0310-339 (SFD)LICENSED CONTRACTOR DECLARATION
I her6by 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
Professionals Code, and my License is in full force and effect.
License # Lic.Class Exp..,Date
a34�£11 l� I,51.
Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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 & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the 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 of the work for which this permit is issued.
( ) I 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 & policy no. are:
Carrier STATE FUND Policy No. 13429"-03
(This section need not be completed if the permit valuation is for $100.00 or less).
() 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 become subject to the
workers' compensation laws of California, and agree that if Vshould become
subject to the workers' compel ation provisions of Sectron,3700 of the Labor
Code, I shall forthwith comply wlthilthose provisions. `,
Date:Applicant_
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & ea
whose request and for whose benefit work is performed under or
any permit issued as a result of this applicaton agrees to, & shall,
& hold harmless the City of La Quinta, its officers, agents and
2. Any permit issued as a result of this application becomes null
work is not commenced within 180 days from date of issuan
permit, or cessation of work for 180 days will subject permit to c4tcI certify that I have read this application and state that the above inion i�correct. I agree to comply with all City, and State laws relating to tI Ing
construction, and heretiy`authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/Agent).: r•�\i•- % Date-! ' 5
-BUILDING PERMIT PERMIT# `
0310-339
DATE. VALUATIONTRACT
7,1.20 LOT .. : f .
t z
JOB SITE ?.
APN
ADDRESS 53-•135 AVELI'.I3 A O.L•$RECW
77 4--044-019
OWNER',,
CONTRACTOR / DESIGNER / ENGINEER
CORONEL RISMLPRISF5
CCR0AM CO. MTR.t7CTTON
PO BOXX 3119
51.103 AVF24MAVILLA, 0101
Lk Q'JWTA CA 92215?
I.A QU N'TP, CA. 92233
(760)5644604 CI:+I t 2261
USE OF PERMIT
STITC -LE FAM.1i Y DWFJ IIWG
W69 SF. SFD PERMIT DOES NUT MICLUDE SL OCK WALIl. P0rJ1JSPA OR.
DPJVEW.AY APPROACH
T11J4,0 T CONSTRUCTION 1,408,00 SF
PORCH/PATIO 36.00 S
k v
r! p.
r F
�{�r�A 1�(C� Sy 9� Qy„ App c�
0AI1AGEICAR PORI' 5 6 113 1 0 09?
h V n
ES't:I1VJ 1'1 D Ct h7_ or C+i NST£ UCIDI:ON
87,125.20
PERMIT FIM 911111Ii►MARY
CONSTRUCTION FEE 101-000-418.0001 $S83,50
PLAN CHECK FEE 101-000-439-3113 f3 $4138.30
Y9E DEPOSiT 101-000.43.'-318 -3130.00
MECHANICAL, I?i0, 101-000-421-300 $52.150
EI&CTRICAL r , 161-000.420.000 SI0$,I@
,
Pj.,tJJl613YN0 PER. 101-000-419-000 $118.00
STRONG MOTION FEE - R=D 101.000.241.000 33:74
ORAD1NO FFIE 101-000-423-000 $15.00
DE'i EWPER IMPACT FGA: 91,40S.00
PRECISE PLAN ] Ci'1-000-dfA 1 -SSS 3100.00
SB -TOTAL. CONZWC'` 1W ANIS PLAN MIEC K
X3,88'1.19
LESS PPRE-PAW FIZZ
-$2,50,00
23 2003 ixym. Pm,Rw.T mas DVT NOW
F LA QUINTA
NCE DEPT.
RECEIPT
DATE r
BY `
ll Fl LED I CTOR
=`1
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Q
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel 1
Combustion Air
*Roof Deck
_
_
Exhaust Fans
O.K. to Wrap 1—
F.A.U.
Framing i
Qli
Compressor
Insulation
Vents
Fireplace P.L. J
Grills
Fireplace T.O.
Fans & Controls
Party Wail Insulation 1
Condensate Lines
Party Wall Firewall I
Exterior Lath 1
Drywall - Int. Lath
w
Final
Final -
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs I
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
!
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
W
Heater Final
Water Piping }
Plumbing Final
Plumbing Top Out !
Equipment Enclosure
Shower Pans
OX for Finish Plaster
Sewer Lateral !
`Pool Cover
Sewer Connection
—
'Encapsulation
Gas Piping
Gas Test ;
Appliances
1
-final
Final
Utility Notice (Gas) } (j el -
ELECTRICAL APPROVALS '
Temp. Power Pole Q
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures I
Main Service }
Sub Panels
Exterior Receptacles 1
G.F.I.
Smoke Detectors i _
Temp. Use of Power
10
Final
Utility Notice (Perm) I
' .,COMMENTS:
-
Date
12/23/03
No.
25316
Owner
Coronel Enterprises
Address
PO Box 389
City
La Quinta Zip a92253
Tract #
Type
Single Family Residence
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
APN #
Jurisdiction
Permit #
Study Area
No. of Units
o�t�sc�o
BERMUDA DUNES r
Cn RANCHO MIRAGE
�+J INDIAN WELLS
PALM DESERT y
LA QUINTA
Q INDIO L�
O
774-044-019
La Quinta
1
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 53135 Avenida Obregon 1408 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.14 X 1,408 S.F. or $3,013.12 have been paid for the property listed above and that
building permits and/or Certificates of Occupancy for this square footage in this proposed project may nowtbe°issued:
Fees Paid By Valley Independent Bank Check No. 297774
Name on the check Telephone
Funding. Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by ,James Kozero Payment Recd $0.0.
$3,0.43.12 {, *funder
Signature i_ .�
NOTICE: Purs Government Code Section 6A20(d)(1), this will,serve to notify you that -the 90 -day approKal,period in which you may protest the fees or
other payment Identified above will begin to run.from the date on which;the building or installation permit:forthis pigject is issued, or from the date on which
those amounts are paid to the District(s) or to another .public entity authorized to collect them on.the,District('s),behi lf;,whichever is earlier.
v
NOTICE: This Document NGT;VALID}irsEf"Duplicated ±�
Embossed Original - Building Department/Applicant Copy - AWicant/Receipt Copy - Accounting
10/29/2003 02:40 FAX. FIDELITY NATIONAL:'TITLE
First Arnei-i; ars Tit!e. ,;om!.)anv
RECORDING REQUESTED BY:.
Fidelity National Title; Company
Ercrow No. 410934 -CB ✓� �I'v (/
Title Order No. .. ' ��� _, • !rk✓OGrI //�
When Recorded Mail Document -
and Tax Statement To:
(\('� Mr, Zeke Cor,onel 7:%� �L f✓�
V 51 10.5 Avenida Villa, #101
^ La Quinta, CA 92253
- (�
(a002
DOC. t3' . 200,31---F30.470a
1e'iaa:izeea.eea .Faa:se. ee
Page 1 of 2 Doc T Tax Paid
Recorded In Officla,l Racor•ds.
county'of Riverside
Gary L Orso
Aes�ssdr,_CounEy Clerk; 6 Recorder,
�1111111IIIIII�lilllllllf�lllhllllllfallllilll111111111�11111
M ' s
U
°AGE 'SIZEOA NOCOR �II.F ! ia•;L.
"PCOM
T
I
A .,R
L
COPT LONG I REFUND HGNG EX A
KIQT It
U The underslgneed,gr2a tor(SY: .- lere(s)
(� Documentary transfer tax Is. 4302:50
l I X ] . computed 'on full value. of property conveyed, or
I ) computed on. full value less value of liens or encumbrances remaining at time of sale, SP
I ] Unincorporated Area City of La Quinta
FOR A VALUABLE. CONSIDERATION,.recelpt.of:which is hereby acknowledged, Frank M. Griswold, Successor
Trustee of The Henry Griswold Living Trust dated June 19, 1995,,
hereby GRANT(S) to Coronel Enterprises, Inc., a California. Corporation
the following descrlbed real +pro perty In the I;,Ity of La Quinta
County.of Riverside, State of California:
SEE: EXHIBIT ONE ATTACHED HERETO AND MADE A PART HEREOF
DATED: September. 19, 2003
STATE. OF CALIFORNIA Fr,arlk�M. Griswold, Successor Trustee of The Henry
COUNTY OF t. .r _ Griswold' Living;,Trust dated e. 19, 1995
ON. before me,
a
sAparsonally appeared By.:. 1�/ir 171, 54
'C
Frank M, Griswold, Trustee
personally known to me (or proved to me on the basis
of satisfactory evidence) to be the personl-4 whose
nameNLis/ate subscribed to the within`instrurrment and
acknowledged to me thathe/sh>;Ltly:exec,uted the
same in his/N/t�ir au thorized•'capacity(i�1,:l3nd that
by his/h'4Utft�r signature(. on the instrument the
person N, or the•entity upon behalf of which the
person( acted;- executed the instrument.
Witness my hand and official seal
Signature
FD -213 (Rov 7/96)
17
LINDAA':GAGNON'
Comrrilssion f 1313093
NoUry'Publlc - Celltornis •�
Orange County ,
My Comm, Expires Jul 13;2005
MAIL TAX STATEMENTS AS DIRECTED: ABOVE
GRANT DEED
nor prop - RV:2003 00804798. : I: 2
10/29/2003 02:41 FAX
:r=
a...
Escrow No. 410934•CB
Title Order No.
FIDELITY NATIONAL TITLE 171003
EXHIBIT ONE
Lots 2, 7 and 10;: Block: 175 of Santa Carmelita at Vale La Ouinta, Unit #.18,:.,as per map recorded in Book 19, Page
31 of Maps, in the Office of the County Recorder'o.f said County.
known as APN #774-044-0.14-5, 774-04470.19-0 and 774-044 02'2 2
Lot 7, Block 281 of Santa Carmelita at Vale La Quinta, Unit #26, as per map recorded,,in Book 50, Page 20 of Maps,
in the Office of the! County Recorder of said County.
known as APN #774 -215 -007 -7 -
Lot 8; Block 137 of Santa Carmelita at Vale La Quinti; Unitafl;,4, as per map recorded in Book 19, Pages 82 - 83 of
Maps; in the Office. of the: County Recorder of."said'Gounty.
known as APN #77.3-093-003-0
.-I (J. 2
APR -27-2004 07:40 AM P.07
l \'(,�l-l_.�1`f'IO. CERTYF�I�CATE . _ �� CF -6R
. 5�--%5" �� ���►� Via• r - `A - -
�ii� •1,!�Irt.s, Permit Number
DUCT LEAKAGE ANn`�DESYGN .DIAGNOSTICS
DUCT LEAKAGE.RfDUCTION
•f e•>t Resuirs•(CFM',@ 2•5 PA) 6�
Test Leakage (CFM).
as 400:cfrNton x number of tons- ,.or,as 21;7 z Heating Capacity
inThousands'ofBtu&,'entercalculate.d'valueherd p�
Tuan now is me,asiired; enter.rneas,urc.d valkie here
1.v;i ge fr3cuo6,. - -Test Leakage/(Measured--or Cnlculaied.Fan.Flow)
Pass.if'leakage'Fraction 5.0.06
Pass ' J!i
F:-vt•,IWSOI. TYPE SEALANTS ONLY - T•h'e, fol.lowi Aiugn•ostic testing was completed:
Duct Fait Pressurization -at rough -in measured leakagc'(CFM):-' .
(. II F.t;'h .AFTER FINISHING WALL:
:> ❑ Nu 13 Pressure pan test or House pressurizationaest
'❑ ': V ❑ Nu ❑ Visual Inspection of Duettoi nnecfions NY ❑ ❑
Pass Fatl
THERMOSTATIC EXPANSION VALVE (TXV)
❑ �',, Thermostatic Expansion Valve (or Commission approv.e:d
equivaien ),is installed and Access is provided for.inspection' ❑
Yes is a'•pass
DUCT DESIGN
❑ .i ❑ �ti RCCA Manual D De.st'gn.calcu'lation'slhavi'beeiicompleted,
Duct Design is on the piens and'duct installation matches
plans,
,,; ❑ �u rxv i`s installed or Fan flow:has been v,eri.fied. r If rio TXV, NIX
verified fan, now matches design from CF- IR, .
Meastired FariTlow = _
❑ o
Yes for both I and 2 is a Pass. Pass Fa
verify Ihnt the above ciiagnostic, tesu result's and the work I performed associated with the tev(; t ,s
Mta :!,C rc,lutrcmcnts for compliance credit [The; buildm-sl all provide the HERS provider a copy of the CF -6R
rui!dCr cinploycrs or sub -contractors certtfyii g -,t* diagnostic testing and instillation meet the requtrements :or
. ... ,r -,•till! ..
Sikrrantre,.Datc Irisiell'iiig'Stbconrrector (Co Manx) OR
Gcncral'Contractor.(Co ;game)
- Ill:'; i'ry�,ucr til•applicabie) .. •
_.._.-nu ^wrier a'c Occupancy
- - r Certificate
.o�
- .of ;Occqp,a
, :4t ra
o ti , ..�.y
14
IraMORRA®
`
OF, N Buildin` & Safet De " artm.ent
- o '. Y; p.
k
This Certificate is issued pursuant. to'the 'requiremi e► ts_,of Section '1,09, of ,the- California Building .vr
Code, . certifying that,- at . the "time fof issuance,', this structure .was in. compliance :. with ',the
provisions of_ z &6',.Building ,Code `'and the various ordinances,- of. the =City. ;regulating building-
construction and/or use.',,:, r - -
IF
'BUILDING -ADDRESS: Z3-135 "ENI DA OBREGON -
Use classification: -R3 Building Permit No 0310-339% , r
j ;
t T e of Construction.`VN Land Use Zone: RC
r Occupancy Group:: SFD . • " yp _
j
Owner of Building: CORONEL ENTERPRISES J- Address: PO BOX 389
City, ST, ZIP: LA` QUINTA CA 92253 _ . • ,.
By: KIRK KIRKLAND ` s
r •
}
-5-3-04: -
_ ,Date:
Building Official
POST INA CONSPICUOUS PLACE