09-0559 (MECH)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number: 09-00000559
Property Address: 54711 SOUTHERN HILLS
.APN: 775-101-070-
Application description: MECHANICAL
Property Zoning: LOW DENSITY RESIDENTIAL
Application valuation: u 7250
Applicant:
Architect or Engineer:. 4
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the B s and Professionals Code, and my License is in full forceandeffect.
License Class: C20 ns 897743
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 ISec. 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).:
1 -71 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 sate (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 o_fproving that he or she did not build or
improve for the purpose of sale.)."
I _ 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.). -
I 1 I am exempt under Sec.. , BAP:C. for this reason - -
Date: Owner:
- - CONSTRUCTION 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:
WALKER LINDA
54711 SOUTHERN HILLS DRIVE
LA QUINTA,• CA 92253
(714)271-1381'
Contractor:
PERFECT WEATHER
P.O. BOX 2359
PALM DESERT, CA 92261
(760)770-0404
Lic. No.: 897743
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777=7153
Date: .6/02/09
v - .
-------------------------------------
WORKER'S COMPENSATION DECLARATION
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 ENDURANCE REINS Policy.Number WEN001920003
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 s 1 become subject to the workers' compensation provisions of Section
.�-3f700 of the Labor ode, I hall forth w' co with those provisions.
Date: -V Applicant:
WARNING: FAILURE TO SECURE WORKERS' 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 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 actor 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, b din construction, and hereby authorize representatives
of this county to enter upon the above-mentioned pro rt
to
inspection p
Date: 12!-2-*( Signature (Applicant or Agent):
Application Number . . . . . .09-00000559
Permit . MECHANICAL
-Additional desc .
Permit Fee ... 33.00
Plan Check Fee
8.25
Issue.Date,
Valuation . . .
. 0
Expiration Date.. 11/29/09
Qty. Unit Charge Per
Extension '
BASE
•FEE
15.00
1.00 9.0000 EA MECH
FURNACE <=100K
9.00.
1.00 9.0000 EA MECH.B/C
<=3HP/100K BTU
9.00.
.. Special. Notes and Comments
REPLACE,EXISTING GAS/ELECTRIC PACKAGE
UNIT -WITH (1)3 TON 16 SEER GAS /
_ELECTRIC PACKAGE UNIT.
-------------------- - -
Fees BLDG STDS ADMIN (SB1473)
----------Other
1.00 ,
Fee summary Charged
Paid Credited
Due
Permit Fee Total 33,00
.00 .00
33.00
Plan Check Total 8.25
.00 .00"
8.25
Other Fee Total 1.00
.00 .00
1.00
Grand Total 42.25
.00 .00
42.25
LQPERMIT -
-
CERTIFICATE OF COMPLIANCE: RE$I
Project Title Date
Documentation
Compliance Method (Prescriptive)
Telephone
?r-10.--690
Climate Zone
/S
Alternative Component Package Method: (check one) C D D (Alternative)
Package C and Package D choices require HERS rater field verification and/or diagnostic testing (see CF -1R page 3)
For Package D Alternative see Appendix B Table 151-C Footnotes 8-14 in the Residential Compliance Manual (RCM)
GENERAL INFORMATION
Total Conditioned Floor Area (CFA) ft2.
Average Ceiling Height: Q ft
Check Applicable Boxes
Building Type: (check one or more) Single Family Multifamily Addition Alteration
(If adding fenestration fill -out WT -4—R, Fenestration Maximum Allowed Area Worksheet and see Section 8.3.2
for Additions and 8.3.3 for Alterations in the RCM.)
• Maximum Allowed Total Fenestration Area ft? (from WS -4R)
• Maximum Allowed West Facing Fenestration Area ft2 (from WS -4R)
• Number of Stories: Number of Dwelling Units:
• Floor Construction Type: Slab/Raised Floor (circle one or both)
• Front Orientation: North / South / East / West : All Orientations (input front orientation in degrees
from True North and circle one).
❑ RADIANT BARRIER (check box if required in climate zones 2 4 8-15)
OPAQUE SURFACES INCLUDING OPAQUE DOORS
Component
Type (Wall,
Roof, Floor,
Slab Edge;
Doors
Frame
Type
(Wood or
. Metal
Assembly U -
factor (for wood,
Cavity Continuous metal frame and
Insulation Insulation mass
R -Value R -Value assemblies)I
Joint
Appendix
IV
Reference.
Roof Radiant
Barrier
Instal�led2
Yes or No
Location
Comments
.(attic, garage,
t ical etc.
1) 'J60 JVIUL tAPPMLUM 1 V 111 aCULIVII I V./, 1 v..i, anu i v.4, wnlcn is the Dasls for the U -tactor criterion. U -factors can not exceed
prescriptive value to show equivalence to R -values.
2) This column is for the Inspector to verify installation of roof radiant barrier.
Residential Compliance Forms December 2005
CERTIFICATE OF COMPLIrANCE:'RESIDENTIAL' (Page 2 of 5) C&IR
Project Title - Date'
FENESTRATION PRODUCTS — U -FACTOR AND SHGC
✓ 13 FENESTRATION MAXIMUM ALLOWED AREA WORKSHEET WS74R - must be included afor New '
-` `- Construction, Additions;•and Alterations.
Fenestration
4/Type/Pos. (Front, Orien-
Left, Rear, Right;' tation, Area U -factor -
Skyligho N, S, E, W' (fe) U -facto[- Source3 SHGC'
Exterior
Shading/Oyerhangs6 7
SHGC V'box if WS -3R is
Sources, 'included `
r
❑'
Thermostat
Type
❑
13❑
t>crs 4.2 -
1) Skylights are now included in West -facing fenestration area if the skylights are tilted to the west or tilted in any direction when
the pitch is less than 1:12. See §151(f)3C and in Section 3.2.3 of the Residential Manual.
2) Enter values in this column from either NFRC Certified Label or from Standards Default Table 116-A.
3) Indicate source either from NFRC or Table 116-A,
4) Enter values in this column from NFRC or from Standards Default Table 116B or adjusted SHGC from WS -311.
5) Indicate source either from NFRC;}Table 116B or WS -3R
6) Shading Devices are defined in Table 3-3 in the Residential Manual and see WS -3R to calculate Exterior Shading devices. '
7) See Section 3.2.4 in the Residential Manual.
HVAC SYSTEMS
Heating. Equipment
Type and Capacity
furnac , heat pump, boiler, etc.
Minimum Distribution
Efficiency, Type and Location Duct or Piping Thermostat. Configuration
SUE or HSPF ducts, attic, etc. R -Value Type s lit or package)
Distribution
Type and Location
ducts, attic, etc.
Z
Thermostat
Type
Configuration
s lit or package)'
S
t>crs 4.2 -
M
Cooling Equipment',
Type and Capacity
(A/C, heat pump, evap.
pooling)
Minimum
Efficiency
(SEER or
EER
Distribution
Type and Location
ducts, attic, etc.
Duct or Piping
R -Value
Thermostat
Type
Configuration
s lit or package)'
S
t>crs 4.2 -
December 2005
I CERTIFICATE OF COMPLIANCE: RESIDENTIAL _ (Pa2e 3 of 5) . CF -1R I
SEALED DUCTS and TXVs (or Alternative Measures)
A signed CF -4R Form must be provided to the building department for each home for which the following are required.
V Sealed Ducts all climate zones Installer testing and certification and HERS rater field verification required.)
ED/, TXVs, readily accessible (climate zones 2.and 8-15 only)
Installer testing and certification and HERS Rater field verification required.)
Refrigerant Charge (climate zones 2 and 8-15 only) (Installer testing and certification and HERS Rater field
verification reouired.) '
` ❑ IAlternative to Sealed. Ducts and Refrigerant Charge /TXVs (See Package D Alternative Package Features fo�
Project Climate Zone in the RM Appendix B Table 151-C, Footnotes 7-14.
❑ No ducts installed.
❑ New ducts from existing space conditioning a ui rrient, not exceeding 4011. in length.
For additions and alterations, duct systems that are not documented to have been previously sealed as confirmed
O ` through field verification and diagnostic testing in accordance with procedures in the Residential ACM Manual.
Duct systems with more than 40 linear feet in unconditioned spaces shall meet the requirements of Section 150(m)
and duct insulation requirements of Package D.
WATER HEATING SYSTEMS
Systems servin sin le dwel ing units See RM Table 5-4, Alternative Water Heating S stems for recirculation requirements)
Water Heater
Type/Fuel Type
Check box if system meets criteria of a "Standard" system. Standard system is one gas-fired water heater per dwelling
Energy
Tank Factor' or
Capacity Thermal
Efficiency
unit.. If the water heater is a storage type, 50 gallons is the maximum capacity and recirculation system is not allowed.
❑
Check box when using Preapproved Alternative Water Heating table, Table 5-4 in Chapter 5 in the Residential
Manual. No water heating calculations are required, and the system complies automatically.
Check box if system does not meet criteria of "Standard" system, and does not comply with the Preapproved
❑
Alternative Water Heating table. In this case, the Performance Method must be used and must be included in the '
submittal.
❑
Check box to verify that a time control is required for a recirculating system pump for a system serving multiple units
Systems servin sin le dwel ing units See RM Table 5-4, Alternative Water Heating S stems for recirculation requirements)
Water Heater
Type/Fuel Type
Rated
Input'
Distribution . Number (kW or
Type' in System Bru/hr(gallons)
Energy
Tank Factor' or
Capacity Thermal
Efficiency
Tank
External
Standby' Insulation
Loss(%) R -Value .
System serving multiple dwelling units (See Residential Manual Section 5.3.3)
Rated
Input'
Water Heater Distribution Number (kW or
Type Type in System Btu/hr)
Energy
Tank Factor' or
Capacity Thermal
(gallons) Efficiency
Tank
External
Standby Insulation
Loss % R -Value
1) For small gas storage water heaters (rated inputs of less than or equal to 75,000 Btu/hr), electric•resistance, and heat pump water heaters, list
Energy Factor. For large gas storage water heaters (rated input of greater than 75,000 Btu/hr), list Rated Input, Recovery Efficiency, Thermal
Efficiency and Standby Loss. For instantaneous gas water heaters, list Rated Input and Thermal Efficiencies.
Pipe Insulation (kitchen lines >_ 3/4 inches) All hot-water pipes from the heating source to the kitchen fixtures
that are 3/4 inches or greater in diameter shall be thermally insulated as specified by Section 150 (j) 2 A or 150 (j) 2 B.
Residential Compliance Forms December 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL (Page 4 of 5) C&IR
Project Title
Date
I:J•'k� �CE2
. 2 _07
SPECIAL FEATURES REOUIRING BUILDING OFFICAL or HERS RATER VERIFICATION
Indicate which special features are parts of this project. The list below only represents special features relevant to the prescriptive method.
(Check Annlicable boxes)
Category
Building Official
Verification of
Special Features
HERS Rater.
Verification
HERS Rater
Diagnostic
Testing
Measure
Ducts
❑
Y.: ,::
100% of ducts in crawlspace/basement
❑
7777777
Y
Buried ducts
❑Y
Diagnostic supply duct location, surface area, and R -value
❑i::T7
77
Duct increased R -value
❑
Y
Duct leakage
❑"
.,Y:..
Ducts in attic with radiant barriers
❑
Y
Less than 12 ft. of duct outside conditioned space
❑
Y
Non-standard duct location
❑
'Y'
Supply registers within two ft of floor
Envelope
❑
Y. `` °
Air retarding wrap
❑
' . 7Y..::.`
Cool roof
❑
;Y::
Exterior shades
❑
Y.
High thermal mass
❑
:;Y .:: ;
Inter -zone ventilation
❑
:';. Y:. ; <:; ."
Metal framed walls
1 ❑
Y': ~::::'.'
Non -default vent heights
❑
Y
Quality insulation installation
❑
Y ::: ' '.':
Radiant barrier
❑
Y
Reduced infiltration (blower door). May also require mechanical ventilation.
❑
Y
Solar gain targeting (for sunspaces)
❑
1:.Y
Sunspace with interzone surfaces
❑
Y:
Vent area greater than 10%
11
HVAC Equipment
❑
Y
Adequate air flow
❑
Y
Air conditioner size
❑
"'
Y
Air handler fan power
❑
Y
High EER
❑
Y . ,.
Hydronic heating systems
❑
Y
Mechanical ventilation
❑
Y
Refrigerant charge
❑
Y
Thermostatic expansion valve JXV)
❑
Y
Zonal control
Water Heater
❑
Y ' --
Combined hydronic
❑
7777T777
High EF for existing water heaters-
eaters❑
0
Y
Non-NAECA water heater
❑
Y
Non-standard water heaters (wh/unit)
❑
Y
Water heater distribution credits -
Residential Compliance Forms December 2005
CERTIFICATE OF COMPLIANCE: RESIDENTIAL.
(Page 5 of 5)' CF -1R
Project Tittle
Date
Special Remarks .
l:V1Vlt'LlA1Vl:1�, J1A1L�1V1r:1V1 /
This certificate of compliance lists the building features and specifications needed to.comply with Title 24,
Parts I and 6•of the California Code of Regulations, and the administrative regulations to implement them. This
certificate has been signed by the individual with overall design responsibility. The undersigned recognizes that
compliance using duct design, duct sealing, verification of refrigerant charge and TXVs, insulation installation
quality, and building envelope sealing require installer testing and certification and -field verification by an
approved HERS rater.
Desiener or Owner (per Business and Professions Code) Documentation Anthar
Name:
DA V 17
Nam
AV 17 Cw
Title/Firm:
TideP"r C -r— Li
Address:
Addess:
Rat pe se,cr, a 2," 1
Telephone:
Telephone:
.760 -770 ^ OVO 41
License #:
License #: (if applicable) 8'Q
(signature) (date)
(signature) (date)
Enforcement Agency
Residential Compliance Forms
December 2005
., �Yx:
• •.i.i+..9. w+x�.,Lr.. 4.ytii�*.' �A4 S7KR€'I�.-iC4�,1• c�`'a.:: �.%kbf.� F. ': :.. ....a .. M..�ik 3A
rrc�vr,H� �c:Ji�rKCC �11oa
Name '. - ,. ,�� .. - - --
� L C.
q ct o
O Li uid & Su i n lines'
Address
\_
Home Phone ,'
t� Line Set Cover? .
so N L1 "
"
'
` ' `
Refrigerant Drier
•
Gry ., State ;! Zip'
/U Z
Work Phon
-'L -, 3 r'
O _Recover Refrigerant
Description of Work
-
- _ + - - _ - t
0 Evacuation,of System
c
CLC. VN-" _
,�r P;
Accurate Charging `
/L9 t V. �U. ,sEEiL ' G S ELE7tl.0
O New_Vent Pipe;& Storm. Cap
fFGE C1N /qf t_�
New Condensate Dram
, . , • ,
;r
�tj fCondensate Nook Up .;+.�::
O. -Condenser Pad
% Seal & Strap Ductwork
.O Return Filter Grille, x
"
O Secondary Drain Pan_°
• - ' -" � _ ..
O -`Roof Curb
)q :Crane 60'� 90'
0 Return Plenum' `
We propose to install and service under warranty (as stated below) all specified equipment, accessories and products for your
0 Supply Plenum.
• home in accordance. with conditions set forth in this proposal.
�'
0. Return Add = Enlarge_
e . • o . • • - o
0 Supply. Add _ •Enlarge_
13 ' Manufacture SEER BTU's. AFUE t Tons. r`' Position
New Gas Cock & Flex-'
r
Gas Furnace
_ t`'
0' Panel Upgrade` ;Amps.
t7•.•Evaporative Coil.
t:
r
6v ii,
Wall Furnace
,?
JU ,'Ele'ctrical.Whio Connector '
-
VVeatherproof.Disconnect
Floor.Furnace
s
'
,� Low Voltage Wiring
P9 Thermostat
W10
O (p, 00)Q,.All
.
Work to Existing Codes
0 Air Handler.
,"
All Required Permits
_.. -
•_ t•�,y •tit iI ._•
'. _._ I -__N;_ r�_:1.. ,
�-
-Jw ,t
`
' x.�
,•
.
t '• r
.I`
.I,
'•4te .fP 'I
'
. ie ,
•
t(.
O Condensing Unit
Gas Package
0 Heat Pump Cond
0 Heat Pump Pack
Manufacture
SEER
BTU's
AFUE
Tons Position
�70
3
Contractors are required by law to be licensed and regulated by the Contractor's State License. Board, which has jurisdiction
to investigate complaints against contractors if a complaint regarding a patent act or omission is filed within four years of the date
of the alleged violation. A complaint regarding a latent act or omission pertaining to structural defects must be filed within 10
years of the date of the alleged violation. Any questions concerning the contractor may be referred to the Registrar, Contractors
State License Board, Post office Box 26000, Sacramento, California 95826.
Failure by the contractor without lawful excuse to substantially commence work within 20 days from the approximate date
specified in the contract when work will begin is a violation of the Contractors License Law.
Upon Satisfactory payment being made for any portion of work performed, the contractor shall furnish a full and
unconditional release from.any claim or mechanics' lien for that portion of the work for which payment has been made.
uction work to be licensed by the Contractors State License Board in the license category in which the contractor is going
State law requires anyone who contracts to do constr
to be working - if the total price of the job is SS00 or more (including labor and materials). Licensed contractors are regulated by laws designed to protect the public.11 you contract
with someone who does not have a license, the Contractor s State License Board • may be unable to assist you with a complaint.. You only remedy against an unlicensed contractor may
be m omfcaurf and you,maybe Gable;for,damages ansing od of yinjunes to the contactor, orhi's or her employees.TheBoard has<omptefe information on,the history of licensed
reactors: iad ruc any: pons ble,suiperts orn reyaAo ris, )ddgement; and ataVonf 71!? Boatel Aasaffices throughout Cal�to)ma PI ase th the,government pages of the White
Y^' 4 � g t � '• is r tt novalsif old HVAC egtupment o the t`�'jstalIaU0r of arry.parts m your home w 11
�4 . k� f cori�ttute comic encementof,.work
Note Thtr proposa) may be•vnthdrawn by d All
not accepted w8h1n n days .
Date Approx. Start Date: r—=
Proposed by 1
Appmx Completion Date: L` �y �QV
Salesman Registration:(f applicable)
0 24 Hour - 7 Days a Week
Parts & Labor for 1 Year
ill. 24 Hour - 7 Days a Week
Parts & Labor for 10 Years
'0 3 Year Comfort Club
Maintenance Agreement
0 5 Year .Comfort Club
Maintenance Agreement
All are Parts Only (No Labor)
0'. Comp esso Years
m..,r,
Copressor 1Q Years
0, Heat Exchanger 10 Years
0 Heat.Exchanger '15 Years
Heat Exchanger 20 Years
0 Heat Exchanger Lifetime
You, the buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See the attached notice of cancellatiot
foi an explanation of this right.
The buyer acknowledges that before signing this contract buyer received and read a legible, completely filled in copy signed by the the seller, the "Notice to Owner' on the r
and two copies of the attached "Notice of Cancellation" and was orally informed of buyers right to cancel.
Total
Amount
"� �S� Down $
Proposed Abo e Specified urnished C maple for Consideration of $ Payment
Accepte Date: b4�
Balance
Acceptance of this proposal: The above prices, specifications and conditions are satisfactory and are hereby accepted. Payment.will be mad s ou8ined above. in the event the terms and conditions of Due &
this contract must be enforced by legal means, the customer agrees to all attorneys fees and court costs. A service charge of 1.5% (18% per annum) will be imposed on the amount due past 30 years.
Bin #
City of La Quinta
Building &r Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
P g
Permit #
6
�!
Project Address: S 711' &07 /f02A- lLCS
Owner's Name: N �K k
A. P. Number:
Address: 5q So�/�S
Legal Description:
Contractor: P �Q,
City, ST, Zip: L I
�� CA -
«:�v:`> ' /:Air::t?7<e:..`i.#:::`�sh'$.::',i. r.i`:.$f�.•v.t:
2�7f3gTelephone:7/�{—
Address: 2 3
Project Description:
City, ST, Zi
h' P c,' -D-os-EL77 CA�Z�
FLCC77�(C- P%1G r4G /V
Telephone: T� "0
:'<>'<':{<'>: <::<':'••: ::»:>:r
::....:.,:.::::............. .....,::
MAJ S— CAS
State Lic. # : T 3
City Lic. #;le—
pac=�KaRe U
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephoner
:':<:>»'•.#::<;<:>=:<:::<::>: <;;,: •:::: >:>tion
.,z •�
:,•::••..«•:::.,:•:••••...,:<><•':
Type: Occupancy:
State Lic. #::»::>«>
Project type (circle one): New Add,n Alter Repair Demo
Name of Contact Person:
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: —
Z qD
�0
Estimated Value of Project:
APPLICANT: DO. NOT WRITE. BELOW THIS LINE
#
Submittal
Req'd
RWd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Pian Check Deposit
Truss Calcs.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
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.
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
''4 Reyiew,.ready for correctionsfissue
Developer Impact Fee
Planning Approval
Called Contact Person
A,I.P,P,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
DAVE STEAVENS
Page of
Inspection Services
PROJECT �4�,A (A 4 o n PROJECT # 62 o o,3 - e) 9
ADDRESS CLIENT 't;GA j c _-, -r
,5,; ray rL
141, 4 J L'04. I f) roc'i0a S DATE cP5' ?v),,NZco -I do 3
BLDG. PERMIT
ENGINEER' .b�,,,J �5AO&,
INSPECTION TYPE
ARCHITECT (�QL�A A i2cl
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CONTRACTOR
INSPECTION REPORT
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CERTIFICATION OF COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted,
substantially ' complies with approved plans, specifications and applicable sections of the building codes. This report covers
the locatio'n'g':*"o�'f,'.t'he"w6�.r'-k*�'�i-'Tnrs6e-cted only and does not constitute engineering opinion or project control.
'CERT NO. !6_0 INSPECTOR NAME -s
lWint Clearly)
DATE Wo 3
INSPECTOR SIGNATURE :—�- ,17,---1— Z. -A.— __1)