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BRES2015-001778-495 CALLE TAMPICO V VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 1/22/2015 Application Number: BRES2015-0017 Owner: Property Address: - 43545 CROISETTE CT ADOM VENTURES APN: . 609052002 77-682 COUNTRY CLUB DR. STE A3 Application Description: DARBY ESTATES TM 31087 LOT 11 PLAN 1X PALM DESERT, CA 92211 Property Zoning: , Application Valuation: $172,362.80 Applicant: Contractor: G H A ENTERPRISES INC 30-875 DATE PALM DRIVE STE C G H A ENTERPRISES INC 30-875 DATE PALM DRIVE STE C CATHEDRAL CITY, CA 92234-3747 CATHEDRAL CITY, CA 92234-3747 Fol (760)969-1400 L L Llc. No.: 750957 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 Professions Code, and my License is in full force and effect. License Class: B License No.: 750957 Dae: l <-- Contractor: OWNER -BUIL ER DECLARA ION 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 he 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 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.). (_) 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 am exempt under Sec. . B.&P.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 Lender's Add 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 Pork for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Sec ` 00 6f -.the Labor Code, for the performance of the work for which "this permit is issued. My workers' compensation insurance carrier and policy number, are: Carrier: _ Policy Number: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I pW-bgcomebject to the workers' compensation provisions of Section 3 oI shall forthwith comply wi those provisions. ApplicanWARNING: FAILURE TO SECURE WORK RS' COMP E 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. r APPLICANT ACKNOWLEDGEMENT IMPORTANT: Application is hereby made to the Building Official 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 ar.d 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 sta 'w ' irta to building construction, and hereby authorize representatives of this ent upon the ove• mentione ,prope y for inspection purposes. Dat "6':7Signature (Applicant or Agen ` "1 I r U DESCRIPTION FINANCIAL ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $7.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $7.00 $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. $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 1 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 ACCOUNT QTY 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 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 i QTY AMOUNT PAID PAID DATE VENT FAN 101-0000-42402 0 $60.45 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE VENT FAN PC 101-0000-42600 0 $24.15 $0.00 PAID BY . METHOD RECEIPT # CHECK # CLTD BY Total Paid forMECHANICAL: $343.24 $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 $559.35 $0.00 PAID BY . METHOD RECEIPT # CHECK # CLTD BY Total Paid forNEW CONSTRUCTION PERMIT: $559.35 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE NEW CONSTRUCTION PLAN CHECK 101-0000-42600 0 $1,159.53 $0.00 PAID BY METHOD RECEIPT #. CHECK # CLTD BY Total Paid forNEW CONSTRUCTION PLAN CHECK: $1,159.53 $0.00 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 $217.62 $0.00 PAID BY METHOD RECEIPT # CHECK #. CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE FIXTURE/TRAP PC 101-0000-42600 0 $217.62 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION. ACCOUNT QTY AMOUNT PAID PAID DATE GAS SYSTEM, 5+ 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, 5+ 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: $563.37 $0.00 DESCRIPTION ACCOUNT • QTY AMOUNT PAID PAID DATE SMI - RESIDENTIAL 101-0000-20308 0 $22.41 $0.00 PAID BY METHOD RECEIPT # - CHECK # CLTD BY Total Paid forSTRONG MOTION INSTRUMENTATION SMI $22.41 $0.00 DESCRIPTION ACCOUNT QTY 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:$0.00 Description: DARBY ESTATES TM 31087 LOT 11 PLAN 1X Type: BUILDING, RESIDENTIAL Subtype: DWELLING - SINGLE Status: APPROVED Applied: 1/20/2015 AZA FAMILY DETACHED Approved: 1/21/2015 AZA Parcel No: 609052002 Site Address: 43545 CROISETTE CT LA QUINTA,CA 92253 Subdivision: Block: Lot: 11 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $172,362.80 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: SFD - PLAN TYPE 1X, LOT 11, 2698 SF LIVING (481 SF 2 CAR GARAGE + 339 SF ATT. CASITA) ELEV.A. 2013 CODES. 2010 ENERGY.PERMIT ISSUED AS PART OF MODEL COMPLEX. ADDITIONAL CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT G H A ENTERPRISES INC 30-875 DATE PALM CATHEDRAL CA 92234- (760)200-5989 MARIOGONZALEZ@GH DRIVE STE C CITY 3747 ACOMPANIES.COM CONTRACTOR G H A ENTERPRISES INC 30-875 DATE PALM CATHEDRAL CA 92234- (760)200-5989 MARIOGONZALEZ@GH DRIVE STE C CITY 3747 ACOMPANIES.COM OWNER ADOM VENTURES 77-682 COUNTRY CLUB PALM DESERT CA 92211 (760)200-5989 DR. STE A3 FINANCIAL INFORMATION Printed: Thursday, January 22, 2015 12:04:28 PM 1 of 5 W .Y.ITFAAS Printed: Thursday, January 22, 2015 12:04:28 PM 2 of 5 CR CV.C7FM.0 C DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BY BSAS SB1473 FEE 101-0000-20306 0 $7.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $7.00 $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 RESIDENTIAL, FIRST 101-0000-42403 0 $145.03 $0.00 1,000SF Printed: Thursday, January 22, 2015 12:04:28 PM 2 of 5 CR CV.C7FM.0 Printed: Thursday, January 22, 2015 12:04:28 PM 3 of 5 (ci? _ SY.CTFM.S CLTD. DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY RESIDENTIAL, FIRST 101-0000-42600 0 $47.86 $0.00 1,000SF, PC Total Paid for ELECTRICAL- NEW CONSTRUCTION: $245.12 $0.00 CONDENSE R/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 $60.45 $0.00 VENT FAN PC 101-0000-42600 0 $24.15 $0.00 Total Paid forMECHANICAL: $343.24 $0.00 MULTI -SPECIES 101-0000-20310 I 0 $1,292.00 I $0.00 RESIDENTIAL 0-8 UNIJ:::� Total Paid forMULTI-SPECIES RESIDENTIAL $1,292.00 $0.00 NEW CONSTRUCTION 101-0000-42400 0 $559.35 $0.00 PERMIT Total Paid forNEW CONSTRUCTION PERMIT: $559.35 $0.00 NEW CONSTRUCTION 101-0000-42600 0 $1,159.53 $0.00 PLAN CHECK Total Paid for NEW CONSTRUCTION PLAN CHECK: $1,159.53 $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 $217.62 $0.00 Printed: Thursday, January 22, 2015 12:04:28 PM 3 of 5 (ci? _ SY.CTFM.S INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE FINAL" PARENT PROJECTS REVIEWS �j REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES DATE7 Printed: Thursday, January 22, 2015 12:04:28 PM 4 of 5 (cp1ff CY.C7FMS !' CLTD.. DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK #� METHOD PAID BY BY FIXTURE/TRAP PC 101-0000-42600 0 $217.62 $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 101-0000-426000 $12.09 $0.00 INST/ALT/REP PC Total Paid forPLUMBING FEES: $563.37 $0.00 SMI - RESIDENTIAL 101-0000-20308 0 $22.41 $0.00 Total Paid forSTRONG MOTION INSTRUMENTATION SMI $22.41 $0.00 SINGLE FAMILY 224-0000-20320 0 $1,837.44 $0.00 DETACHED Total Paid forTUMF - RESIDENTIAL: $1,837.44 $0.00 TOTALS:•.4 00 INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES DATE DATE FINAL" PARENT PROJECTS REVIEWS �j REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES DATE7 Printed: Thursday, January 22, 2015 12:04:28 PM 4 of 5 (cp1ff CY.C7FMS 1ST PW GREENI AMY YU I 1/20/2015 I 1/27/2015 I 1/21/2015 I APPROVED I I SHEET Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED DOC 1/20/2015 ANGELICA ZARCO PAD CERTIFICATION, LOT PAD CERTIFICATION, LOT 0 ll.pdf ll.pdf Printed: Thursday, January 22, 2015 12:04:28 PM 5 of 5 CR CV.fTFMS Date 1/23/15 No. 31691 CERTIFICATE OF COMPLIANCE q�'S moo Desert Sands Unified School District 47950 Dune Palms Road < ° Q BERMUDA DUNES r � RANCHO MIRAGE d La Quinta, CA 92253 INDIAN WELLS DES760 771-8515 `fes PALM LA QUIN A r () y JINDIQ Owner Adorn Ventures APN # 609-052-002 Address 77682 Country Club Dr., Ste. A3 Jurisdiction La Quinta City Palm Desert Zip Permit # see below Tract # 31087 No. of Units 1 Type Single Family Residence Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 11 43545 Croisette Court 2698 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments Permit No. BRES2015-0017 At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, 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 $3.36 X 2,698 S.F. or $9,065.28 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 CC-Rabobank - Laken Jones Check No. 010007332 Bank Name/Recipient of Certificate Telephone Funding Residential BY Dr. Gary Rutherford Superintendent Fee collected /exem Ped b Sh n vrey Payment Read 'L�p.O 40 $9,065.28 = ver/Unaer� ` r �'p Signature fYr NOTICE: Pursuant to Government Code Section 66020(d)(1), thVjll 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 Bin # City of La Q grin to . Building 81: Safety Division P.O. Box 1504, 78-495 Calle Tampico . La Quinta, CA 92253 - (760) 777-7012. Building Permit Application and Tracking Sheet Permit # ProjectAddress. (7,r o (T Owner's Name: �(��y}� >✓ ��S A. P. Number: 0 a _ 2 Address: -7 (L g 'L ('� �n Ct Legal Description:Ubi b 5 S f aCA- a 11�) q City, ST, Zip: Contractor: TdcPho e. lZpp— S 1 Address: '� Project.Description:�c�C b tS�a`e (aL City, ST, Zip:. Kl,Cil U� e' \ �3 g� t u e l V n Tele P hon 0 Q� 0 r r 'u n State Lie. # : City Lie. #: Arch., Engr., Designer: Address: �� `�'l�G.�(� • City., ST, Zip: 1 Telephone: — P "SS� '<> ?;:<<:;:r:::::: <<r;;z>;:.>:<::.....:;::: > .......................................... Construction Type: Occupancy: 11 State Lie. # AlterDemorojcype(crceon , par Name of Contact Person:. O Sq. Ft.: I # Stories: # Units: I Telephone #,of Contact Person: Q Estimated Value of Project: APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Rcq'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Ca1e5. 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 Dccd Plans picked up S.M.I. Ii.O.A. Approval Plans resubmitted Grading IN HOUSE:- 3" Review, ready for corrcctionsfissuc Developer Impact Fee Planning Approval Called Contact Person - A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees