0401-086 (SPIN)A
Permit -I
62 4pI
t
7f Project Address:
A. P. Number
City of La Quinta
Building at Safety Division
P.O. Box 1504, 78-495 'Cafie. Tampico
La Quinta, CA 92253 - (760) 777-70:12
Building 'Permit Application and TrackingSheet
40i0 t>Al %A Ov�•nces'Natne: M pittt�- 1iMdi-ni
X Contractor.. C1'5
Address: PO- Irby- Met
�C City, ST, Zip:s1e-
X Telephone: Zp 5z e -gap
State Lic. g : W-Ilsi t/�^" City Lic: #:
Arch., -Engrg, Designers IST tth
Address
City, ST, Zip:
City. ST, Zip: BM"t" DPW Q1. N �$ CD� , 4 ZZ o
Telephone:
�roject'Descripdon: 1.�uc� i3lIX
eFZ:To
I�T✓1GUL�'-'T ,Ip -57.5- --I,VI rn "" a - I'
Telephone: 9�� f(zo a3 3 Y ''' �gConsttnctionTypc: occupancy:
State Lic M: h _ Pmjecttype.(cireie une) ew Add -n Alter Repair Demo
1C Name of Contact Person: f i6s Sq. Ft.: r606"b d Stories: Z N Units:
X Telephone f!' of Contact'Person: � {e0 imated Value of Project:
APPLICANT: DO NOT WRITE BELoW THIS UNE
p ':.1 Submittal
Plau',Sets
StrocturalCales.
Truss Cala.
Energy Cala.
Flood plain play
Grading plan
Subcontactor Lust
GrantDeed
H.O.A. Approval
IN HOUSE: -
Pub. Wks. AW
Scbool'Fees
�wk- -A/ s
rise Check submitted
Reviewed, ready for` corrections
Called Contact Persou
Mans bieked up
Maas resubmitted
V Review, ready for eorrectionsrssue
Caned Contact Persou
Plans picked up
Mans resubmitted
3" Review,.ready,for eorrccd .. o
Called Contact Person t
Date of oermirissue
Item
Mas Cbeck Deposit
Man.Cbeek-Bahaee
Construction
Electrical
Plumbing
S.1 U.
uwnw ua .
RZ/ 'Developer impact Fee
Amount
Total Permit Fees
S7/ -u -T P�F / r�� SS • o �„ ; s i..o�c E
X4 -0,D NmA,+ ?2e To