04-6165 (CGAR) Revision 1L A. A 1Z E&&vAT#vm
City of La Quinta
/ Building a Safety Division
Permit 7 P.O. Box 1504, 78-495 Calle Tampico
�U La Quinta, CA 92253- (760) 777-7012
Building Permit Application and Tracking Sheet
Project Address:
Owner'sName:%
A. P. Number: Address: -) (1�1 Y) l \ 1 S
1 U,
Legal Description: City, ST, Zip: `
Contractor: �,
Telephone: I .
Address: Project Description:
City, ST, Zip:
Telephone: s
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State Lic. # : City Lic. #: `
Arch., Engr., Designer.
Address:
City, ST, Zip:
Telephone: Construction Type: Occupancy:
-
State Lic. #:
: Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: l ��G Sq. Ft:: #Stories: #Units: "
Telephone # of Contact Person: IQ (Estimated Value of Project:
l3 APPLICANT: DO NOT WRITE BELOW THIS LINE
# Submittal Re 'd Recd TRACKING PERMIT FEES
Plan Sets O� ` ? Plan Check submitted ��� � Item
Amount
Structural Calcs. Reviewed, ready for corrections ��/� Plan Check Deposit
Truss Calcs. Called_ Contact Person Plan Check Balance "
Energy Cales. Plans picked up/ S(o tj` %�c�
Construction
Flood plain plan Plans resubmitted i'
Mechanical
Grading plan
2°" Review, ready for correctio s/issue
allaq Electrical
Subcontactor List Called Contact Person
06utM.5b Plumbing
Grant Deed Plans picked up S.M.I.
Ii.O.A. Approval Plans resubmitted Grading
1N HOUSE:- 7rd Review, ready for corrections/issue Developer Impact Fee
Planning Approval Called Contact Person
A.LP.P:
Pub. Wks. Appr Date of permit issue
School Fees
Total Permit Fees
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