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BRES2017-000578-495 CALLE TAMPICO LA QUINTA CALIFORNIA 92253 T4ht 4 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BRES2017-0005 Property Address: 45640 COLDBROOK LN LN APN: 604432014 Application Description: SANKEY / CHANGE OUT (8) WINDOWS Property Zoning: Application Valuation: $11,525.00 Applicant: GO PERMITS 20 DOUGLAS RO GLASTONBURY, CT 06033 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, C20, C39. C17; C-2, D65. C5A C35. C -6M10, C33. C36. D28 License No .• 72137 Date: 1 �Z .I ! 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. 7031.5, 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).: ( ) 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 improvemenYis 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 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 Address: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 1/12/2017 Owner: m WAYNE SANKEY tn- Z 92253 z c c rT- e D T Q z � !�► Contractor: SEARS HOME IM L?MEN11`RROD CTS INC 1024 FLORIDA Cd5f PAR �Y LONGWOOD, FL 5-6- D (407)551-5402 m No.: Llc. 721379 rn E WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of t -ie 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 ofthe wo k for which this permit,is issued. 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: ACE AMERICAN INSURANCE COMPANY Policy Number: WLRC48609247 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 beco subject to the workers' compensation laws of California, and agree t t� if I shouecom subjectto the workers' compensation provisions of Section 700 of the r Co eI shall forthwith comply with hose pr visions. (� Date: ///-z 11-7 Aoolicant: IL's... I j I,, Ul WARNING: FAILURE TO SECURE WORKERS' COM?ENSATION 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 3uilding 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 thework being performed under or following issuance of this permit. 2. Any permit issued as a result of this applicaton 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 statrthat the ab ve informat'on is correct. I agree to comply with all city and county ordinances and sta laws vela ng to ilding construction, and hereby authorize representatives this ci to enter poen th above -men ioned roperty forinspection purpo4es. f Date: � lz Signature (Applicant oi Agent): Detail: CHANGE OUT (2)SLIDING GLASS DOORS AND (6) WINDOWS LIKE FOR LIKE. 2013 CALIFORNIA BUILDING CODES. 1 1 Date: 1/12/2017 Application Number: BRES2017-0005 Owner: Property Address: 45640 COLDBROOK LN LN WAYNE SANKEY APN: 604432014 Application Description: SANKEY / CHANGE OUT (8) WINDOWS 92253 Property Zoning: Application Valuation: $11,525.00. Applicant: Contractor: GO PERMITS SEARS HOME IMPROVEMENT PRODUCTS INC 20 DOUGLAS RO 1024 FLORIDA CENTRAL PARKWAY GLASTONBURY, CT 06033 LONG W DOD, FL 32750 (407)551-5402 Llc. No.: 721379 Detail: CHANGE OUT (2)SLIDING GLASS DOORS AND (6) WINDOWS LIKE FOR LIKE. 2013 CALIFORNIA BUILDING CODES. 1 1 FINANCIAL • ' + • DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:. $1.00 DESCRIPTION ACCOUNT CITY AMOUNT SMI - RESIDENTIAL 101-0000-20308 0 $1.50 Total Paid for STRONG MOTION INSTRUMENTATION SMI: $1.50 DESCRIPTION ACCOUNT aTY AMOUNT. TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 DESCRIPTION ACCOUNT QTY AMOUNT DOOR/WINDOW, RETRO/REPAIR, EA ADDITION 5 101-0000-42400 0 $10.64 DESCRIPTION ACCOUNT QTY AMOUNT DOOR/WINDOW, RETRO/REPAIR, FIRST 7 101-0000-42400 0 $63.84 DESCRIPTION ACCOUNT QTY AMOUNT DOOR/WINDOW, RETRO/REPAIR, FIRST 7 PC 101-0000-42600 0 $62.32 Total Paid for WINDOW/SLIDING GLASS DOOR/FENESTRATION: $136.80 TOTALS: $144.30 F QUITA �.a� 6 Y �� B�iL OIO & SAFL --TY ®�F'T. APF T v FOR COAsUCTI DATE � 3 of 3 , 1 F QUITA �.a� 6 Y �� B�iL OIO & SAFL --TY ®�F'T. APF T v FOR COAsUCTI DATE � 3 of 3 1 of 2 - - JOE NUMBER: 21483419-0001 PROPOSAL DATE: 12/26/2016 WINDOW ORDER ADDENDUM 1 WP -SLIDER 1 58 W X.58 H WHITE ; LOWE/ARGON/CLEAR FULL SCREEN MAX CLEARANCE DIMENSIONS=[23.5 X 52.75] 2 WP.- SLIDER 1. 58 W X 58 H WHITE LOWE/ARGON/CLEAR FULL SCREEN _ MAX CLEARANCE DIMENSIONS=[23.5 X 52.75] F 3 WP - SLIDER 1 46 W X 58 H WHITE LOWE/ARGON/CLEAR FULL SCREEN MAX CLEARANCE DIMENSIONS=[17.5 X 52.75] . 4 WP - SLIDER 1 70 W X 58 H ' WHITE LOWE/ARGON/CLEAR Ij FULL SCREEN MAX CLEARANCE_ DIMENSIONS=[29.5 X 52.75] 5 WP - SLIDER 1 70W X 58 H WHITE LOWE/ARGON/CLEAR I FULL SCREEN MAX CLEARANCE DIMENSIONS=[29.5 X 52.75] 6 WP - SLIDER 1' 58 W X 58 H WHITE LOWE/ARGON/CLEAR FULL SCREEN MAX CLEARANCE DIMENSIONS=[23.5 X . 52.75] 7 WP - SLIDER 1 58 W X 58 H WHITE LOWE/ARGON/CLEAR FULL SCREEN . MAX CLEARANCE, DIMENSIONS=[23.5 X' ` 52.75] 1 of 2 '8 WEATHERBEATER_C - PATIO DOOR 1 60610 WHITE=[60610] ' u RIGHT,OPENING •r' LOWE/ARGON/CLEAR . { DUPLICATE KEYED PD LOCK `- FOOTBOLT , TOTALS: 8 , COMMENT: . F. _ U�• 12/26/2016 ,. 12/26/2016 Customer Signature Date Customer Signature Date S, t ' - 2of2 ,• f .' . ... IIIIIIIII� III III Office Location: SAN DIEGO Proposal Date 12/26%2016 lJob Number 21483419 Sears Home Improvement Products, Inc. Customer Name P.O. Box 522290, Longwood, FL 32750-7579 WAYNE SANKEY e.?(qa��a, i Home Improvement Products Phone (800) 4694663, Notice of Cancellation may be sent to this address Customer's Home Phone Cus tomer's Work Phone (760) 360-0862 Street Address ESTIMATE AND PROPOSAL' Contractor LicenselRegistration Number 45640 COLDBROOK LN Windows CA (721379) city State LA QUINTA, CA JZjpCode 92253 Is installation within city limits? (Yes/No): YES Installation Address County RIVERSIDE Billing Address (d different from above) City State Zip Code Project Consultant Name & License No. (if applicable) HUGH GAGEN 34056 Description of the Project and Description of the Signficant Materials to be Used andEquipmerit to be installed 1. Remove existing units to be replaced. (PLEASE NOTE: The removed units are likely to be damaged.) 2. Prepare openings as necessary to receive replacement units. (No finish work other than normal installation is to be done unless otherwise noted below.) 3. Installation includes the dean -up of all job-related debris upon completion of the job. 4. (If applicable) After the completion of the project, the customer will be responsible for the application and removal (storage) of shutter panels. In the event that the project requires the installation of storm shutters or egress windows, Sears Home Improvement Products, Inc. ("Sears") will not re -install any affected security bars. 5. (If applicable) In the event Sears is unable for whatever reason'to obtain the proper permits prior to the commencement of any work, Sears will refund any previous payment and this contract will be automatically cancelled. Summary of Window Order Addendum (see detailed Window Order Addendum for more information): Type: WBTR PLUS (ALSIDE) Quantity: 7 Type: WBTR LTD (ALSIDE) Quantity: 1 ,—Type: Quantity: . Type: Quantity: Type: Quantity: The Window Order Addendum is made a part of and incorporated into this contract by Customer(s) initials W reference. Additional work t0 be done: NO ADDITIONAL WORK TO BE DONE Work NOT to be done: NO CHANGE WINDOWS IN 2 BATHROOMS NO CHANGE GARAGE WINDOW. SPECIAL INSTRUCTIONS:'CHANGE 7 WINDOWS ONLY AND 1 PATIO DOOR All of the above check boxes, 'Work NOT to be done," `Additional work to be done," and Customer(s) initials `Special U Instructions" sections have been reviewed and explained to me. SWI -C4 (Dig.) Rev 06/14/2016 Page 1 of 4 Job Nunber: 21483419 APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximately 3-4 WEEKS (Approximate Start Date) It will be substantially completed by approximately 1-2 DAYS (Approximate Completion Date) These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products, Inc. ("Scars") or at any other time by mutual written agreement. Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule the actual start date. ASBESTOS ABATEMENT: This Estimate and Proposal assumes that there are no asbestos containing materials ("ACMs") that would be disturbed in the performance of the installation work. If upon further inspection by the contractor or others it is learned that ACMs have -o be disturbed to perform work, then Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fails to arrange for necessary asbestos abatement within thirty (30) days, Sears may cancel this contract upon Customer(s) initialsW S 1F written notice to Customer. ��$11,525.72 The TOTAL PRICE including all labor, material, taxes and any applicable discount is $ 11, 525.72 Contract Price Initial Payment (not to exceed 30% of Total Price unless Special Order) $ 3,457.72 State Sales Tax ( 0.00 %) $0.00 Final Payment (balance payable upon completion of job) $ 8,068-00 Local Sales Tax ( 0.00 %) $ 0.00 The Initial Payment is due prior to Sears ordering products. Total Amount Due $11: 525.72 The form and method by which the Customer(s) will pay is described in a separate Cash/Credit Customer(s) initials 14 Card Payment Addendum made a part of and incorporated into this contract by reference. NOTICE TO BUYER: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY (FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER) AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. ADDITIONAL PROVISIONS Proposal and Approval. Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached sketches and specification sheets for the TOTAL PRICE shown. This offer must be approved by the Installation Department. If this is a credit sale or a payment on completion sale, it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with the law, this offer will be withdrawn and any payments you have made will be refunded to you: Any materials left over after the installation has been completed are Sears property and will be removed by Sears. Installation. I understand that Sears will not install the materials but will arrange for the installation. Sears is not responsible for materials or installation NOT furnished or arranged by Sears. Sears' installation contractor(s) will obtain all building permits required by local law. For comes located in historic or landmark zoning districts, Customer will be responsible for obtaining required approvals and related permits prior to the commencement of work on this contract. Authorization. I authorize Sears to: (1) arrange for a contractor (licensed where required by law) to make the installaticn of materials; (2) issue a work order for this installation to a contractor, (3) inspect the installation; and (4) pay the contractor when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. Delays in Installation. I agree that Sears is not responsible for delays in delivery or installation due to weather, fire, strikes, war, government regulations or any causes beyond Sears' control. Oral Agreements and Changes in Contract. I understand that there are no oral agreements between Sears and me. Everything I expect Sears to do has been included in writing in this contract. Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears. Responsibility of Buyer. I agree that any information or measurements that I give to Sears are correct and complete.: am responsible for any special work described in this contract. Electrical & Plumbing Service. I will provide adequate electrical and/or plumbing service(s) to run any newly installed appliances or other furnishings. If the electrical and/or plumbing service(s) do not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary changes at my expense unless Sears has agreed in this contract to make the changes. Payment. I will pay Sears the cash price that covers the price of material and installation as shown on the first page. Warranty Information. Appropriate product warranty documents will be given to me by