Legal. Description: City, ST, Zip: gng irA GA 919 02- 2ConVactor. Contractor: OleTelephone: ((PI9) 4-72— 17 Address: Project Description: RCPLrAce CLO SiNGLC— City, ST, Zip: 444a WINDOWS wirX4 NGW CNMI& Telephone: _ _ kG(isN Qt -197!; ME State Lic. # : City Lic. #.- Arch., ;Arch., Engr., Designer: Address: City., ST, Zip: Telephone: ......{3s.:<� ;: ::: ( .i'.y'`i' Construction Type: Occupancy: State Lic. #: Project type (circle one): New Add'n a Alter Repair Demo Sq. Ft.: C I OO # Stories: # Units: 3 Name of Contact Person: I Ca=(4 1: Z/A+40fLA,' Telephone # of Contact Person: 1-9 87& - F,7 '2.7 Estimated Value of Project: 1§1'6CO-- 20 a APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Rec'd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan . - 2°" 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:- ''d 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. ees