05-3877 (AR) Revision 1Permit #
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Project Address: x
A. P. Number: 27
Legal Description: f jl jC r— [ 1
Contractor:
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Cit of La �
y Quinta -Jog
Building & Safety Division �—
P.O. Box 1504, 78-495 Calle Tampico ZY ��''s-1 7
La Quinta, CA 92253 - (760) 777-7012 %��•, —
Building Permit Application and Tracking Sheet
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Address: t Z-(;::- W
City, ST, Zip:
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Telephone
State Lic. #
Arch., Engr., Designer: r
Address:
City, ST, Zip:
Telephone:
State Lic. #1
Name of Contact Person: : j
Telephone # of Contact Person: I
# Submittal
-Plan Sets
Structural Calcs.
Truss Calcs.
Energy Cales.
Flood plain plan
Grading plan
Subcontactor List
Grant Deed
H.O.A. Approval
IN HOUSE: -
Planning Approval
Pub. `Vks. Appr
School Fees
Lic.
Owner's Name:(
NiAddress:!
City, ST, Zip: (A- ZZ S 3
Telephone:�� --�
Project Description:jr
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Construction Type:"�� Occupancy
Project type (circle one): Cw Add'n Alter Repair Demo
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Sq. Ft.: 13 �— # Stories: #Units:
Estimated Value of Project: 9)
APPLICANT: DO NOT WRITE BELOW THIS LINE
Recd TRACMG _
PERMIT FEES
Plan Ch k t
Total Permit Fees
Amount
ec submitted
Reviewed, ready for corrections
Called Contact Person -),3LJ4
Plans picked up
Plans resubmitted
2nd Review, ready for eorrectiDIps/issue
Called Contact Person
Plans picked up
Plans resubmitted
hd Review, ready for corrections/issue
Called Contact Person
Date If permit issue
Item
1
Plan Check Deposit
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Plan Check Balance
Construction
Mechanical
Electrical
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Plumbing
S.M.I.
Grading
Developer Impact Fee
Total Permit Fees
Amount