Sears. Sears' Warranty on Installation is: SEARS' LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer warranty extended to you on the product(s) used (which warranty becomes effective the dE.te the merchandise is installed), if the workmanship (or application) of any Sears' arranged installation proves faulty within (i) one year for Weatherbeater Value Line, (ii) two years for Weatherbeater Plus, or (iii) three years for Weatherbeater Max, and Weatherbeater Stormbeater, then upon notice from you Sears will cause such faults to be corrected by repair at no additional cost to you. If Sears determines that repair is not commercially practicable or cannot be timely made, then, at Sears' sole discretion, Sears may elect to provide replacement or refund. Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1-800.222-5030, Option 4. This warranty gives you specific legal rights, and you may also have other rights that vary from State to State. SW3-CA (Dig.) Rev 06/14/2016 Page 2 of 4 Alside Window Comparison Sheet Rev. 3292016 Platinum Platinum Mezzo Vinyl Lifetime 31/4" Beveled Frame 31/4" Beveled Frame 3 ,/4" Beveled Frame — -- lifetime Fusion Welded Fusion Welded Fusion Welded - Lifetime 0-20 yrs 10096 21-30 yrs 75% 31 yrs plus 50%- Sloped SII Sloped Sill Sloped Sill Frame Accessory Track In & Out Accessory Track In & Out Accessory Trackin & Out Labor Balance Covers Balance Coven Balance Covers Constant Force Coil Spring Balance System Constant Force Coil Spring Balance System Constant Fome Coil Spring Balance System Brass Rollers Brass Rollers Brass Rollers Dual Cam Lodes Dual Cam Locks Dual Cam Lola Fusion Welded Fusion Welded Fusion Welded Foam Filled Sash Chambered Sash Chambered Sash Sash Triple Barrier Weather-stripping Triple Barrier Weather-stripping Triple Earner Weather -stopping Interlocking Meeting Rail Interlocking Meeting Rail Interlocking Meeting Rail Integral lift rail Integral lift rail Integral lift rail Dual Vent Latches Dual Vent Latches ')ual Vent Latches Dual Pane Dual Pane Dual Pane Double Strength Laminated Security Glass Double Strength 0oubte Strength 13/16" IGU 3/4" IGU 3/4" IGU Glass Intercept Spacer. Intercept Spacer ilntercept Spacer Soft Coat Low E Soft Coat Low E Soft Coat Low E Argon Filled Argon Filled Argon Filled Tempered Available Tempered Available Tempered Available Decorative Glass Options Obscure Obscure Obscure Screens Full Screen Standard Fiberglass Full Screen Standard Fiberglass Full Sween Standard Fiberglass White White White Interior Almond Almond Almond Clay Clay Clay White White White Colors Almond Almond 'Almond Exterior Clay . Clay Clay Bronze' Colonial Colonial Colonial Grids Prairie Prairie Prairie Perimeter Perimeter Perimeter Double Hung Double Hung Double Hung Picture Window Picture Window Picture Window Casements, Siders Casements, Sliders casements, Siders Bays, Bows Bays, Bows Bays, Bows Types Garden Windows Garden Windows Geometria Geometria Geometria Endvent Endvent Endvent Patio Door- Std ONLY Patio Door Patio Door ilC Yes Yes Yes Warranty = WoAcmariship, ,Original'Owneci - - - Vinyl Lifetime lifetime _ Lifetime - — Hardware — -- lifetime lifetime --- Ufetime _- - Screens - Lifetime 0-20 yrs 10096 21-30 yrs 75% 31 yrs plus 50%- -- ,— Lifetime 0-10 yrs 1009A 11-20 yrs 50% 20 yrs plus 0% Lifetime 0-5 yrs 100% 5 yrs plus 0% --------- _ -- Glass - obstruction _ - Glass - breakage -_- _--- — _ .- --- , — Lifetime -- _-__ _ 20 Yrs —_- _ - -^_ 10 Yrs Labor 3 Yrs 2 Yrs 1 Yr �'fhetinal�Perfoimariopt� - - U -Factor R -Value 0.23 4.30 0.18 ------_-- - 0.32 -- - -- -- - 0.25 4.01 0.20_ - - --- - - 0.42 - -_-- 0.30 -- 3.32 -- _----_ _ - — _ 0.22--_ -- 0.49 SHGC _ _ Visible Transmittance— CONTRACTORS CHIC 7 STATE LICENSE BOARD ACTIVE LICENSE . 