BMCH2015-0065or
78-495 CALLE TAMPICO O.�i D VOICE (760).777-7125
LA'QUINTA,'CALIFORNIA 92253 FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 3/9/2015
Application Number:
BMCH2OIS-0065 •
Owner:
Property Address:
53167 AVENIDA DIAZ
KEN MASTER
APN:
774041020
53167 AVENIDA DIAZ
Application Description:
MASTER/ADD HVAC 15SEER/8.7HSPF
LA QUINTA, CA 92253
Property Zoning:
Application Valuation:
$5,000.00
Applicant:
Contractor:
BLAIR AIR INC DBA BLAIR HEATIN
BLAIR AIR INC DBA BLAIR HEATIN
653 OLEANDER ROAD
653 OLEANDER ROAD
PALM SPRINGS, CA 92264
PALM SPRINGS, CA 92264
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 Pro scions Code,
and my License is in full force and effect.
License Classy C20 C . License No.: 953427
Date / J Contra J'
L k -
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).:
( 11, 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 ) 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 Name:
Lender's
(760)537-1120
Llc. No.: 953427
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 r which this permit is issued.
J
ave 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: _ 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 should bee sub to the
workers' compensation provisions of Section 37�00 of �the Lab Cod shall forthwith
comply with those provisions.
Date: 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 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 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 corre .
I agree to comply with all city and county ordinances and state laws relating buing
construction, and hereby authorize representatives of this city to en r upo t
mentioned property for inspection purposes. �1 .
/i
Date: � � / J Signature (Applicant or Agen[y—/—
STATE OF CALIFORNIA �!
,ALTERATIONS - HVAC
CEC-CFIR-ALT-04-E Revised 06/14
CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE
CFIR-ALT-04-E
`Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC)
(Page 1 of 1)
Site Address:
Enforcement Agency:
Date Prepared:
Permit#:
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat.
Required R -value
Floor Area (sq ft)
❑ Packaged System
Mkvaporator Coil
N% AFUE
COP
❑ R-6 (CZ 2, 8-13) Ducting
Served by system
Setback
,❑, �Sp•System
Split
❑ Condensing Unit
❑ Compressor
S
Qlit
J
❑ R-8' (CZ 11, 14, 15) Ducting
I UCX�sgft
(if not already
Mini
SEER
fJ HSPF
❑ R-6 (all CZ's) Plenums
present must
❑ Furnace
❑ Lineset1
1 EER
❑ R-5 or R7.5) Lineset°
be installed)
❑ TXV
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled -out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
❑ 1. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF111-ALT-02-E '.
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS'
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Air Handler/Furnace' (Can include new ducting)
Installer Requirement: Duct leakage (< lS%, or < 109 to outside, or seal all accessible leaks), Air Flow Z 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. -There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building
2. New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts3 CFIR-ALT-02-E
including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Mini Splits require CFIR-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.S8W/CFM), Air Flow ;-> 350 CFM/ton (or alternative), Refrigerant Charge
❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site foe Final:
All New Ducts3 and one or more of the following CFIR-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow z 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts3 CFIR-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (<_15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
' Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24); or Refrigerant Charge verification MECH-25
3 All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may.consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
° R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over•1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-25/8", 2.5 -3T -2Y4", 3.5 to 4T -2y.", ST -4y."
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. lam eligible under Division 3 of the California Business and Professions Code to accept responsibility -for the information -on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR). I . .
4. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the CCR.
5. The building design features or system design features identified on this Certificate o Compliance are consistent with the information
it
provided on other applicable compliance documents, worksheets, calculation pl and specifications submitted the enforcement
agency for approval with this building permit application.
Responsible D
A�Apy:
igner Name:
Responsible Designer Sig
Date Sign
1/�
license: '
3Yz,
vSv�
Company :
Address:
G y/State/Zip:
Phone:
For assistance or questions regarding the Energy Standards, contact the Energy,Hotline at: 1-800-772-3300
STATE OF CALIFORNIA
ALTERATIONS TO SPACE CONDITIONING SYSTEMS
CEC-CF1 R -ALT -02-E (Revised 06114) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF1R-ALT-HVAC) (Page 1 of 6)
Project Name: ,A A4 r 6n -Date Prepared: 3-4715
A. GENERAL INFORMATION
-
01
02
CF1R-ALT-02 is applicable to multiple space conditioning systems contained within a single dwelling
unit. When multiple dwelling units must be documented, use one CF1R-ALT-02 document for
each dwelling unit.
06
07
08
01 Project Name:
S�Iex-S:
1 02
Date Prepared:
03 Project Location:'
'Lo tie . i A Z
04
Building Type:
05 CA City:
LA Q V j A
06
Dwelling Unit Name:
07 Zip Code:
ZZ S-3
08
Dwelling Unit CFA (ft2):
09 Climate Zone:
30
Number of space conditioning (SC) systems
AIV
In this dwelling unit:
B. Space Conditioning (SC) System Information
-
01
02
03
04
05
06
07
08
09
10
SC System
Identification or
Name
SC System
Location or Area
Served
CFA served
by this SC
System
(ft2):
Is the SC
system a
ducted
system?
Installing a
refrigerant
containing
component?
Installing new SC
System
components?
Installing more
than 40 feet of
ducts?
Installing
entirely new
duct system?
Installing
entirely new
SC system?
Alteration Type:
t vhi 1,
�c� res
600
No
/VO
/Vo
AIV
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
ALTERATIONS TO SPACE CONDITIONING SYSTEMS
rNMr-M-)
CEC-CF1 R -ALT -02-E Revised 06114 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF1R-ALT-HVAC) (Page 2 of 6)
Project Name: Date Prepared:
C. Extension of Existing Duct System, Greater Than 40 Feet (Section 150.2(b)iDiib)
of
02
System
Identification
or Name
New Duct
R -Value
c
<<First system of
<<calculated
Type C in Section
field: if A09= CZ
B above»
1-10, 12, 13, then
"R-6."; else if
A09=CZ 11, 14-16
_
then "R-8."
Required Documentation:
CF211-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R & CF3R-MCH-20-H — Duct Leakage Verification
- Leakage rate compliance: <— 15%, or15 10% leakage to outside, or seal all accessible leaks
Exceptions:
Existing duct systems constructed, insulated or sealed with asbestos are exempt from MCH -20 duct leakage testing requirements
Registration Number: Registration Date/Time:
CA Building Energy Efficiency Standards - 2013 Residential Compliance
HERS Provider:
June 2014
STATE OF CALIFORNIA
-ALTERATIONS TO SPACE CONDITIONING SYSTEMS
M 11
NITaOl
CEC-CFIR-ALT-02-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION -mss'
.CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF1R-ALT-HVAC) (Page 4 of 6)
Project Name: f� /� �� n Date Prepared:
E. Entirely New or Complete Replacement Duct System, with
or without Equipment Changeout
(Sections 150.2(b)1Diia and 150.2(b)lE, F)
01
02
03
04
05
06•
07
08
09
10
11
System
Altered
Heating
Heating
Minimum
Cooling
Cooling
Minimum
Required
Identification or
Heating System
Heating
Efficiency
Efficiency
Altered
Efficiency
Efficiency
Thermostat
New Duct
Name
Type
Component
Typ'eI<n
Value
Cooling System Type
Cooling Components
Type
value
Type
R -Value
Q
'
�5S
1 F4f
1/
/Z55
ISU�jS�,
Un
IV
Required Documentation:
CF2R-MCH-01-E - Space Conditioning Systems Ducts and Fans
-Duct insulation requirement for new plenums: R6.
CF2R & CF3R-MCH-20-H Duct Leakage Verification required.
-Leakage rate compliance: 5 6%.
CF2R & CF3R-MCH-22 Fan Efficacy Verification
-
CF2R & CF3R-MCH-23 System Air Flow Rate Verification
-Compliance: Fan Efficacy <_ 0.58 W/cfm and System Airflow >_ 350 cfm/ton.
- Alternative Compliance: CF2R & CF3R-MCH-28 Return Duct Design Verification is an alternative to MCH -22 and MCH -23 verification.
.CF2R & CF3R-MCH-25-H Refrigerant Charge Verification required when refrigerant containing components are installed or altered (applicable in CZ2, 8-15).
Exceptions: -
Heating -only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements.
Note:
An "entirely new or replacement duct system" means at least 75 percent of the duct system is new duct material; and up to 25 percent may consist of reused parts from the dwelling unit's existing
duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material) if the reused parts are accessible and can be sealed to prevent leakage
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
STATE OF CALIFORNIA
-ALTERATIONS TO SPACE CONDITIONING SYSTEMS
"U_lm
CEC-CFIR-ALT-02-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CF1R-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF1R-ALT-HVAC) (Page 6 of 6)
Project Name: Date Prepared:
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
�- -
Documentation Author Signature:
t-vSvr
Company:Signature
�
NJ14 al p
Date: f
P6
Address:CEA/
fa 6�� d�ea���.7p-
HERS Certification Identification (if applicable):
City/State/Zip: ' I'-, S p—I ^ C/4 9'��b q
Phone: 53 / //ZO
RESPONSIBLE PERSON'S DECLARATION STATEMENT .
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible
designer).
3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or -system design identified on this Certificate of
Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents,
worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency
for all applicable inspections. I understand that a registered copy of this Certificate of Compliance is required to be included with the d cumen ion the builder provides to the building
owner at occupancy.
Responsible Designer Name:
Responsible Designer Signature:
Company:
DIA/,a
Date Signed:
-3
Address:
O/eAN/,%r 'DD
License:
%
City/State/Zip:
pz:�i-44S' ,e� n� S C A
Phone:
760 _5-- %'//ZD
Registration Number: Registration Date/Time: HERS Provider:
CA Building Energy Efficiency Standards - 2013 Residential Compliance June 2014
t
• ' •
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'FAID�DATEK
..a ... ._<DESCRIPTION�E <` ,gr�ACCOGtVT� a.;QTY nAMOUNT ct #ea,Ts w a�PAI{D�"
BSAS SB1473 FEE 101-0000-20306
0 $1.00
$0.00
Y"rsblr.aM1t'f,'P �' ^r^4,' f .,. i�`�!v;.4, 3w {lam£ 1 k','i—'rcg-!..4
PAID BY Er _'
$
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.
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:•
s;�
aCLTD
�,, t ..
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 -' '
zAMp
z -TS§y£ �,;3-.::-.4' ,..'r"�tF
c"s. TbL-k''1iE.:';5`r"?Js3 .�`n-'�:,K�:q§.i.
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9 &'".. 3.' '.: �"b�
',>,,,,.$0.00
$1 .(5-'P'SL,a.'.,•..-
PAID>DATE::
P,:. 3 ,. DESCRIPTION
?
QTY
AMOUNTqq
w,
PAID cc
iT.Y �
HVAC CHANGEOUT - SPLIT-SYSTEM
101-0000-42402
0
$72.52
$0.00
ry
PK:,{;y_s%'k
+i: .3're,::: iL:{.
,� 4:T o '3I .,P}
#4.
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& BY:
t;,`RECEIPT#�";:
.. CHECK . F:
CLTD
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�... kcsS'iy:x§^*i'A`�.?e. 3Ty?' n
ACCOUNTE&§
"g`3 .+x . ,
QTYi41NI0UNT"?
ix.,i�i Y' .wr' 'Sk.F:HI3fP .. F
��s
. �h£rsy{'.:e"k'{y:
-< 'PAID
K .DESCRIP,TIONbr s
`�i
FPAIDDATE-
HVAC CHANGEOUT - SPLIT -SYSTEM PC .
101-0000-42600
0
4$36.26
$0.00
t
:4..rF•: r:,ra ::..
METO<
bs:; Is:r-'XSfrx-'Su2'
£'f
C+dH.a:E- CK
#[
`a4PAIDBY
D BY
.y.'
3wa'.§.iR
,.E4.•:t:S,E
f
„CL�'
.,
Total PaidlorCHANGEOUT: $108.78 $0.00,
9 $
-. 4 +d4 !t•`e'�s
DRIPTIONY§€��Y,
A
f "•�tihACCO,RU�}: Nb T4 i �av
'xY' bSA:wMi:�nS�F ..
YP
H.IfD'lP•Dy"A
TEOUNTgp
fki
_..Cr
r+�
Qr%x TY�
r@ham
yfP'1t PAI:D:
PERMIT ISSUANCE
.101-0000-42404
0 „
$91.85
$0.00
METHOD�s
M.:
-i .r§�;.zri.'c.--;"-, i�,.�`z"ii�'''..,K
#�>
:• a:
K'�'
BY
_��RECEIPT
z.CHECK#€ :.•�
,CLTD
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
• 00
c
1
Description: MASTER/ADD HVAC 15SEER/8.7HSPF
Type: MECHANICAL Subtype: Status: UNDER REVIEW Applied: 3/9/2015 SKH
Parcel No: 774041020 Site Address: 53167 AVENIDA DIAZ LA QUINTA,CA 92253 Approved:
Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 178 Lot: 10 Issued:
UNIT 18
Lot Sq Ft: 0 Building Sq Ft: 0' Zoning: Finaled:
Valuation: $5,000.00 Occupancy Type: Construction Type: Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
Details: HVAC CHANGE OUT - 15SEER/8.7HSPF SPLIT SYSTEM [2013 ENERGY) CARBON MONOXIDE ALARM(S) TO BE INSTALLED PRIOR TO
FINAL INSPECTION. 2013 CALIFORNIA BUILDING CODES.
Printed: Monday, March 09, 2015 11:41:27 AM 1 of 2
SYSTEMS
ADDITIONAL
NAME TYPE
NAME
ADDRESSI
CONTACTS_CHRONOLOGY
CITY
STATE
ZIP
PHONE FAX EMAIL
APPLICANT.
BLAIR AIR INC DBA BLAIR HEATIN
653 OLEANDER ROAD
PALM SPRINGS
CA
92264
(
Printed: Monday, March 09, 2015 11:41:27 AM 1 of 2
SYSTEMS
Printed: Monday, March 09, 2015 11:41:27 AM 2 of 2
SYS7EM5
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
HVAC CHANGEOUT -
101-0000-42402
0
$72.52
$0.00
SPLIT -SYSTEM
HVAC CHANGEOUT -
101-0000-42600
0
$36.26
$0.00
SPLIT -SYSTEM PC
Total Paid forCHANGEOUT:
$108.78
$0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE:
$91.85
$0.00
TOTALS:00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR
SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE
DATE
MECHANICAL FINAL"
Printed: Monday, March 09, 2015 11:41:27 AM 2 of 2
SYS7EM5
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
Permit #
Project Address: j 3 ((o� U� DIA2_
Owner's Name: K i A _ 2
A. P. Number:
Address: �j ((� % V,.
Legal Description:
City, ST, Zip: L_.A_ C�IUINl'A ,
�
Contractor: k�
j
t ' , N)! , f
Telephone:
p
'sr
Address: O e A 7V e,� ]%
Project Description: �o I e) N A
City, ST, Zip: �-M N, S;) P_ l N S i C, A
M11\J1 S 14-4e* M +0AT)D
Telephone:
:
;y
y�
I A 2 � A ' � C A N
State Lie. #:
City Lie. #:
C-)... Q F� 0 /V\<
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
State Lie. #:
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Construction Type: S 1 e Occupancy:
Project type (circle one): New Add'n) Alter Repair Demo
Name of Contact Person:
Sq. Ft.: I
# Stories: !
# Units:
Telephone #,of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
i/ Submittal Req'd Recd TRACKING PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Caics.
Reviewed, ready for corrections
Plan Check Deposit
Truss Caics..
Called Contact Person
Plan Check Balance.
Title 24 Cala.
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
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"' Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees