SFD (9708-020)51715 Avenida Madero
9708-020
LICENSED CONTRACTOR DECLARATION
U)
' 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
C14 LU Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
LU
oZ r-_ Date Signature of Contractor'-'
CL) 0-
H 0 OWNER -BUILDER DECLARATION
H d co
r— I hereby affirm under penalty of perjury that I am exempt from the Contractor's
U) License Law for the following reason:
Z_ ( ) 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
L
N Date Signature of Owner
Q N
M
a Q WORKER'S COMPENSATION DECLARATION
C) 2 Z I hereby affirm under penalty "of perjury one f the following declarations:
Lo O () 1 have and will maintain a certificate of consent to self -insure for workers'
X W = compensation, as provided for by Section 3700 of the Labor Code, for the
Q J Q performance of the work for which this permit is issued.
m Q C) ( ) I have and will maintain workers' compensation insurance, as required by
Q U Section 3700 of the Labor Code, for the performance of the work for which this
d 0 Z permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier C'a.',vloiv 1"';ri Policy No.
co
. O
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 37007of the Labo
Code;' I shall forthwith comply with those provisions!' ' r
Date: 9 ' r Applicant _".e • .-'`
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is .1
• correct. I agree to comply with all City, and State laws relating to the building;
construction, and hereby authorize representatives of this City to enter upon
the/above mentioned property for inspection puurrposes. f
i, w'.G.. f. .,F. /- , .r...•
Signature (Owner/Agent) t s Date
BUILDINGPERMIT PERMIT# CONTROL#
DATE VALUATION 8713+.x.60 LOT 3 TRACT 0. Y f, i
JOB,5ITE51 71$ AVE N19AIMAI "Ito
APN 773-1,124h).5 ►
`ADDRESS
OWNER
CONTRACTOR / DESIGNER / ENGINEER
y
y Y
1',/i (:)L)iltif r C'A 92253
LA i)WN':f'fl, C A P.225.
'
1 4
USE OF PERMIT
.",;3 D -1'.I &I1 t':DkjLS i WAi4LS 0k.3400L.
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fir WLN)b FENCT. 20.401F
91 RAf i P VICE S9.11!• ''v AR
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Pi, Agl t;11i 13 f xe,'%, Cay
IMM -1
RiE0rAN tCAA. 41. $53,50
F '1'ltTf t1L 1` j l;-Oil" 1yti-tif3 :$T24.t1!
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RECEIPT
DATE
BY
DATE FINAL ED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade Z2/
Return Air
Steel ✓
Combustion Air
Roof Deck _
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
FinalPOOLS
BLOCKWALL APPROVALS
-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 APPROVALS
Gas Test
Electric Final
Waste Lines
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 1 -
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVAILS
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 /q
Utility Notice (Perm) Ej I /,
COMMENTS:
1
P.O. BOX 1504
Building /j yT 78-495 CALLE TAMPICO
Address Sj 7 5 NVN / 7 't r / U LA QUINTA, CALIFORNIA 92253
Mailing ^ 3,
Address ,./
Cty Zip Tel.
-/t S 3
Contractor /'
/ p r d it C/ ! d n$ f rel Ti gni
Address O
City/ Zip Tel
r 4 ' V4— Z2 5 3 SG i-
State Lic. /Q City
& Classif. / Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
r LICENSED CONTRAQ.TOR'S DECLARATION
I hereby affirm ihed u rovisions of ter 9 (commencing with Section
7000) of Divisi a Bu s tl PVbfessions Itcense is Irfull fgrcea d
A DATE
DECLARA
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5.8usiness 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-1 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 such improvements are not intended or offered for sale. If, however, the building
orimprovement 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.)
ll 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
does not 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.)
i 7 I am exempt under Sec. B. 8 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
n Copy is filed with the city. O 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 ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address :F >• +^
This is a building permit when properly filydd o9t, di6n9dJAd validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and counjTlgrQiParfcek ng t to laws relating to building
construction, and hereby authorize repj6ep ' efft} uaativY Q(i$Ty to enter the above-
mentioned property for inspection purposes. II JJ
Signature of applicant Date
Mailing Address
City, State, Zipw • .
APPLICATION ONLY
BUILDING: TYPE'C—OryNST. OCC. GRP.
/
A.P. Number 7 3 //L2 40e f
Legal Description Z o —3 ! / 2 P, 6),74 L..
Project Description S• F D
ZONE:
BY:
Minimum Setback Distances:
Sq.Ft. / 4
Size a '-<( J 1
size
/ No.
stories
stories Units
New - Add ❑
Alter ❑ Repair ❑ Demolition ❑
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR+
Issued by:
Date Permit
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
j D
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
4
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR+
Issued by:
Date Permit
Validated by:
Validation:
r WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
r
Desert Sands Unified School District
Notice: 82-879 Highway 111
Document Cannot Be Duplicated Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Date 9/3/97
No. 16038
Owner Name Esequiel Coronel
No. 51715 Street Avenida Madero
City La Quinta
Tract # Lot #
Type of Development Single Family Residence
Comments
APN #
Jurisdiction La Quinta
773-112-005
Permit #
Log #
Zip 92253 Study Area
Square Footage 1386
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 1,386 or $ 2,550.24 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 Enterprises Telephone 564-4604
Name on the check !
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Pauline Pearson
Signature
Payment Received $2;550.24
Check No. 141758
10TICE: 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 other payment identified
bove 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
ollect 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
f
Payment Received $2;550.24
Check No. 141758
10TICE: 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 other payment identified
bove 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
ollect 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
J y
a
JAMES O. WALLACE
Aorlcuftal Commluloner
Director of Weights & Measures
DATE (Y/ S,_X
OFFICE OF THE
AGRICULTURAL COMMISSIONER
CALVIN C. KAMINSKAS
P.O. BOX 1089
AssIstant ComrNssloner
RIVERSIDE CA 92502-1089
DAN RILEY
PHONE (909) 2753000
Sealer, Welghts & Measures
FAX (909) 2753012
(909) 2753030
FAX (909) 276-4728
46-209 OASIS STREET, ROOM 14
INDIO, CA 92201
W15 863-8391
CASE NO. ' f C Cl<
DEVELOPER'S NAME: co!-nA'e-1 Co K3Ie' ,c-rl"
ADDRESS:
TELEPHONE: `7-- `7' O
Dear Developerf .
After reviewing your landscaping plants, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be
notified immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free
environment..
Agricultural Commissioner -s --Office
cc: Indio and Riverside
0
SALE ESCROW INSTRUCTIONS
THIS DOCUMENT WII,L AFFECT YOUR LEGAL RIGHTS - READ IT CAREFULLY!
TO:.COMMONWEALTH LAND TITLE COMPANY Escrow No.: 97.6760KC
72855 Fred Waring Dr. Date: 07/11/97
Suite A5 Page: 1
Palm Desert, CA 92260 /
(760) 836-3726 " de'r
Escrow Officer: Kelly Collier
THE ESCROW HOLDER IS COMMONWEALTH LAND TITLE COMPANY WHICH IS LICENSED
BY THE CALIFORNIA DEPARTMENT OF INSURANCE.
Buyer will hand you additional funds prior to closing in the amount of .......... $ 15.000.00
TOTAL CONSIDERATION $ 15,000.00
and any additional funds and instruments required from me to enable you to comply with these
instructions, which you are to use on or before August 11, 1997, and when ORANGE COAST TITLE
COMPANY can issue a Standard Policy of Title Insurance Owners form, with liability of
$15,000.00, on real property in City of LA QUINTA, County of Riverside, State of CALIFORNIA viz:
Commonly known as: APN 773-112-005, LA QUINTA, CALIFORNIA
THE NORTH ONE HALF OF LOT 3 IN BLOCK 26 OF SANTA CARMELITA AT VALE LA QUINTA,
UNIT NO. 2 AS SHOWN BY MAP ON FILE IN BOOK 18, PAGE 55 OF MAPS, RECORDS OF
RIVERSIDE COUNTY, CALIFORNIA
Except any reservations of record of minerals, oil, gas, water, carbons and hydrocarbons.,
Showing title vested in:
ESEQUIEL M. CORONEL „ A SINGLE MAN
Free from encumbrance except:
A. Current general and special taxes for the fiscal year in which this escrow.closes, and
taxes for the ensuing year, if any, a lien.not yet due or payable.
B. The lien of supplemental.taxes, if any assessed pursuant to the provisions of Chapter
.3.5 (commencing with Section 75) of the Revenue and Taxation Code of the State of
California.
C. Special improvement assessments, if any.
D. Easements, rights, rights of way, covenants, conditions, restrictions and reservations w
record.
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS: 51-715 AVENIDA MADERO
Use classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9708-020
Occupancy Group: R-3 Type of Construction: VN
Owner of .Building: ESEQUIEL CORONEL
Building Official
Land Use Zone: . RC
Address: PO BOX 389.
City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 12/15/97
POST IN A CONSPICUOUS PLACE