SFD (9612-058)51700 Avenida Madero
9612-058
LICENSED CONTRACTOR. DECLARATION
I hereby affirm under penalty of perjury that I arri licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 39f the Business and
Professionals Code, and my License is in full force and effect./r'
License # Lic. Class Exp. Date
vE?tJE ,4. 1; sib,
8
VDate `"/ 744,
4,nature of Contractor '
g `
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.. 1.
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 'Policy No. •
(This section need not be completed if the permit valuation is for $900.00 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 Califbrnia, and agree hat if I. should become
subject to the workers' compeQsa ion provisions of/Section 3700 of the Labor—
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 'ori 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.
I certify that I have. read this application and state that the above informatioois
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City fo enter upo
the above-mentionedropel rty for inspection purposes.
! ;, y
Signature (Owner/Agent) `, xi Date
BUILDINGPERMIT PERMT# °°NTR°`
4503DATE %!<„% VALUATION + i'%40.; LOT TRACT
•JOBS ITE APN
ADDRESS . ^% a AI IDA iSe ,Ei e.RO 77XII-5-004
OWNER \ CONTRACTOR / DESIGNER / ENGINEER
.1tCwim, qc,l :la't 'tI T
.77936 AWNID . NION I is 'YAJA /I
f -.A QIJIM-CA G.f` a,A, QUO1IVA. CA 92233
It,# 2261
USE OF PERMIT
Sj,Ni;Itat+:ttti9f..'r` i'74i+ i1.f .f.N(3
lit`+1LL Ok POOL.
'#'itAr—'t' CONSTRUCtION &
#OR47, l/lI lTIO
liJi.tLF tJE aGAf 'i; I 'f' v(ut,fJi►
.
'El STSNIY. TICe:l) Ca%7 Or. CM.Jivi}.Y..A.I.t"C-1110N,
r`•faN8'M_il+C`4°f0.N VET
101-000-41M41t1
PLANC IRECKFEE
isf,i Ytctw'AI. t ERS
10.1-000-420-M10
5J 3.A
111.1-N.BI.1 O3•F; `
1,01•-000-419-000
$134.75
: 7I .C2't sP IC3'I'ii' 7idE:1 s?)
101. w-24''41.000
$3,89
o,?tIZ.:►1 G
i. 'ipCt Q- 12 L-C3tlf1
$ h::.t3f!
YNFRA'SI! U4."'. "k0CF
F3dlRt"WE;N."Aw
iQ1-004,441-345
Zi
Is, C04-TIOTAI
LESS PRE -PAID FEES
[ 'Tp py t, fy S+X,+y, f rf Al. t/yq
+.)T.;4ll PFIk; :01. .4' FFIR eY l'}RS,
ONY
BY ! DATE FINALED INSPECTOR
M.X6i. 0
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade 1i
Return Air
Steel
Combustion Air
Roof Deck 42
Exhaust Fans
O.K to Wrap >
F.A.U.
Framing i
Compressor
Insulation o
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL A POVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
• Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test .
Final
Gas Piping
PLUMBING APPR VALS
Gas Test
Electric Final
Waste Lines 44& Wfe
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas) --141111( RIK
ELECTRICAL P ROVALS
Temp. Power Pole 10111flW6
Underground Conduit
Rough Wiring
Low Vottage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
4
P.O. BOX 1504 ' APPLICATION ONLY
Building` AIX
_ O . YACAS• Q 0 LA QUINTACCAL FORNIA 92253
Address Vl.
Owner . /
Mailing 71BUILDING: TYPE CONST. OCC. GRP.
Address 0 . ARM 1 -Dx Z 8
Cit - 1 Zip Te
l.
7(t
Contra •tor
Address 36 5
Cly r Ulifr Zlp ZZS3 Tel. b41' 1/6 d7
State Lic. / City
& Classif. j )1 / Lic. # 22
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
JJ LICENSED -CONTRACTOR'S DECIzARATION
I hereby of fm that I/am liceris/ed Ander provisioll eChapter 9 (commencing with Section
7000) olsDiv(j.S ion 3 of the Bus-hess and Professioh ode and my licen e/ 's in furlSorc n
effect'.' / / -! ( — <I ^ V
SIGNATURE [ DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
(; 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, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that suchimprovements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
II I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
doesnot apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
17 I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
r7 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant —Date—
Mailing
ateMailing Address
City, State, Zip
BUILDING DIVISION
A.P. Number / } ^ /
Legal Description v f 'J 1/,/. ` ` h ( 4- I
Description
Sq. Ft. J No. No. Dw.
Size Stories Units
New Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
AMOUNT
Const.
Mech.
Electrical
Plumbing-
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
r Setbk frc ear Prop. Line
n rS-id . tre .l etb rom Center Line
Syi de.Setback frooperty Line
FINAL DA C--- UJECTOR_
Issued by:.Q,.tA
Validated by:_
Validation:
It
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING F
1ST FL. SO. FT. @ $
2ND FL. SO. FT. @
POR. SO. FT. @
GAR. SO, FT. @
CAR P. Sfl. FT. @
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
AA
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
SO. FT. .@ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1 I c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/4c
HOUSE SEWER
REMARKS:
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
11
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP,
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
_
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
Notice: 82-879 Highway 111
Document Cannot Be Duplicated Indio, CA 92201619-775-3500
CERTIFICATE OF COMPLIANCE
Date 12/12/96
No. 15077
Owner Name Esequiel Coronel
APN # 773-113-004
Jurisdiction La Quinta
No. 51730 Street Avenida Madero
City La Quinta Zip 92253
Tract #
Lot #
Type of Development Single Family Residence
Comments
to 51-700 Avenida Maderd
Permit #
Log #
Study Area 113
Square Footage 1416
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 exeiiipt'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 1,416 or $ 2,605.44 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
Fees Paid By ccNalley Independent Bank/Coronel Telephone 564-00,46
Name on the check
By Dr. Carol McGrew r
Administrator in Charge
Fee collected /exempted by Pauline Pearson Payment Received $2,605.44
Check No. 129520
Signature
10TICE: Effective January 1, 1997, Pursuant of Assembly Bill 3081 (CHAP 549, STATS.,1996) this will serve to notify you that the 90 -day approval -period in which you may, protest the fees or
ether payment identified above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public
entity authorized to collect them on the District('s)(s') behalf, whichever is earlier.
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
"OUP REPUBLIC T!'LE CO. .
RECORDING REQUESTED BY: V
,
9b.60g5KC ,
THEN RECORDED MAIL THIS DEED AND,
UNLESS OTHERWISE SHOWN BELOW,
MAIL TAR STATEMENTS TO:
ESEQUIEL M. CORONEL
51-540 EISENHOWER DRIVE
LA QUINTA, CALIFORNIA 92253
0
C)OpY Of Dopument Regia l \;
to as No. y7_
n cc
&CE ABOVE THIS LINE FOR RECORDER'S USE
R 773 -//3-0054 7S'/3 APN: 773-113-004
paoo i7 GRANT DEED
The undersigned grantor(s) declares):
Documentary transfer tax is $11.06
XXX Computed on full value of property conveyed, or
Computed on full value less liens.-and.encumbrances remaining at time of sale.
Unincorporated area: ( ) City of and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
LORI YERGER, AN UNMARRIED WOMAN
hereby GRANT(S) to
ESEQUIEL M. CORONEL, A SINGLE MAN
the real property in the. City of LA QUINTA, County of Riverside, State of California,
described as:
THE SOUTH HALF 'OF LOT 6, BLOCK 25, SANTA CARMELITA AT VALE LA QUINTA,
UNIT NO. 2, AS SHOWN BY MAPON FILE IN BOOK 18', PAGES 55 AND 56 OF MAPS,
RECORDS OF RIVERSIDE COUNTY, CALIFORNIA
SEE EMIBIT 'A' ATTACHED HERETO FOR A COMPLETE LEGAL DESCRIPTION
Dated October 17,.-1996
State of Cal'fornia
Count of ). S.S. G R
On _
before me,
-*- Personally eared .
personally knoyff me (or proved to me on
the basis of satisfactory evi, nce) to be
the person(d) whose name(f) is ar-e-subscribed
to the witWsAe
'nstrument an& acknowledged to
me t hethey-executed the same in
lit /her theFepperson(-s-),
thorized capacity(i ), and
th y 4the-tr-signature( -) on the
instrument or the entity upon
behalf of which the person( acted,. executed
the instrument.
WITNESS my,ha d and ff' al seal.
Signature
MAIL TAR STT NTS TO: SAME AS ABOVE
.-. OFFIC-AL SEAL - 986890
KATHRYN G. GRAHAM Z
U . - NOTARY PUBLIC - CALIF. n
COUNTY OF SONOMA
My Comm. Exp. March 19.•1997 r
(This area for official notarial seal)
Notice:
Document Cannot Be Duplicated
Date 12/12/96
No. 15077
Owner Name Esequiel Coronel
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
No. 51730 Street Avenida Madero
City La Quinta
Tract #
Lot #
Type of Development Single Family Residence
Comments
APN # 773-113-004
Jurisdiction La Quinta
zip 92253
Square Footage
Permit #
Log #
Study Area 113
1416
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 1,416 or $ 2,605.44 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued
Fees Paid By ccNalley Independent Bank/Coronel ` Telephone :564-0046
Name on the check
By Dr. Carol McGrew
Administrator in Charge
Fee collected /exempted by Pauline Pearson Payment Received $2,605.44
Check No. 129520
Signature n
40TICE: Effective January 1, 1997, Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 9D -day approval period in which you may protest the fees or
Mar payment identified above will begin to run from the dale on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public
entity authorized to collect them on the District('s)(s') behalf, whichever is earlier.
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
JAN -03-97 SAT 08:37 AM TRUSSWORKS 6193433491
odo
0® "Reliabilitj, In Acvorz "
C L A R Y
December 4, 1989
CORPORATION
Food Stock West
P.O. Box 604
ThoUsand Ralms, California 922716
Attn: Bob Randolph
Dear Bob,
In response to inquiries about the spacing of trusses
installed versus the spacing of trusses as designed I would point
out that so long as the total dimension found from adding
together half the distance from each adjacent truss does not
exceed the design spacing, the truss is uneffected.
The sheathing spanning between trusses is rated for certain
allowable spans, .if'. it's an APA rated plywood. If these allowably:
spans are exceeded and the truss is not overloaded (this does not
exclude the -truss supporting more area than originally intended),
some' ladder framing should be considered.
Individual truss designs for residential construction: mai
allow sufficient redundancy for copin.: Lith a number of
installation problems without e::tensive repair or modification,.
If I can answer any questions for you, please don't hesitate
to contact me. _--i
Manager
P. 01