721379 CORP SEARS HOME IMPROVEMENT PRODUCTS INC B C20 C39 C17 C-2 C61/1365 C54 C15 C6 C10 C33 C36 IL 04/30/2018 www.csib.ca.gov STATE OF CALIFORNIA RESIDENTIAL ALTERATIONS CEG CF -1 R -ALT (Revised 03110) CALIFORNIA ENERGY COMMISSION Prescriptive Certificate of Compliance: Residential CF -IR -ALT Residential Alterations age 2 of Project Name: �E to '1 a Co (d 1_ ` Climate Zone # # of Stories 1. Indicate the type of assembly to include; Hollow Unit Masonry Walls, Solid Unit Masonry, Solid Concrete Walls, Etc. Additional assemblies can befound Reference Joint Appendix JA4. 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 JA4. The equation is the inverse of Column added to Column I. Column K is the inverse from column J. 7. Insert the calculated U -factor value on to the ODaaue Surface Details in Column J FENESTRATION PROPOSED AREAS 0 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. ❑ Adding 50ft2 or less of window area — Newly installed windows shall meet the U -Factor and SHGC Value n_quirements of Component Package 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 D in Table 151-C. Complete the Altered Fenestration Allowed Area Tably on Page 2 of the CF- IR -ALT Orientation D E Fenestration Type and Frame (North, East, PropsedArea' Maximum Maximum NFRC or Default indow, Glass Door or skylight) South, West (ft) U-factor2, I SHGC2 1,4 Values -o d vv S S .JL ac t o�.cm��..�•—IN tow w - 2� • e C -CA- s % of Fenestration Area Fenestration Area t l.Nccm&-J P,4reboar N • 30 . a C). 1. Fenestration area is the area of total glazed product (i.e. glass plus frame). Exception: When a door is less than 50%glass, the fenestration area may be the glass area phis a 'T 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 U factor and/or a lower SHGC value than that specified on the CF -IR ALT Form. 4. Submit a completed. WS -3R Form if a reduced SHGC is calculated with exterior shading. 5.If applicable at this stage enter `NFRC" or NFRC Certified windows or are CEC "Default " valuesfound in Tabi�e 116-A or B. ALTERED FENESTRATION ALLOWED AREAS (Complete if more than 50J?z offenestration is added~ A B C D E F G CFA of Allowed Existing Allowed Entire % of Fenestration Area Fenestration Area Proposed Area' 4 Dwelling CFA2. 3 Area4 Removed Area Added A xB -D + C Total Fenestration Areae ft2 West Fenestration Area (Required In CZ's 2,4&7-15 Registration Number: • Reg str - I n Date Time: TIERS Pr?vider: 2008 Residential Compliance Forms _ March 2010 . . . Bin # City of La Quinta ' Building & Safety Division Permit # P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Buildin Permit Application and Tracking Sheet (.� g Project Address: Owner's Name: wet,, se", �t A. P. Number. O y c�-G / 7 a Address: `l s (� �G C, d l ��! v� Gn •. Legal Description: l..,-- Qe//m--8 ' city, ST. zip: �At, s, C4 99-aS 3 2a�� Contractor: cars Prete n. i0/z� V(_rr%z Telephone: 2Ir PG -34,0 - 03- (v,i . Address: 16,W Ro-r `d -r— fi= r pc ( 10 Project Description: City, ST, zip: Lev,—O—ad FL 3a 7S07 P(_,rncY4,a l �• c -t Telephone: 9(Q() _el SQ: -g114 4. .1I>; w 14, l.Zp� S a .-n State Lie. # : e7a / ,3 9 City Lie. NO601R& G7 �� • � �f v` '• tea( tea , , . Arch., Engr., Designer. Plan Check Deposit Address: City' ST, Zip. Telephone:' Called Contact Person Construction Type: Occupancy: Project type (circle one): New Add'n Alter R Demo State Lic. #: _ } '"' '�Y Name of Contact Person: Sq. Ft.: # Stories: # Units Telephone #,of Contact Person: Estinu&A Value of Project: // f Sa -!S;_ APPLICANT: DO NOT WRITE BELOW THIS LINE N Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Cates. Reviewed, ready for corrections Plan Check Deposit Truss Cates. Called Contact Person Plan Check Balance Tide 24 Coles. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2'! Review, ready for correctiousfissue Electrical Subeontaetor list Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''d Revlew, ready for correctionalssue Developer Impact Fee lannl"g!►PPr�val_ Catled Centazt.Yerson Y P - Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees