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BRES2015-01217&--455 CALIE TAMPICO LA QUINTA, CALIFORNIA 92253 16' � 4 4 4" IMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2015-0121 Property Address: 80486 CHAMPIONS WY APN:' 775220021 Application Description: THE SIGNATURE PH 1 ESTATES LOT 77 TM 36537 Property Zoning: 5927 PRIESTLY DR STE 110 Application Valuation: $221,596.30 Applicant: CALIFORNIA WEST CONSTRUCTION I 5927 PRIESTLY DRIVE STE 110 CARLSBAD, CA 92008 • VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 (760)918-6768 Lk. No.: 927267 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I I hereby affirm under penalty of perjury one of the following declarations 9 {commencing with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self -insure for workers' and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance License Class�6 License No.: 927267 of the work for which this permit is issued. 3I have and will maintain workers' compensation insurance, as required by Dat S Contracto . 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: OWNER -BUILDER DECLARATION Carrier: Policy Number: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State I certify that in the performance of the work for which this permit is issued, 1 License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith signed statement that he or she is licensed pursuant to the provisions of the comply with h se pro •ions 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 pplicirit:10 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 WARNING: FAILURE TO SECUiE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO (_) 1, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose (_) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or the Contractors' State License Law.). following issuance of this permit. (_) I am exempt under Sec. . B.&P.C. for this reason 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. 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 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 city to enter upon the above• mention-eydpr erty r inspection purposes. DateCnature(Applicant orAgent),� Date: 4/8/2015 .Owner: RREF II CWC LAQ LLC 5927 PRIESTLY DR STE 110 CARLSBAD, CA 92008 FID Contractor:CALIFORNIA WEST CONSTRUCTION5927 PRIESTLY DRIVE STE 110CARLSBAD, CA 92008 -L. (760)918-6768 Lk. No.: 927267 LICENSED CONTRACTOR'S DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter I I hereby affirm under penalty of perjury one of the following declarations 9 {commencing with Section 7000) of Division 3 of the Business and Professions Code, I have and will maintain a certificate of consent to self -insure for workers' and my License is in full force and effect. compensation, as provided for by Section 3700 of the Labor Code, for the performance License Class�6 License No.: 927267 of the work for which this permit is issued. 3I have and will maintain workers' compensation insurance, as required by Dat S Contracto . 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: OWNER -BUILDER DECLARATION Carrier: Policy Number: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State I certify that in the performance of the work for which this permit is issued, 1 License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith signed statement that he or she is licensed pursuant to the provisions of the comply with h se pro •ions 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 pplicirit:10 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 WARNING: FAILURE TO SECUiE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO (_) 1, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose (_) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or the Contractors' State License Law.). following issuance of this permit. (_) I am exempt under Sec. . B.&P.C. for this reason 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. 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 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 city to enter upon the above• mention-eydpr erty r inspection purposes. DateCnature(Applicant orAgent),� FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID'DATE ART IN PUBLIC PLACES - RESIDENTIAL 270-0000-43201 0 $53.99 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forART IN PUBLIC PLACES - AIPP: $53.99 $0.00 DESCRIPTION ACCOUNT _ QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $9.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING. STANDARDS ADMINISTRATION BSA: $9.00 $0.00 DESCRIPTION_ ACCOUNT QTY AMOUNT PAID PAID DATE DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $0.00 - PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION . ACCOUNT QTY AMOUNT PAID PAID DATE DIF - COMMUNITY CENTERS 254-0000-43200 0 $129.00 .$0.00 - PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY. DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - LIBRARIES 253-0000-43200 0 $344.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION, ACCOUNT QTY AMOUNT: " PAID PAID DATE DIF - PARK MAINTENANCE 256-0000-43200 0 $40.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - STREET MAINTENANCE 255-0000-43200 0 $116.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY . DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE DIF - TRANSPORTATION 250-0000-43200 0 1 $2,842.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE TEMP POWER SERVICE 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # ' CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE TEMP POWER SERVICE PC 101-0000-42403 0 $16.92 $0.00 PAID BY METHOD RECEIPT# CHECK # CLTD BY Total Paid for ELECTRICAL: $41.09 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, EA ADDITION 1,000SF 101-0000-42403 0 $36.99 $0.00 PAID BY . METHOD- RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RESIDENTIAL, EA ADDITION 1,000SF, PC 101-0000-42600 0 $15.24 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY, DESCRIPTION ACCOUNT QTY: AMOUNT PAID PAID DATE RESIDENTIAL, FIRST 1,000SF 101-0000-42403 0 $145.03 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNTQTY: AMOUNT PAID .. PAID DATE RESIDENTIAL, FIRST 1,000SF, PC 101-0000-42600 0 $47.86 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL -NEW CONSTRUCTION: $245.12 $0.00 DESCRIPTION ACCOUNT ' . QTY AMOUNT PAID PAID DATE RESIDENTIAL FINISH GRADING PC 101-0000-42600 0 $143.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forGRADING: $143.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR 101-0000-42402 0 $72.52 $0.00 PAID BY METHOD RECEIPT. # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE CONDENSER/COMPRESSOR PC 101-0000-42600 0 $48.34 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE EXHAUST HOOD :'- • 101-0000-42402 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE EXHAUST HOOD PC 101-0000-42600 0 $4.83 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FURNACE 101-0000-42402 0 $72.52 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FURNACE PC 101-0000-42600 0 $48.34 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN 101-0000-42402 0 $72.54 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN PC 101-0000-42600 0 $28.98 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forMECHANICAL: $360.16 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE MULTI-SPECIES RESIDENTIAL 0-8 UNITS 101-0000-20310 0 $1,292.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forMULTI-SPECIES RESIDENTIAL $1,292.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PERMIT 101-0000-42400 0 $593.89 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forNEW CONSTRUCTION PERMIT: $593.89 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,260.92 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,260.92 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BACKFLOW DEVICE 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BACKFLOW DEVICE PC 101-0000-42600 0 $4.83 $0:00 PAID BY METHOD RECEIPT # CHECK #. CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BUILDING SEWER PC 101-0000-42600 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID. PAID DATE FIXTURE/TRAP 101-0000-42401 0 $229.71 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT - QTY AMOUNT PAID PAID DATE FIXTURE/TRAP PC 101-0000-42600 0 $229.71 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT - QTY AMOUNT PAID PAID DATE GAS SYSTEM, S+ OUTLETS 101-0000-42401 0 $36.26 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, S+ OUTLETS PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID • PAID DATE WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER HEATER/VENT PC 101-0000-42600 0 $7.25 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 $0.00 PAID BY METHOD RECEIPT_# CHECK ## CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 $0.00 PAID BY,: METHOD RECEIPT # CHECK # CLTD BY Total Paid for PLUMBING FEES: $604.47 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE' SMI - RESIDENTIAL 101-0000-20308 0 $28.81 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMI; $28.81 $0.00 DESCRIPTION ACCOUNT QTY -1 AMOUNT PAID PAID DATE SINGLE FAMILY DETACHED 224-0000-20320 0 $1,837.44 $0.00 PAID BY 'METHOD RECEIPT# CHECK# CLTD BY Total Paid forTUMF - RESIDENTIAL: $1,837.44 $0.00 TOTALS:00 Description: THE SIGNATURE PH 1 ESTATES LOT 77 TM 36537 Type: BUILDING, RESIDENTIAL Subtype: DWELLING - SINGLE Status: UNDER REVIEW Applied: 4/7/2015 MFA FAMILY DETACHED Approved: 4/8/2015 MFA Parcel No: 775220021 Site Address: 80486 CHAMPIONS WY LA QUINTA,CA Subdivision: PM 20426 Block: Lot: 77 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $221,596.30 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 CALIFORNIA WEST CONSTRUCTION I Details: 3,479 SF DWELLING 179 SF BALCONY- PLAN 4AR, LOT 77 [VB/RES-3/CLASS A-FR/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH. 2013 CALIFORNIA BUILDING CODES. ADDITIONAL SITES __j Applied to Approved Printed: Wednesday, April 08, 2015 3:20:06 PM 1 of 5 SYSTEMS CHRONOLOGY CONDITIONS NAME TYPE NAME ADDRESSI CONTACTS CITY STATE ZIP PHONE FAX EMAIL APPLICANT CALIFORNIA WEST CONSTRUCTION I 5927 PRIESTLY DRIVE STE 110 CARLSBAD CA 92008 LBELLOSO@CALWESTC OMMU.NITIES.COM CONTRACTOR CALIFORNIA WEST CONSTRUCTION I 5927 PRIESTLY DRIVE STE 110 CARLSBAD CA 1 92008 LBELLOSO@CALWESTC OMMUNITIES.COM OWNER RREF II CWC LAQ LLC 5927 PRIESTLY DR STE 110 CARLSBAD. CA 92008 Printed: Wednesday, April 08, 2015 3:20:06 PM 1 of 5 SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID. PAID DATE RECEIPT # CHECK # METHOD PAID BY CTD . BY B ART IN PUBLIC PLACES - 270-0000-43201 0 $53.99 $0.00 RESIDENTIAL Total Paid forART IN PUBLIC PLACES - AIPP: $53.99 $0.00 BSAS SB1473 FEE. 101-0000-20306 0 $9.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $9.00 $0.00 BSA: DIF - CIVIC CENTER 252-0000-43200 0 $942.00 $0.00 DIF - COMMUNITY 254-0000-43200 0 $129.00 $0.00 CENTERS DIF - FIRE PROTECTION 257-0000-43200 0 $433.00 $0.00 DIF - LIBRARIES 253-0000-43200 0 $344.00 $0.00 DIF - PARK 256-0000-43200 0 $40.00 $0.00 MAINTENANCE DIF - PARKS/REC 251-0000-43200 0 $2,048.00 $0.00 DIF -STREET 255-0000-43200 0 $116.00 $0.00 MAINTENANCE DIF - TRANSPORTATION 250-0000-43200 0 $2,842.00 $0.00 Total Paid for DIF - SINGLE FAMILY DWELLING: $6,894.00 $0.00 TEMP POWER SERVICE 101-0000-42403 0 $24.17 $0.00 TEMP POWER SERVICE 101-0000-42403 0 $16.92 $0.00 PC Total Paid for ELECTRICAL: $41.09 $0.00 RESIDENTIAL, EA 101-0000-42403 0 $36.99 $0.00 ADDITION 1,000SF RESIDENTIAL, EA 101-0000-42600 0 $15.24 $0.00 ADDITION 1,000SF, PC Printed: Wednesday, April 08, 2015 3:20:06 PM 2 of 5 CM SYSTEMS DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY RESIDENTIAL, FIRST 101-0000-42403 0 $145.03 $0.00 1,000SF RESIDENTIAL, FIRST 101-0000-42600 0 $47.86 $0.00 1,000SF, PC Total Paid for ELECTRICAL - NEW CONSTRUCTION: $245.12 $0.00 RESIDENTIAL FINISH 101-0000-426000 $143.00 $0.00 GRADING PC Total Paid forGRADING: $143.00 $0.00 CONDENSER/COMPRES 101-0000-42402 0 $72.52 $0.00 SOR CONDENSER/COMPRES 101-0000-42600 0 $48.34 $0.00 SOR PC EXHAUST HOOD 101-0000-42402 0 $12.09 $0.00 EXHAUST HOOD PC 101-0000-42600 0 $4.83 $0.00 FURNACE 101-0000-42402 0 $72.52 $0.00 FURNACE PC 101-0000-42600 0 $48.34 $0.00 VENT FAN 101-0000-42402 0 $72.54 $0.00 VENT FAN PC 101-0000-42600 0 $28.98 $0.00 Total Paid for MECHANICAL: $360.16 $0.00 MULTI -SPECIES 101-0000-20310 0 $1,292.00 $0.00 RESIDENTIAL 0-8 UNITS Total Paid forMULTI-SPECIES RESIDENTIAL $1,292.00 $0.00 NEW CONSTRUCTION 101-0000-42400 0 $593.89 $0.00 PERMIT Total Paid for NEW CONSTRUCTION PERMIT: $593.89 $0.00 NEW CONSTRUCTION 101-0000-42600 0 $1,260.92 $0.00 PLAN CHECK Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,260.92 $0.00 Printed: Wednesday, April 08, 2015 3:20:06 PM 3 of 5 i SYSTEMS Printed: Wednesday, April 08, 2015 3:20:06 PM 4 of 5 SYS7: M 5 CLTD DESCRIPTION ACCOUNT CITY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID.BY BY BACKFLOW DEVICE 101-0000-42401 0 $12.09 $0.00 BACKFLOW DEVICE PC 101-0000-42600 0 $4.83 $0.00 BUILDING SEWER 101-0000-42401 0 $12.09 $0.00 BUILDING SEWER PC 101-0000-42600 0 $12.09 $0.00 FIXTURE/TRAP 101-0000-42401 0 $229.71 $0.00 FIXTURE/TRAP PC 101-0000-42600 0 $229.71 $0.00 GAS SYSTEM, 5+ 101-0000-42401 0 $36.26 $0.00 OUTLETS GAS SYSTEM, 5+ 101-0000-42600 0 $24.17 $0.00 OUTLETS PC WATER HEATER/VENT 101-0000-42401 0 $12.09 $0.00 WATER HEATER/VENT 101-0000-42600 0 $7.25 $0.00 PC WATER SYSTEM 101-0000-42401 0 $12.09 $0.00 INST/ALT/REP WATER SYSTEM 101-0000-42600 0 $12.09 $0.00 INST/ALT/REP PC Total Paid for PLUMBING FEES: $604.47 $0.00 SMI - RESIDENTIAL 101-0000-20308 0 $28.81 $0.00 Total Paid forSTRONG MOTION INSTRUMENTATION SMI $28.81 $0.00 SINGLE FAMILY 224-0000-203200 $1,837.44 $0.00 DETACHED ' Total Paid forTUMF - RESIDENTIAL: $1,837.44 $0.00 TOTALS:00 Printed: Wednesday, April 08, 2015 3:20:06 PM 4 of 5 SYS7: M 5 FINAL" IBLD BOND INFORMATION ATTACHMENTS Printed: Wednesday, April 08, 2015 3:20:06 PM 5 of 5 SY57FM5