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12-0069 (RER)
f P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tih t 4 4&Q" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: 12-00000069 Property Address: 53,400 AVENIDA HERRERA APN: 774-084-009-16 -000000- Application description: REMODEL - RESIDENTIAL Property Zoning: COVE RESIDENTIAL Application valuation: 2050 Applicant: Architect or Engineer: 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 S, 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 an applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).: 1 1 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.). 1 _ 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 Licen a Law. l. l _ 1 I am exempt under Sec. , B.&P...Sfor this reason te: 2,a t ner: JCC. 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: krx LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/25/12 Owner: SEAN O'BRIEN 53400 AVENIDA HERRERA LA QUINTA, CA 92253 Contractor: Owner ,O 0 I_ 7---JAN-2 v 2012. J € CITY 0F LA WINTA e 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 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 - - - - - - - - - - - - - - --- - -- - -- 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 come subject to the workers' compensation provisions of Section 0124 7 3700 of the Labor Code shall fort ith comply with those pl',ovisions. e: 2'4 p cant: �� WARNING: FAILURf TRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP'TO ONE HUNDRED THOUSAND DOLLARS 15100,0001. 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 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 state laws relating to building co truction, and hereby authorize representatives of thiscounty to enter upon the above-mentioned property for i pection p,, oses. at5 we Signat%u (Applicant ar Agent(: r_ J Application Number . . . . . 12-00000069 Permit BUILDING PERMIT Additional desc . . Permit Fee . . . . 54.00 Plan Check Fee 35.10 Issue Date Valuation . . . . 2050 Expiration Date 7/23/12. Qty Unit Charge Per Extension BASE FEE 45.0.0 1.00 9.0000 THOU BLDG 2,001-25,000 9.00 ----------------------------------------------------------------------------- Special Notes and Comments REPLACE VARIOUS WINDOWS & DOORS - REFER TO APPLICATION & ENERGY SHEET. 2010 CODES. ---------------------------------------------------------------------------- Other Fees . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged. Paid. Credited Due Permit Fee Total. 54.00 .00 .00 54.00 Plan Check Total 35.10 .00. .00 35.10 Other Fee Total 1.00 .00 .00 1.00 Grand Total 90.10 .00 .00 90.10 LQPERMIT Prescriptive Certificate of.Compliance: Residential , CF -IR -ALT Residential Alterations Page I of 5 Project Name: �/,DD�-,/Jt/J .• Climate Zone # ofStories General Information Site Address: Enforcement Agency: Date: Building Type® Single Family ® Multi Family Circle the Front Orientation: N, E, S, W, or degrees Conditioned Floor Area (CFA): Project Type: 0 AlterationsEnvelope Fenestration Roof HVAC Replacement or Change Out 8 Duct Replacement ® Water Heater. NOTE: This form is not to be used for Newly Constructed Buildings or Additions Insulation Values For Opaque Surfaces (for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration Opening of framed 'cavity alone— Alterations that involve the opening of the framed cavity of a wall, ceiling, or floor must install the mandatory minimum insulation value per §1.50 for the altered assembly. Fill in Columns A —C and enter mandatory insulation value in Column H. ®Replacement of entire assembly—Replacement ofan entire wall, ceiling, or floor assembly requires the installation of Component Package- D insulation values in Table 151-C. Fill in Columns A —J. Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. A B C D E F G I H I I J Proposed bee Note Standard Values From JA4 Table M Framing Thickness, Framed Continuous JA4 Proposed Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly ID' or Type' and Size' or Other' factor Numbers R-value6 R -Value' Row/Cole U -factor' Joint Appendix Table 4.3.5 4.3.6 4.3.7 Joint Appendix Table 4.3.1.3 N O N y T y N J. Assembly j o o .L F F$ C � > 7 Final Note: For furred assemblies, accounting for Continuous Insulation R -value, see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and Furring Construction table below. . 1. For Tag/1D indicate the identification name that matches the building plans. 2. Indicate the Assembly Name or type: Roof/Ceiling, Walls, Floors, Slabs, Crawl Space, Doors and etc... Indicate in column G the Frame material and Size: For Wood, Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16 "or 24 "OC; or Other for all other assembly description such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc.... 4. Based on the Climate Zone; enter the equivalent U factor found in JA4 Table based on the R -Value from Table 151-B, C, or D 5. Enter the Table number that closely resembles the proposed assembly. 6. Enter the R -value that is being installed in the wall cavity or between the framing; otherwise, enter "0 ". 7. Enter the Continuous Insulation R -value for the proposed assembly; otherwise, enter "0 ". 8. Enter the row and column of the U factor value based on Column F Table Number and enter the Assembly U factor in Column J 9. The Proposed Assembly U factor, Column J, must be equal to or less than the Standard U factor in Column E to comply. Furring Strips Construction Table for Mass Walls Onl A I B I C I D I E F I G I H I J I K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference Joint Appendix Table 4.3.5 4.3.6 4.3.7 Joint Appendix Table 4.3.1.3 N O N y T y N J. Assembly j o o .L F F$ C � > 7 Final Mass Name or JA4 Table �' y x o ._ > 2 0 ; Assembly Thickness T Number;U. ¢ > U -factor '� Comment ��tiix •b. Re ist atibn um ¢r . _ _ ; _ _ s Re "slration Dat ,i»re t• r _ HERSProv'der: #' 2008 Residential Compliance Forms March 2010 Prescriptive Certificate of Cotn liance: Residential . - CF4R-ALT' Residential Alterations' A B Page 2 of 5)*, Project Name _ �3�19� �4-�/� ITC/ � I,t) O W Climate Zone # 2 # of stories CFA of Allowed Existing Mass and Furring Strips Construction(footnotes) 1. Indicate the type ofassembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional assemblies can e found . Reference Joint Appendix JA 4. 2. This is the U -Factor based on the thickness of the assembly in inches. 3. The R -value of the insulation to be added on the interior or exterior of the assembly. 4. The Calculated R- Value is the R -value of the furred out section of the assembly. -6: The Final Assembly is calculated using Equation 4-2 or Equation 4-4of the Reference Joint Appendix JA 4. The equation is the inverse of Column added to Column 1. Column K is the inverse from column J. 7. Insert the calculated (I- actor value on to the Opaque Sur ace Details in Column J FENESTRATION PROPOSED AREAS Replacing window alone — Replacement windows shall meet the U -Factor and SHGC Value requirements of Component Package D in Table 151-C. • The Total Fenestration and West facing Area requirements are not applicable. MAdding 50ft2 or less of window area — Newly installed windows shall meet the U -Factor and SHGC Value requirements of Component !"kage D in Table 151-C Adding more than 50ft2 of window area — Newly installed windows shall meet the U -Factor and SHGC Value and the Fenestration Area requirements of Component Package Din Table 151-C. Complete the Altered Fenestration Allowed Area Table on Page 2 of the CF -IR -ALT Orientation Fenestration Type and Frame (North, East, PropsedAreaMaximum Maximum NFRC or Default indow; Glass Door or Skylight) South, West ft U-factorz• 3 SHGC2.3• ° Values gQ-RLVA WINDOWS �/ 1:A 0+ 0.3 33 0- 0 Rvtfk— Luolj'Oo W S d C404. 0.3 -93 0-30 AT 10 0.O s. S ifAf D. 2 q 1. Fenestration area is the.area of total glazedproduct (i.e. glass plus frame). Exception: When.a door is less than 50% glass, thefenestratioll 'area may be the glass area plus a "2 inch frame " around the glass. 2. Enter value from Component Package D Requirements in Table 151-C. 3. Actual fenestration products installed and as indicated in CF -6R -ENV Form shall be equivalent to or have a lower Ufactor and/or a lower SHGC value than that specified on the CF -1 R ALT Form. 4. Submit a completed WS -31? Form if a reduced SHGC is calculated with exterior shading. 5. Ifapplicable at this stage enter "NFRC'' or NFRC Certified windows or are CEC "Default " valuesfound in Table 116-A or B. ALTERED FENESTRATION ALLOWED AREAS (Complete if more than 50ft2 offenestration is added) A B C D E F G CFA of Allowed Existing Allowed Entire % of Fenestration Area Fenestration. Area Proposed Area Dwelling CFA'-' Area° Removeds Area Added A x $) (E -D) + C - Total Fenestration Areae ft > West Fenestration Area (Required In >_ CZ's 2,4&7-15 1. The Proposed West Fenestration Area includes West -sloping skylight area and any other skylight area with a pitch less than 1:12. 2. Enter 20% when no West orientation restriction or 15% when West fenestration is being installed in Climate Zones 2, 4, & 7-15. Note that the maximum allowed fenestration can only be 5% of the CFA as indicated in Column F. Column G must be equal to or less than Column F. 3. In climate zones Z 4, 7-15, no more than 5% of the CFA is allowed for west facing glazing. 4. Existing Fenestration area must be counted toward the maximum allowed 15% or 20% of the whole building and calculated in Column G. The Proposed Area must be less than or equal to Column F. 5. Enter the fenestration removed as part of the alteration if any in column D. 6. Enter the Fenestration area that is being added as part of the alteration. ReQistra&on Num er: t: _ .,. , Riistratibn dte/Time: — -.%--_ _ _ ERS.P.rovi 2008 Residential Compliance Forms March 2010 r -# 30 E) (100 SSD d 0 Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations Page 5 of 5 Project Name: Climate Zone # # of Stories HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to the HERS Measures specified in this checklist below. A completed and signed CF -4R Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealing & Testing HERS verification is required for this measure. YES © NO YES: In Climate Zones 2 and 9-16, if more than 40 linear feet of new or replacement ducts are installed in unconditioned space, the ducts are to be sealed per §152(b)1Dii.and the newly installed ducts are to be insulated per §151(f)10. . ® EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. ®YES ®NO YES: In Climate Zones 2 and 9-16, if the existing space -conditioning system (HVAC equipment and ducting) is replaced, the ducts are to be sealed per §152(b)IDi. ®YES ®NO YES: In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system, cooling or heating coil, or the furnace heat exchanger) the ducts are'to be sealed per § 152(b)1 E. E3 EXCEPTION: Duct systems that are documented to have been.previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RA3. ® EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. EXCEPTION: Existing ducts stems constructed, insulated or sealed with asbestos. Refrigerant Charge -Split System HERS verification is required for this measure. ® YES ® NO YES: In. Climate Zones 2 and 8-15, when the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system A/C or heat pump, cooling or heating coil, or the furnace heat exchanger) a refrigerant charge measurement shall be verified per§152(b)IF. Central Fan Integrated (CFI) Ventilation System and Fan Watt Draw The ventilation requirements of §150(o) do not apply to existing residential homes. Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. ElYES [3 NO YES: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is replaced, the airflow and fan watt draw shall be verified per 152(b)lCi to meet therequirements of §151(07B. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and corn le e. Name- �,� (gR I ( N Signature: Company: Date: w� / Address: 7 /� �� ` /� a If Applicable = CEA o CEPE J %!"'�� C�IQ/�G�% (Certification 4): y- City/State/Zip: /Iq a utw / A '�41�iCAJIlf • Responsible Building Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with. this building permit application. Name: Signature: Company: Date: Address: License: City/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline at. 1-800-772-3300. Re istrationNumber: gid..__ ;_ _ ,____ Registration: atefTimer 2008 Residential Compliance Forms March 2010 gEO t2 o01 1360&01( W[4)1)OV l �/ .� �� w CITY OF LA QUINTA BUILDING & SAFETY DEPT., APPROVE® FOR CONSTRUCTION DATE 0S'' AY- ("i I 'kiD 6 ,IjS SITE REQUIREMENTS INTERIOR LOT SIDEYARD; 5 FEET REARYARD: 10 FEET MI 4DA' JM EACH SIDE MY)JTKMTM i I I I Ivf� i i FRONTYARD: 20 FEET h'P�IIMiJM I W � I I . . I -I lxo2.w w I AREA TO BE lAMSCAPED i �--- PROPERTY � LII1ES E;Et� . 6\10'r-2 - CURBLWE P -O . BOA i 504 LA Q.UINTA, CALIFORNIA 92247-1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 I/,i(/a(-)WS BUILDING & SAFETY DEPARTMENT PROPERTY O'PENER'S PACKAGE (760) 777-7012 FAX (760) 777-7011 Disclosures & Forms for.0*fier-Randers Ap p4ring €or Construction PerWts ' f lui0�('R 'IY) RA�n�uix'Ar'sr rt ..m . Dear Fcoperty Owner. �rc�rel ". application. for a building permit has bom submitted in your name listing yourself as the budder of the pwporty imus specified at We ase providing YM V' ith an Owner -Builder Avkww1 edg3ment and Infotmatien Yerd'tEatiea l=oan to orlon your avam of your cespo ilities and WMble risk you may Mew by lug t#tis permit-Wmdinn your name as .the Ott -Builder. We wM rent issste a biding pavdt rata y :h&ve read, your.sad s of eack, provision, signed, and returned this form to us at our otneW address indleated. An agent of the owner cannot exeevft dais, notice unless You, the property owner, obtain the prior approval of the permitting authority. I. - . U-7-Mr-jr-W, II, 1 -Y-Mil=1 ±" 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builds building permit that erroneously implies that the property owner is providing his or her own labor and material pers aft. I, 1 an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed pem and his or her employees while working on my property. My homeowner's insurance may not provide coverage. for tho injuries- I am wd f WY acting as an Owner -Builder and am aware of the limits of my insurance -coverage for injuries to worim on niy property. �p 2. I understand building permits are not squired to be signed by property owners unless they are responsible for i e 11".ction and are not hiring a licensed Contractor to assume this 3. I understand as an "Owner-Btuldee' I am the responsible party of record on the permit I understand drat I may pro myself from potential financial risk by hiring a licensed Contractor and having. the permit filed in itis or tier came instad of own 4 -I `understand Contractors are required by law to be licensed and bonded. in California and to list their license mrmbe permits and contracts. <A) 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "empl under state and federal law. 6. I understand if I am considered an "employee" under state and ftderal law, I must register with the stela and 1 government, withhold payroll taxes, provide workers, compensation disability insurance, and contribute to unemplc compensation for each "employee." i also understand my failure to abide by these laws may subject me to serious 6 risk �7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family res structures cannot legally build them with the intent to offer them for sale unless all work is .performed by 9 subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is pe under contract with a licensed general building Contractor. 8. I understand as an Owner -guilder if I sell the property for whicb-this permit is issued; I may be held liable for any dal or. Personal. ut>es aarstxhtod b as subs ueat :o s that result from an latent construction defects in the h}l . Y . Y �l () Y worlananship osmate ial&_... 9. I understand I • may obtain more informationiegacdir►g my obligations as an "employer" froth the inRsec IA RVIMue . Service, the United States Small Business Administration, the California Department of Benefit Paymemo " the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSI at 1- 800-321-CSLB (2752) or www.eslb.ca_gov for more information about licensed contractors. am aware of and consent to an Owner -Budder building permit applied for in my name, and understand that I am the party legally and financially responsibk for proposed construction activity at the following address: 1 L I agree that, as the party legally and financially responsible for this proposed construction activity. I will abide by all applicable lava and requireatents that govern Omw-Builders as well as employers. �n 12. l.agree to. notify the issuer of this form immediately of any additions, deletions, or eh W IMYof tho infcxmaUM I have provided on .this form. Licensed contractors are regulated by laws designed to protect the public- U you cmract with someone who does not have a !roam, tato Conaaotors' State Lw=e Boa cd may be uwMc to ar .SM YOU with any Bard toss You may sustain as a,result ofa complaint. Your only remedy against uaiceasod Contractors may be Invivil MaL It is also intpo�at for you to undcaata nd that if = uolivewd (battactor w entptoyaa of that i &v'idud or fhm is i d w!itc. working on you pmpertY: You may be Add ft duaMm If you obtain a permit as oww-Builder a -v4 w*h m hire xors you wilt be respot to fvr ve ring or not these are pr�#y lid and the sdttus of wotkm eampensation insurance rouge. Before a building permit can be hsa4 ibis foto mast be completed and signal by the property owner and retarded t the agency raapondMe for bwdft tha fwa& Nota, A copy of *c peri* awe's &*Vec's i fWM *@ft*"brh odwr vero7zadan alar qp&*& to tfre agency fs ragrtl " to be pra+crcted when than pgrMi.t Fs : to ► ' de propel owner's signatnrt. Sigma www of property owner72 pate;. d V 2— Note: Note: The following Authorization Form is required to be completed by the property owner only when designap an agent of the property owner to apply for a construction permit for the Owner -Builder. A[TTHO ?A' CkN OFA GMT TO &C T ON MQI?U.n EiWNI�'�i'S B Excluding.the Notice to Property Owner, the oxecartiou of which I understand is my persbnd _bi4ty, I hereby audx the follOwins perwn(s) to act as my ogeat(s) to apply for, sign, and file the documents neceSMY 110 obtain an Owner -Bulb Permit for my project. Scope of Construction Project (or Description of Work): Name of pLuthorizod Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that 1 am the property owner for the address listed above and I personally filled out t) information and certify its accuracy. Note: A copy of the owner's driver's hiceme, form notarization, or other ver0cap acceptable to the agency is req to bep ed when the permit is issued to verify the property s signature Property Owner's Signature: Date: OV �p0 h �'l,vQowS Bin # City Of La Q[((11ta r .' Building 8i Safety Division Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 (760) 777-7012 Building Permit Application and Tracking Sheet • Permit #P.O. �� . - 0' Project Address: 53 7 B D A V rNI D,4 Owner's Name: 5 &q A) J Woe( CA/ A. P. Number: Address: S3 fd--p & rljl6ef // �i/Q X r eq - Legal Description: City, ST, Zip: 41q U1,0719 CglG- - Contractor: Telephone Address: Project Description: FeeP ,i4C 6j1A1,o dW S City, ST, Zip: Telephone: Rewr� State Lie. # : City Lie. #: 3 /W16 lwf C Arch., Engr., Designer: ` LV7i/�/U. /�'�!� 'bod4 SL -1,6 lows . Address: — �%Zd A/ T �(J� —36 1 ( City, ST, Zip: Telephone: :::`' ' s «:. '>' .�v J•a:;�zJ" � �.�.�s.:.J.�:�i��• ., :�.1 •',';: fi;<� . pe: Occupancy: State Lie. #:c cle one): New Add'n Alter Repair Demo # Stories: # Units: rFt: Name of Contact Person: Telephone # of Contact Person: e of Project: 2 O SO '4 I t;4l"��_ APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calls. Reviewed, ready for corrections Plan Check Deposit Truss Calls.: Called Contact Person Pian Check Balance. Title 24 Calcs. Pians picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan Z' Review, ready for correctionsAssue Electrical Subcontactor List Called Contact Person Plumbing Grant Decd Plans picked up S.M.I. �;✓� ' H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 7rd Review, ready for correctionsAssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees