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13-0665 (RER)P:O. BOX 1504 4 r 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY. DEPARTMENT BUILDING PERMIT Application Number: 13-00000665 Property Address: 77450 CALLE TECATE APN: 774-293-025-12 -000000- Application description: REMODEL - RESIDENTIAL Property Zoning: COVE RESIDENTIAL - Application valuation: 150000 Applicant: Architect or Engineer:' 1 V -------------------------------------------------- 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 o1 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 live hundred dollars ($600).: as owner of the property, or my employees with wages as their sole'componsadon, will do the work, and ! %o the structure is not intended or offered for sale ISec. 7044, Business and Profossiuns 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 ono your of complation, the owner -builder will have the burden of proving that he or she did not build or unprovo for the purpose of sale.). u1eoa?. owner of, the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Bus(nyss 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 contractors) licensed npursuant to the Contractors' State License Law.).. am exempt under Sec. , B.&Por this rdnson A.,- I CONSWUCTION LENDING AGENCY 1 hereby affirm under penalty of perjury that there Is Pgonstruction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ, C.I. Lender's Name: Lender's Address: LQPERMIT Owner: EDWIN BURGOS 1603 2ND STREET MANHATTAN BEACH, CA 90266 Other struict info . •, Contractor: Owner DITION 20 VOICE (760) 777-7012 r FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 10/23/13 C - ------------------ WORKER S COMPENSATION DECLARATION 1 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 ii,.,tce, as required by Section 3700 of the Labor Code, for the performance of the work for wh 'lFthis permit is issued. My workers' compensation �person �anymanner Eas mber are: Carrier_ ---Policy Nmr or �jofthe work on'wliich this permit is issued, I shell not employ any become s joct to the workers' compensation laws of California, and agree that, if I should. mesub' of to the workers' compensation provisions of Section 37 .0 ol. the L_a..ho�r "Cods 11•f 1 Ith comply with those provisions. Date:' � �• � '�jAppll,���" • WARNING: FAILURE TO SECURE WORKER OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 16100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 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 sot 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 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'daya from date of issuance of.such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that 1 have read this application and state that the abovt�ion mation I drreeI. I agree to comply with all city and county ordinances and state laws relating to building cction, -a hereby authorize representatives 01 It Js Our t�'(b1 I tier upon the above-rnendorietl proper o� ri poses. Oa y��Ar�l/�/.SignOturO (Applicant or Agangt 0 Application'Number 13-00000665 s Permit BUILDING 2013 Additional desc .. .. Permit Fee . . . . 533.11 Plan Check Fee .00 Issue Date Valuation 150000 " Expiration Date 4/21/14 Qty Unit Charge -'Per < Extension BASE FEE 431.86 125.00 .8100 THOU BLDG $25,001-$200,000 101.25 Permit ELECTRICAL 2013 Additional desc . Permit Fee 23.83 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date 4/21/14 Qty Unit Charge Per Extension 1.00 23.8300 LS ELEC FIXTURES, FIRST 20 -------------- 23.83 Permit MECHANICAL 2013 Additional desc. Permit Fee 35.76 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date 4/21/14 Qty Unit Charge Per. Extension 1.00 11.9200 .EA MECH APPL.REP/ALT 11.92 1.00 11.9200 EA MECH VENT FAN 11.92 1°"00 11.9200 EA MECH EXHAUST HOOD 11.92 Permit PATIO COVER 2013 Additional desc .. . •Permit Fee 131.56 Plan Check Fee .00 Issue Date Valuation 150000 Expiration Date •• 4/21/"14 " Qty Unit Charge Per Extension 1.00 131.5600 EA MISC PATIO COVER, SPEC 131.56 Permit PLUMBING 2013 Additional desc .: .. Permit Fee 286.08 Plan Check Fee .00 Issue.Date Valuation .0 " LQPERMIT - Application Number 13-00000665 Permit . . . PLUMBING 2013 - Expiration Date 4/21/14 • Qty Unit Charge Per Extension 11.00 11.9200 EA PLBG FIXTURE/TRAP 131.12 10.00 11.9200 EA PLBG ROOF DRAIN 11920 1.00 11.9200 EA PLBG WATER HEATER/VENT 11.92 1.00 11.9200 EA PLBG WATER INST/ALT/REP 11.92 1.00 11.9200 LS -PLBG GAS SYS, 1-4.OUTLETS 11.92 ----------- _-------------------_--:--_----- --.._ Special. Notes and Comments REMODEL, CONVERT EXISTING GARAGE TO LIVING.SPACE 450 SQ. FT. 806 SQ. FT. PATIO -ADDITION, NEW GARAGE OF 456 SQ. FT. WITH 144 SQ, FT. LIVING SPACE ADDITION. 368 SQ. FT. DECK AND NEW FIRE SPRINKLERS @ 3731 SQ. FT. PER 2010 CALIF BUILDING CODES. August 5, 2013 12:49:33 PM JJOHNSON. Other Fees . . BLDG STDS ADMIN (SB1473) 6.o6 - PLAN -CHECK, ELECTRICAL 23.83 _ PLAN CHECK, REMODEL 253.11• PLAN CHECK, MECHANICAL 19.08 " PLAN CHECK'; PLUMBING 293.22 . _ STRONG MOTION (SMI) - RES 15-.00 Fee summary.' Charged Paid Credited Due ----------->---.--- - -------- - - - - - - - - --_ ---------- Permit Fee Total 1010:34 .00 .00 1010.34 Plan Check Total .00 .00 .00 .00 Other Fee Total 610.24 .00 .00 610.24. Grand Total 1620.58 .00 .00 1620.58 LQPERMIT It _ _... _ (� City of. La QuInta Permit #' P.O. Box f504,78-495 Caffe Tamptco 4 QAta, CA 92253 -:(760) 7774012 it 4 - Building Pennit -AWfcatlon'and Trackinje Sheet - Pwj=t:Add"--/7-qbD C)WE Ovmees Nme,. W A) 90-P-(705 A. P. Number. :7 0 0 Z s Address: 1 3 Z IVD SIF - Legal Description: CDntractqr. 0 '/\m) F 0 City, ST. Zip: Telephone: Address' E!rOJCr tion: -,dPOSE70 Fr-fAhVljn�-) 4D=ip pf /,0 A/ City. . $T, Zip. —INCUOIA47 �- NFVNJ Telephone: State Lic,latyu,&- 1� Am(L, Eag., DMguerL/ & \,Jf-�j CO Aj- Trj Address , Io Clty.ST,�P: 14 6VIA/ c--4 Telephono0o� 56- 4 - q-'70 Cautmcdon T�pt. 0 'M StatcLia #.- Project -C7 -14 Name ofConWPerson .- Sq. Ft I"' Tetepiwac # of Contact Pelson: (710 �6 I -f 1470 7 �value offlmjcct i'n Alta air Demo #Utdt;: 9 Submittal plan sea Rtqd '-Rec'd TRAXMG Plan Check submitted . . . . . . . . . .ItemAmotmt PERMYFM- r -stmet" cjac& RevicW4 Mdtr for corirecdow rim chcckDqmIt, TYross Calks. Called CmituA Pusan V Plan Check Balance. LTIde 24 Calci. Plans plekid up 0 CMtrtd,u Flow plain plan Plans raubrilftV. k �s mmmfik� Grading plan T� Review. ready rco �04 Electrical� Subcontactor LAA Great Deed-- called contact P Plans picked up PtumbC�ml S&MJILL C- I OQ-5 i tki) , FO qnOA,) ILOA., Approval Plans resabraitted Vl� C-raing6�,,b P&PA IP IN YZE0 USIL. Planning Approval. 3" Review; ready for awrectionvissue Called Contact Person Dcv*elo Impact Fee ip. 1- 4-11 CAj Pub. Wks.'Appr Date of perwit!"t wl (ifqtm Oca-t uro A— School Fees Total P Fees *1NSD(,jai 1'05 AAPRO b .4 Date 9/30/13 No. 31826 Owner Burgos Address 77450 Calle Tecate . City La Quinta Zip 92253 Tract # - - Type Residential Addition Lot # No. Street Unit 1 77450 Calle Tecate Unit 2 Unit 3 Unit 4 Unit 5 Comments CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 S.F. 594 Unit 6 Unit 7 Unit 8 Unit 9 Unit 10 APN # Jurisdiction Permit # No. of Units Lot # No. C Q BERMUDA DUNES r 00 RANCHO MIRAGE b N INDIAN WELLS PALM DESERT, t� LA QUINTA 4INDIO 774-293-025 La Quinta Street S.F. At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies,that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $3.20 X 594 S.F. or $1,900.80 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 C/C Union Bank, Ben Gilmore Check No. 0113017671 Bank Name/Recipient of Certificate Telephone 760/989-0188 Funding Residential By Dr. Gary Rutherford Superintendent ' Fee collected lexemd by Patricia Barbuzza Payment Recd $O.OoT', . $1,900.80 .Over/Under Signature "KI, NOTICE: Pursuant to Government Code Section 6 0(d)(1), this will serve to notify you that the 90 -day approval period in which you may protest the fees or 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 District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID without embossed seal Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting r Twitt a." P.O. BOX 1504 LA QUINTA, CALIFORNIA 92247-1504 BUILDING & SAFETY DEPARTMENT 78-49.5 CALLS TAMPICO (760) 777-7012 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011 PROPERTY OWNER'S PACKAGE Disclosures & Forms for Owner-Bui tiers Applying for Construction Permits _40WORMAT! NOT )CCE TQ PROPERTY OWNER Dear Property Owner An, application fora t his been sub ed in your name u'�ting yotuxelf as the builder of the Property improvements specified ab��:�: � (� ���Q- y t ti G We are providing you with as Owner -Builder Acknowledgment and Information Verification Form to make you awave of your responsibilities and possible risk -:you may,mcur by 4ving.thispermit issued in your name as the Owner -Builder. We will not issue a building pexmit until..you have read, initialed your understanding of eack'provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. cr vy"V.4k -a AliAr0J1VYL;"1lyj:ly'1AND'VERIFICATION OF WFOPMA NIN DIRECHONS: Read and initial each statement below to signify You understand or verify this information. understand a frequent practice of tinlicensed persons is to have the property owner obtain an "Owner -Builder" budding 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. w My homeoner's insurance may not provide coverage for those mjunes..l am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. understand as an "Owner-Buildee"I'am the responsible party` of record on the permiL I 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. tugderstand Contractors are required by law to be licensed and bonded,in California and to list their license numbers on permits and contracts. Q/understand if I en'iploy o'r otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at: least five hundred dollars ($5;00), including'labor and materials, I may be considered an "employer" under s'taie and federalYlaw. 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 woiicets' compensation disability insurance, and contribute. to unemployment compensation for each "employee. I also understand my failure to abide by these laws may subject me to serious financial risk. q4(j7-I`understand under California Contractors' StateLicense 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 performed 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. understand as an Owner -Builder if 1 sell the property forwhich this permit is issued, I may be he'd liable, for any financial or personal. 4uries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. ` �41 JL��l understand I may obtain more information regarding my obligations as an "employee' from the h tenml Revenue ervice, 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 (CSLB) at 1- 800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors. tL�tw_ I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand'that 1 am the party le ally and financially res while for proposed conslt�uetion activity at the following address: 117 " I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all app ble laws and requirements that govern Owner-Btnldersas well as employers. agree to notify the issuer of this form immediately of any additions; deletions, or changes to any of the information I 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' Yore only remedy against unlicensed Contractors may be in civil court- It is also important for you tounderstand that if an unlicensed Contractor or cnVloyee'of that individual or firm is injured while wodling on your property; you may be held fiable for damages. If you obtain a permit as,Owner-Builder and wish to bin Contractors, you will be responsible for verdy'arg whether or not those Contractors are property 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 aad returned to the agency responsible for issai>ag. Note:. py of tke propety owner's diriver'sliapnsv� faun no4ia[>7trtr m or other vert tcation aeceptable a ag r ' ed a be presented when the permit is iastted to ver* the pmperty owner's signature. Signature of property owner Date:_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 understandis my personal responsibility, l hereby authorize the following persons) to act as my agents) 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): JZEIW004_ � 'EX 5T%t-1(r b1MC Project Location or Address: �O GaLL..E TC— Name of Authorized Agent: AGN ALM OQE Tel N441/00-) Address of Authorized Agent: 5(4q95 AUC -01M M AL.VAa^06 ILAVIO,^ CA 4t225?2 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 neriine of : .Copy e o er's driver's license, form notarization, or other verification acceptable to the agency is requ' ed to e r d w n the permit is issued to verify the prop rty o en's signature. CJ Property Owner's Signature: Date: ' CITY, Of LA JOB ADDRESS 450 _ CALLC-- TE -C -AVE PERMIT NUMBER f . QUINTA-SUB-CONTRACTOR L1 -ST ' OWNER' El '90RkS : BUILDER QtAIJ.EVZ-/ Y3U(L.�IrL. times in a conspicuous placer Only persons appearing on'this list or their employees are authorized to work on this job. Any -changes to this list must be approved by the Building Division prior to commencement of work. 'Failure to comply will result in a stoppage of work and/or the voidance of. building permit. For each applicable trade, all information requested below must be com'Dleted by applicant "n., GiIA_" ie not an accPntahI6 rPcnnncP Trade Classificat / �o Contractor . . ' ... State..Contrac . ....::::..... .....;: tot sLicense :..;-; -- � �� ' � � �- : . .. .;:' :' • ... Workers GompensaLon'insurance''•. -::, '...::;:�.. : `;.' ` :.. 'City Business Lic�nse�:::• { Company Name Classification License Number Ezp. Date Carrier Name Policy Number Exp. Date License Number Ex Date p� le.g. A, B, C-8) (xxxxxx) (xz/xx/xx) (e.g. State Fund, CalComp) (Format Varies) • (xx/xx/xx) (xxxx) (xx/xx/xx) EARTHWORK (C712)'--'.:. NbIJ� CONCRETE (C-8)' �T-Z c n1acCETE CO. G- 8 gl3Z.�, � .30 � ST��. i�tr.P. '�r�� ��!� .t``��f$"T S�' tz 13..307-9 FRAMING :(.0-5) L q C-(JSCOYKwo 4 Qg S �� 3l 4 iA Ca7 � `, :vap b 5 2 13 - 9 a g. ,' X53 cb 3t 14 STRUCT.'STEEL fd-, 1) I) 1 t 41.. l) n MASONRY'(C>29) k :_ f 1 i (1 n �� U 1� 11 PLUMBIN(i_(C-36.. - �VIO PL.UrA9(aG.. CC a. t �0� -1 /� �7 G 5TATC �:o PV ��9 OD 78 3 1 14 2 -7 ( 7 � .1%131114 A HeLASTE ; rJ-Gic1R_�rw 33 2 l - QTWoo DRYWALL (C-9) :.:.. + soTa VP I a �. �ws. .x- �{�� 8g 3 yF3L l'� ST,�ME ru.�9. OL x{0-7 513 ' g)2J 14 4.3 zo -1 31 t HyAc.'tc-zor .°::.'> _ `� I. AgVAr`rCllcrc kTtaG.. ,��y. G- 2-n 2 7-8�ZIo` ELECTRICAL.(C=1 :.` : REPiCScL- E�EG'frt�t� e-- 53 S 2 $ 15 ' EFE(ZR�o . tlnn QS T44 Q0 . �' 1 O 8�-3 RQOFING.IC.=3 y e''39 2 Q J t 7 bZ� o 7-°I 11 ?j0 �� III 3o ISL rU�1% qV g l3 ST�'Cc �J,J�7 0q1g �/ k3 1 14 :SHEET.META 3 . FLOORING (C:14'P1 GLAZING (C-17) it T L.Et/_ r a. N ?'..' �2 3 i8; I - _ �. -.,1 �.( 3. 1 68��� Z v; 6 0"1 INSULA W72) : ' . ' IhASGo Car3CRl►cts(L f�vICGS - L` Z .c' ZZt "1 °� 30 �5 �Q �fj °Rc4'73Zo 611 ��� 0 181,9. 3. SEWAGE DISP.11,42) �/ 2 qq I . o �L 30 .. - . 'PAINTING (C-33) ; �C�1i $ �2i-11J-T "wS, 5A vwlC /S S A(3U C CERAMIC TILE (C-54) b W NCtZ QUIT-TJf�{Z. CABINETS (C-6) ,� t1�Ro►►sc coo§ • = N c - .SAM L A5 A 13 o V t= FENCING (0-13) .' 5AVA�S �0C'S LANDSCAPING (C=27:)';: (1�1-t�D r:�(Z d.... �L S/�✓✓vt✓ A-5 lwU� on'n� rr c�►('��..._ ., 11 �1-r27 ��'.._1� '��-.lr �iL 4V�'� 7�S !d✓���) � � .. �F �wa�ra Building & Safety Department 78-495 Calle Tampico La Quinta, CA 92253 (760) 777-7012 voice — (760) 777-7011 fax RECEIVE® JUN 17 2013 CITY OF LA QUINTA C0MUIdI7y DEWLOPMENr To: Greg Butler, Building Official To: PD: May 28, 2013 From: Les Johnson, .Community Development Director Due date: ASAP Permit #13-665 Status:_1 ST Review Building Plans Approval (This is an approval to issue a Building Permit) .CVMSHCP Applicable Fee N/A. .The Planning Department has reviewed the Building Plans for the following project: Description: Remodel of SFD in the Cove Address or general location: 77450 Calle Tecate APN: 774-293-025 Applicant Contact: Steve ph: 760-564-4707, r The Planning Department finds that: , ❑ ...these Building Plans do not require Planning Department approval. these Building Plans are approved by the Planning Department. ❑ ...these Building Plans require corrections. Please forward a copy of the attached correctionsto he applicant. When the corrections are made please return them. to th Plann' g Department for review. ZME Les ohns ,Community Development. Director„ 'Date NOT ' PLE E RETURN PLANS WITH GREEN SHEET TO THE BUILDING AND SAFET EP RTMENT 0 f 4' Bin #City of La Quinta Building 8t: Safety Division P.O. Box 1504, 78-495 Calle Tampico 3 La Quinta, CA 92253 - (760) 777-7012 --- Building Permit Application and Tracking Sheet Permit Project Address. `-- Q `LC Owner's Name: A. P. Number: Address: Legal Description: City, ST, Zip: Contractor: Telephone: Address: Project Description: City, ST, Zip: IE S 0\J 1) tj P�1lL Telephone: State Lic. # : City Lie. #: Arch., Engr., Designer: Address: City., ST, Zip: Ae_,_& Telephone: r..;;:n:;;;;:<•:: is `:� r<> <»=`><<>' � :?<^< ........................................::::::::::::: Construction Type: Occupancy: State Lic. #: . Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: 1 L_U�� Sq. Ft.: #Stories: #Units: Telephone # of Contact Perso (o 0 F) ,E�> Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE /1 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 Cala. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 21" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. R.O.A. Approval Plans resubmitted Grading IN ROUSE:- '"' Review, ready for correction issuDeveloper Impact Fee Planning Approval Called Contact Person. 1/a° A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees �2-S[lot� "" �i� ELSE W +K3 Au hwt ti - LO -MM, Flt" Q4 -C �►-tirr�{ zo ►S�t�,