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06-0739 (SFD)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 T,iht 4 4 a" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: O6-000007_3:9- Property Address: 53220 AVENIDA NAVARRO APN: 774-065-010-14 -000000- Application description: DWELLING - SINGLE FAMILY DETACHED Property Zoning: COVE RESIDENTIAL Application valuation: 112619 Applicant: Architect or Engineer: ----------------------------------------------- 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 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 i 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, 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 Date:Owner: CONQrR,,CJnN 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 Owner: KHAIR JOSEPH P O BOX 12734 PALM DESERT, CA Other struct .Contractor: Owner DITION VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 11/01/06 92260 info . . . . . C MY 0 7 2006 2001 CBC�AF11AaIauur.. + i 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. 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 3 . 00 Policy Number NO I certify that, in the performance of the work for which this permitis 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, j shall forthyvith comply vvA those provisions. WARNING: FAILURE TO SECURE WORKEi1S' 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 requestand 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 enter upon the above-mentioned property for inspection purposes. r� Application Number . . . . . . 06-00000739 Permit . . . BUILDING PERMIT Additional desc . Permit Fee 685.00 - Plan Check Fee 445.25 Issue Date Valuation 112619 Expiration Date.. 4/30/07 Qty Unit Charge Per Extension BASE FEE 639.50" 13.00 3.5000 THOU BLDG 100,001-500,000 45.50 -�-,• Permit ELEC-NEW. RESIDENTIAL Additional desc Permit Fee . . . . 102,.48 Plan Check Fee25.62 Issue Date Valuation . . . . 0 ` Expiration Date .. 4/30/07 Qty Unit Charge Per Extension BASE FEE 15'.00 " 1808.00 0350 ELEC NEW.RES - 1 OR 2 FAMILY 63.28 460.00 0200 ELEC GARAGE OR NON-RESIDENTIAL -9.20 1.00 15.0000 EA ELEC TEMPORARY POWER POLE 15.00 Permit GRADING PERMIT Additional desc . Permit .Fee . . 15.00 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date 4/30/07 Qty- Unit Charge Per Extension BASE'FEE 15.00 rte, ------------------------.---------------------------------------------------- Permit MECHANICAL . Additional desc . Permit Fee . . . . 59.00 Plan Check Fee 14-75 Issue Date . . . Valuation . . . . 0 Expiration Date 4/30/07 Qty Unit Charge Per Extension BASE FEE 15.00 1; UO 9.0000, EA MECH FURNACE .<=100K 9.00 1.00 9.0000 EA MECH B/C <=3HP/100K BTU 9.00 3.00 6.5000 EA MECH VENT FAN 19:50 1.00 6.5000 ----------------------------------------------------------------------------- EA MECH EXHAUST HOOD 6.50" LQPERMIT _ Application Number, 06-00000739 Permit PLUMBING Additional desc . Permit Fee . . . . 123.00 Plan Check Fee 25.88 Issue.Date Valuation . . 0 Expiration_Date 4/30/07 Qty Unit Charge .Per Extension - BASE FEE 15.00 9.00 6.0000 EA PLB FIXTURE •54.00 1.00 15.0000 EA PLB BUILDING SEWER 15.00 1.00 7.5000 EA PLB WATER HEATER/VENT 7.50 ,_- 1.00 3.0000 EA PLB WATER INST/ALT/REP. 3.00 1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM 9.00. 6.00 .7500 EA PLB GAS PIPE >=5 4.50 1.00 15.0000 EA PLB GAS METER 15.00 Special Notes and Comments 1808 SF. SFD PERMIT DOES NOT INCLUDE BLOCK WALL, POOL/SPA OR DRIVEWAY APPROACH Other Fees . . . . ART IN PUBLIC.PLACES-RES 20.00 DIF COMMUNITY CENTERS -RES 74.00 DIF CIVIC CENTER - RES 480.00 ENERGY REVIEW FEE 44.53 DIF FIRE PROTECTION -RES 140.00 HOURLY PLAN CHECK 220.50 DIF LIBRARIES - RES 355.00 DIF PARK MAINT FAC - RES _22.00 DIF PARKS/REC - RES 892.00 STRONG MOTION (SMI) - RES 11.26, DIF STREET MAINT FAC -RES 67.0,0 �] DIF TRANSPORTATION - RES 1666.00 Fee summary Charged -- - - - - - - - - - - - - - ---- Paid Credited -- - - - ------- - - - - -.---- - - - - ---- Due -.- - - - - -- ` Permit Fee Total - 984.48 .00 .00` 984.48 Plan Check Total 511.50 .250.00 .00 261.50 Other Fee Total 3992.29 .00 .00 3992.29 Grand Total 5488.27 250.00 .00 5238.27 .. LQPERMIT Building Address C 3 v Owner 771 Mailing�1 �'p Address 1-1-C) DQx l�'�� �a4.vE >cc� P.O. BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO r / SLA QUINTA, CALIFORNIA 92253 Contractor_ Jr Address City Izip JTel. & Classif. I Lic. # Designers "r '�­� f&.,,u I 8�o — p State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file 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, Business and Profes- sions 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 im- provement 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 construct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply 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. S% p. & P.C. for this reason Date -Ow er WORKER'S COM PEN SATIONECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec'V8`00, Labor Code.) Policy No. Company. ❑ Copy is filed with the -city. O 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 (S1,09), valuawn 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 Workers' Compensation Lawsof California. Date Owner NOTICE TO APPLICANT If, after making this Certificate of Exergpfion you should become subject to the Workers' Compensation provisions of the Lab9f Code, you must forthwith comply with such provisions or this permit shall be deemed r9voked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lencjiagency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Eode.) 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 suspeFded for 180 days. I certify that I have read this Zpplication and state that the above information is correct. I agree to comply with all city nd county ordinances and state laws relating to building construction, and hereby aut raze representatives of this city to enter the above-mentioned property for inspection purr ses. Signature of applicant Date Mailing Address City, State, Zip BUILDING: TYPE CONST. :OCC. GRP. A.P. Number 7 74 of_,2!5�A • C1 o Legal Description L T A 6ke,A1 . Project Description Sq. Ft. Size %SZ New S—' �f No. / No. Dw. Stories l Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ S' t' ated aluation CITY OF LA QuiWTA ---- ---- - PERMIT AMOUNT 00 Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. / Grading Driveway Enc,z Infrastructure TOTAL REMARKS BY: 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 Validated by: Validation: WHITE = BUILDING DEPARTMENT YELLOW = APPLICANT PINK = FINANCE At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: This certifies that school facility fees imposed pursuant to in the amount of $2.63 X 1,808 S.F. or $4,755.04 have been paid for the property listed above and that. building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid. By Official check Wells Fargo/Joe Khair Check No. 009180.3420 Name on the check Telephone 818-389-3594 Funding Residential By Dr. Doris Wilson Superintendent k LL Fee collected /exempted by Espe Lara Payment Recd nde� $4,755.04.QverlU. - s Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees o r other payment identified above will begin to run from the date on which the building or installation permit for this project is -issued, or from the date on which those amounts are paid to the Districts) or to another public entity authorized to collect them on the District('s) behalf, whicP.ever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accountingu- CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road zgcsU o BERMUDA DUNES r Date 11/1/06 La Quinta, CA 92253 RANCHO MIRAGE - INDIAN WELLS r No. 29005 (760) 771-8515 PLA DESERT y �%' INDIOa Owner Joe Khair APN # 774-055-010 Address 53-220 Avenida Navarro Jurisdiction La Quinta City La Quinta Zip 92253 Permit # Tract # Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 53220 Avenida Navarro 1808 Unit 6 Unit 2 Unit 7 Unita Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 = Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: This certifies that school facility fees imposed pursuant to in the amount of $2.63 X 1,808 S.F. or $4,755.04 have been paid for the property listed above and that. building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid. By Official check Wells Fargo/Joe Khair Check No. 009180.3420 Name on the check Telephone 818-389-3594 Funding Residential By Dr. Doris Wilson Superintendent k LL Fee collected /exempted by Espe Lara Payment Recd nde� $4,755.04.QverlU. - s Signature NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees o r other payment identified above will begin to run from the date on which the building or installation permit for this project is -issued, or from the date on which those amounts are paid to the Districts) or to another public entity authorized to collect them on the District('s) behalf, whicP.ever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accountingu- v ZS € - Im Y _ W 0 ® y 6D u! W. b o u CI �< N.• a .o g : ,� au 10- Cn W � � c7 SPACE ABOVE THIS LINE FOR RECORDER'S USE Documentary transfer tax s. .7r1t ................... K Computed on full value of property conveyed, or (] Computed on full value less liens and encumbrances remaining thereon at time of sa.e. Signature ofdeclarant'6r agent determining tax—firm name, 311bibibua l grant ;Deeb WESTERN TITLE FORM NO. 104 ,J - FOR VALUE RECEIVED," GRACE J. HUME, a widow GRANT to JOSEPH KHAIR, a'single man all that real property situate in the unincorporated area of the County of -Riverside , State of California, described as follows: Lot 14 in Block 204 of SANTA CARMELITA AT VALE LA QUINTA. UNIT #20 as per map recorded in book 19, page 38 of•Maps, Records of Riverside Count -7y, California. txt�z3 ..r. STATE OF CALIFORNIA Countysof Riverside J} SS' On•Tii1y 24th 19 78._, before me, the undersigned, a Notary Public, in and for said State, personally appeared_ Grace J. Hume known to me to be the person_ whose name i S subscribed to the within instrument, and acknowledged to me that 5—he— executed the same. otary P lic Robert Del Gagnon FOR NOTARY SEAL OR STAMP .................� ` OFFICIAL SEAL ROBERT DEI_ GAGNON . NOTARY PUB!AC•CALIFORNIA RIVERSIDE COUNTY My Comm ssion Expires Feb. 16,198*' ...............::................... ....... I ... .......w^ni...... MAIL TAX STATEMENTS AS DIRECTED ABOVE RECORDING REQUESTED BY Western Title ;Insurance Co. ,. ';AND WHEN`.RECORDEDMAIL TO '.'y t NAME ' Mri ; Joseph IQlai± -- ADDRESS C/O nllalr ... ., 111.5. 111�i11.:... -+Clrr 134'55 Ventura- Blvd:. #222 81.; STATE -LSheinid 'Oaks;'• CA.:- 91423 J F Title Order No. Escrow No. 37956 MAIL TAX STATEMENTS TO NAME Same as above ADDRESS CITY & STATE y L r v ZS € - Im Y _ W 0 ® y 6D u! W. b o u CI �< N.• a .o g : ,� au 10- Cn W � � c7 SPACE ABOVE THIS LINE FOR RECORDER'S USE Documentary transfer tax s. .7r1t ................... K Computed on full value of property conveyed, or (] Computed on full value less liens and encumbrances remaining thereon at time of sa.e. Signature ofdeclarant'6r agent determining tax—firm name, 311bibibua l grant ;Deeb WESTERN TITLE FORM NO. 104 ,J - FOR VALUE RECEIVED," GRACE J. HUME, a widow GRANT to JOSEPH KHAIR, a'single man all that real property situate in the unincorporated area of the County of -Riverside , State of California, described as follows: Lot 14 in Block 204 of SANTA CARMELITA AT VALE LA QUINTA. UNIT #20 as per map recorded in book 19, page 38 of•Maps, Records of Riverside Count -7y, California. txt�z3 ..r. STATE OF CALIFORNIA Countysof Riverside J} SS' On•Tii1y 24th 19 78._, before me, the undersigned, a Notary Public, in and for said State, personally appeared_ Grace J. Hume known to me to be the person_ whose name i S subscribed to the within instrument, and acknowledged to me that 5—he— executed the same. otary P lic Robert Del Gagnon FOR NOTARY SEAL OR STAMP .................� ` OFFICIAL SEAL ROBERT DEI_ GAGNON . NOTARY PUB!AC•CALIFORNIA RIVERSIDE COUNTY My Comm ssion Expires Feb. 16,198*' ...............::................... ....... I ... .......w^ni...... MAIL TAX STATEMENTS AS DIRECTED ABOVE r RC DISTRICT., PLANNING .REVIEW FORM This form is to .be used by CDD staff for review of. single family dwellings -in the RC (Cove Residential) District. per Section 9.50.090 'of the Zoning Code. Its purpose is -to determines 1) that the proposed housing design does not duplicate the same, architectural style of any house :within 200 feet of the. applicant,:.and/or`2) if there is a need for. the applicant to file for Master Design Guidelines. If the applicant does need to file :a Master. -Design Guideline; please transmit this information to the Building, and Safety Department as. part of yc-.ur ;correction Iist. Please attach .additional explanations as necessary: o APPLICANT: -T6,S . r1I/lcll SITE ADDRESS: 53 _02-0' aVF- VV U APN %% - �%� I b CASE NO.: Iy�� LEGAL: LOT BLOCK aA>t� UNIT ?A S.C:@V.L.CL CHECK AND APPROVED.BY: � \ DATE: Inform the assigned Building plan, checker.upon your assignment'to this case. The CDD Executive Secretary maintains a log book to track applications and a;:sign case numbers. REQUIRED ITEM. Y_ N COMMENT/CORRECTION Verify legal and APN information : Consistent with. MDG .on file (as applicable) MDG filing required (5 filings since 9/3/98) Architectural. variety within 200 . feet of the surrounding area: APPROVED BY COMMUNITY DEVELOPMENT DEPAR7 MEN i BY DATE EXHIBIT CASE NO. %L- 04 ' o a" Architectural design features . Other Requirements: OCT -04-2007 08:55 AM CERTIFICATE OF FIELD Plan Number P.02 CF -4R HEaStar T lephone Sample Group Number /o o -7 rtlfyinp Signature D e Sample House Number Firm: S C. '0� A",- S HERS Provider: C II EEX S Street Address: 2Sguo A'PytA d Circ /�� cityistatwZip: Copies to: Builder, HERS Provider RB SUER COMLLIMCE &WIMENT The house was. Tested ❑ Approved as part of sample testing, but was not teeted As the HERS rater providingdiagnostic testing and field verification, I certify that the houses Identified on this form cam with the diagnostic ested compliance requirements as checked on this form. Distribution system Is fully ducted (i.e., does not use building cavities as plenums or platform returns In lieu of ducts) Where cloth backed. rubber adhesive duct tape is Installed, mastic, and drawbands are used In combination with cloth backed, rubber adhesive duct tape to seal leaks at duct connections. MINIMUM REQUIREMENTS FOR DUCT LEAKAGE REDUCTION COMPLIANCE CREDIT Duct Diagnostic Leakage Testing Results (Maximum 6% Duct Leakage) Measured Duct Pressurization Test Results (CFM ® 25 Pa) valued Test Leakage Flow In CFM If fan flow Is calculated as 400cfm/ton x number of tons enter calculated value here If fan flow is measured enter measured value here -Leakage Percentage (.100 x Test Leakage/Fan Flow) Check Box for Pass or Fall (Pa9sv6% or lose) X�- ❑ Pass Fall 14eTMERMOSTATIC EXPANSION VALVE (TXV) or Commission approved equivalent JeYes ❑ No Thermostatic Expansion Valve (or Commission approved . equivalent) is Installed and Access is provided for Inspection ❑ Yes Is a pass - Pass Fail ❑ MINIMUM REQUIREMENTS FOR DUCT DESIGN COMPLIANCE CREDIT 1, O Yes 0 No ACCA Manual D Design requirements have been met ' (rater has verified that actual Installation matches values In CF -1R and design on plan. 2. ❑ Yes O No TXV is installed or Fan Flow has been verified. If no TXV, verlf led fan flow matches design from CF- 1R. Measured Fan Flow = O O Yes for both 1 and 2 is a Pass Pass Fail Dec 13 2007 9:34 HP LASERJET FAX p.2 INSULATION CERTIFICATE This is to certify that insulation has been installed in conformance with the current energy regulation, California Administrative Code, Title 24, State of California, in the building located at: 53-220 Avenida Navarro, La Quinta, California CEILINGS: TYPE_ BATTS MANUFACTURER: CERTAINTEED Thickness: R-38 WALLS: TYPE: BATTS MANUFACTURER: CERTAINTEED Thickness: R-13 �j,� GENERAL CONTRACTOR: �. A i✓L. LICENSE # BY: TITLE: PARAGON SCHMID BUILDING PRODUCTS, A MASCO COMPANY LICENSE # 221517 BY: TITLE- OFFICE MANAGER DATE: 1213/2007 City of La Quinta Building u Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # ,96-- Project Address: ' A VA (Zeo Owner's Name: .Jsprz�, 1 A. P. Number: '77 4- d Address: -P-o,K Legal Description: 1' o -F . 14- ':�,4- C AICA , . City, ST, Zip:. Contractor: �tT�# z7 Telephone: - Address: v 4Gc6D,� 7. Project Description: City, ST, Zip: Telephone: State Lie. # : City Lie. #: Arch., Engr., Designer: 0,�0�4 , Address: P O 4 -so City, ST, Zip: UC krrA Telephone: 64 r State Lie. I Em Name of Contact Person: Construction Type: Occupancy: Project type (circle one): New Add'a Alter Repair Demo Sq. Ft.: a t7 # Stories: # Units: Telephone # of Contact Person: Estimated Value of Project: 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 Cales. Called Contact Person Plan Check 3alance Energy Calcs. Plans picked up Constructiot 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:- ''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 �O LL S Total PermitFees