9606-0018 (SFD)54685 Avenida Alvarado
TEL 619-777-7012
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LICENSED CONTRACTOR DECLARATION
I hereby 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
634981 131/98
Date f Signature of Contractor'/s
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
Thereby 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;asskeli /Iy tw,orkers' compensation insurance carrier y_po4cy no. are:
Cartier Policy No.
J (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 I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I.shall forthwith comply with those provisions.
Date• /' 1 r off. 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 forthon his
application. •
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void, if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
f'tr; I certify that I have read this application and state that the above information is
• correct. I agree to comply with all City, and State laws relating to the building
• construction, and hereby authorize representatives of this City to enter upon
Gl the above-mentioned property for inspection purposes.
2
?Signature (Owner/Agent) E•' Date" t2
BUILDINGPERMIT PERM TJ/ CONTROL 71
9606-01%•
3697
DATE VALUATIONLOT TRACT
7/12196 5161,239.60 --9 269 .
JOB SITE •
APN
ADDRESS 54-685 AVENIDA ALVARADO
774272021.
OWNER
CONTRACTOR / DESIGNER / ENGINEER
iSEQU1EL M. CORONEL
CORONE1. CONSTRUCTION
P.O. BOX 389
77836AVENIDA MONTTPZUMA #
LA QUINTA CA C.A. 92253
LA QUrNTA CA 92253
66.1 95644604 - -
619%44604 C13L/1- 2261
USE OF PERMIT
S1N'T;U* PAM11,Y IYWItILINC.11
.,
SFi)- 1 RM1'1' DOES NOT INCLUJDU FLOCK WALL OR POOL..
TRACT CONSTRUCTION 1,29(100 ::317-
PORCH/PATIO 36.00 SF
0ARAt /CARPORT M5•00 SF
TRACT CONS'IllUCT10N 1.290M0 SF
36.00 Sr
BPORCtf.?PAT1O
C,AR., I'E/ A1bPORT 515.09 SF
01191igp
'
ESTIMATED COST OF CONSTRUCTION
, .64)
I'k114MtT FEE SUMMARY .
CONIrTRUCTION FES 1014)0.418-•000 $554.00
'1'f.A'N CHECK FEF. 101••000.439-318 $469,91
FG1? DEPOSIT 4250.00
MFC'RAN!CAL FEE .101-0130-421-000 $53.50
ELECTRICAL FEE ' - -101-000-X12€1-000 $'f 18.95
PLUMBING FEE . 101-000.419-004 $12w.75
S'1'ON MOTION 1 IE . R1:,'7 O 101.000-241.000 $8.06
GRADING FEE -101-000-423-000 $29.00
1NFRASTR,LTC'f'uR FEE 225000-443-342 $1,803.17
Iti'REC1SE PLAN 1101-000.441-345 . - • $23.00
SUB -TOTAL CONST[UJCFION:ANI)
PLAN CHECK
$3,175.34
LESS PR -C'A1D FEES
4250.00
ID
TOTAL
1I
M-TFEI?.$DUE NOW
- $2.915,14 R.;:
l
JUL 15 19-
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•
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IIIIIIIIIIIIIIIIIIIIIIIII 75
_ IE
`INSPECTOR
t-...----,... ^-...__ ✓'
RECEIPT
DATE
BY
/t
DA E F ,9L.E1q /
INSPECTION RECORD
•
•
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
%//46
j%�
Underground Ducts
Forms &Footings
Jr /
Ducts
Slab Grade
7/,/,,,,*
/
Return Air
Steel
Combustion Air
Roof Deck
%,(
/
Exhaust Fans
O.K to Wrap
/ -'e,
F.A.U.
Framing ,j�/3/}(0
r,; i, ."i ; %„' .' 4-/i '
Compressor
Insulation
/9 9 ,r
Vents
Fireplace P.L.
.p-
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
•
Condensate Lines
Party Wall Firewall
Exterior lath
feeDrywall
-Int. Lath
Final
Final
/0/8,/ /Ci.
POOLS - SPAS
BLOCKWALL APPROVALS
steel
Set Backs
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
,//(j/ .
,L /
Heater Final
Water Piping
Plumbing Final '..
Plumbing Top Out
. Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
!
Sewer Connection
7//7 '7
Encapsulation- '. ;
Gas Piping
Gas Test
Appliances
•
Final
COMMENTS:
.
.
.
.
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
40i11(
Utility Notice (Perm)
111111 011E III 1011 IIII 76
IE
Notice:
Document Cannot Be Duplicated
Date
7/9/96
No. 14671
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Owner Name Coronel Construction
IIIIIIIIIIIIIIIIIII111 77
IE
APN # 774-272-021
Jurisdiction La Quinta
No. 54685 Street Avenida Alvarado
City La Quinta
Tract #
Lot #
zip 922853
Type of Development Single Family Residence
Comments
By
Permit #
Log #
Study Area 110
Square Footage 1290
No. of Units 1
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 or
replacement mobilehomes. It has been determined 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 Government Code 53080
in the amount of 1.84 X 1,290 or $ 2,373.60
the property listed above and that building permits and/or Certificates of Occupancy for
_V f,
this square footage in this proposed project may now be issued.
a j"
Fees Paid By cc/Bank of the Desert/Esequiel Coronel _ Telephone X64-460..4
s ,..:i
W 4
Name on the check
Dr. Carol McGrew
Administrator in Charge
Fee collected /exempted by Pauline Pearson Payment Received $2,373.60
Signature
all A A -AAA --
Check No. 16556
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting