04-5662 (SFD) Revision 1Permit # 5 ��
Project Address: ' �]'l. r 1'j 0
A. P. Number:
Contractor: r`iW1NCN
City of La Quints
'Building ex Safety Division
P.O. Box 1.504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
S ( L Owner's Name: /p
Address: aSS. A OG. A (Lp9D
City,, ST, Zip: C, t) p� t%1 -Z: 3
Telephone: 4k I — 01 GGh is
Address:
Project Description:
U e-
City,.ST, Zip:/
/�•
Telephone:��
State Lic. # :
City Lic. #:
/
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:
State Lic. #:l
Construction. Type: Occupancy:
Project type (circle one): New Add'n Alter 'Repair Demo
Name of Contact Person:, 2166')
�
61 L -,w 1 v6
Sq. Ft.:
# Stories:
#Units:
Telephone # of Contact.Person:
Cj % C.
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal
Req'd
Recd
TRACIONG •
PERMIT FEES
Plan sets*
Plan Check submi
14q
Item
Amount
2 Structural Cales.
Reviewed, ready fo corrections L2 Z
Plan Cbeck.Deposit
Truss Calcs.
Called'Contact Pe
C.
Plan Check Balance
40
Energy Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2" Review, ready for correctio ue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.L.
H.O.A. Approval Plans resubmitted Grading
IN HOUSE:- 'a Review, ready for correedons/issae. Developer Impact Fee
Planning Approval Called Contact Person AJ.P.P.
Pub. Wks. Appr Date of permit issue l
School Fees
l
Zv
lzfz3 flk�o Rh L
Total Permit Fees
PA A
• Ing ti NS Rbmo y To (SS lj -