SFD (9801-087)53380 Avenida Madero
9801-087
LICENSED CONTRACTOR DECLARATION
!!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
tai f3 ......
sem` •=_-r =-` T --al COU .
atie4) 1` -' Signature of Contracto
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).
( ) l,, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 704.4, Business & Professionals
Code).
O I am exempt -under Section B&P.C. for this reason
Data Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ),; I have and will maintain acertificate 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 Policy'No.,
GOLD.ENE,AGLE 943. taWIC42.1.89200 .
(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' compensatR_ion provisions o, f SectioTr37O of-the-Labo_r_
. ...
Coded shall folthwith.comply with thos prSulslons-
Eater /C ' Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section -3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building.and Safety
for a permit subject -to the conditions and restrictions set forth on :his
application.
1. Each person upon whose behalf this application is.made & each person at
whose request and for whose benefit work is performed under or pursuant to
.any permit issued as,a result of this applicaton agrees'to, & shall, indemnify
& hold harmless the City of La Quinta; its officers; agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date. of issuance of such
permit, or cessation of work for 180•days will subject permit to cancellation.
I certify that l have read this application and state that the above information is
Correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon.
the above-mentioned property.,for-in
- a-p e - e tion purposes.
,/Signature (Owner/Agent) Date 3
BUILDINGPERMIT PERMIT "°NTR°`#
DATE VALUATION LOT 9843.1-Q)Ri TRACT.
653
589,413,.50 18 131. 2, VQ 18
JOB SITE
APN
ADDRESS
53-380 AVE, NIDA MA. DERO
OWNER
CONTRACTOR/DESIGNER/ENGINEER
ESEQUfEL CORONET. •
COR.ONEL L6N.S'1'R;UCT1oNr
P.O.:$OX 389
P.i:}. BOX. 389
LA QUINTA CA 92253
LA QUINTA. CA. 42.253
(766)%4404 COO 2261
USE OF PERMIT
Sim-.€+ECzM T DO .NOT TNCLu7DF FAL 0CK'WALL S OR P0C L,
TRACT CONSTRUCTION 1,421.00 SI'
P012.MPAT.TO 36,00 SF
GARAGE/CARPORT 514.00 SF
`
6 FT. WOOD FENCE 200..110 LF
ESTIMATED COXT OF CIONI$t RUCTla. N
89,413:51 -
PERMIT 1D'E"E WIMMARY
CON•STRIJCfION FEE 101-000.41$-000 $394 3 '''•;
PLAN CHECK FEE 101-000439-318 $499.43
E
t MCHANICALFU 101400-1:21-000 $0,56
E7,;ECTRtCAL EEE .101-1300-420400 31215200
PLUI MING FE -1101-000419-000 $133,50
CD
STRONG MO ON FEF -• R. 10 1.0.1.0001241-000 58 91.
o0
GRADINGEE'E .101-000-423-000
1NFRAS 1"RUCi URF ME 225-000-443-342. $.t,9b2. is
2: LL
PRET !'SF't'I.AAf 10.l QOp-441.345 $26;00
ME OEPOSI1' -$2$0.00
13WfOTALCON;SMUG'1'IONAND I; u°yr
$5,408./19
((?yPCf1`lLAN ggC l (iE
. .1...ESS PRE -PAID FEES
-s,250.0o •'xl
`YTOTAi<, PERMIT .FFES .DUE -.MAY
'S3,158.19"
DATE
BY
DATE FINALED
INSPECTOR
,RECEIPT
t
/a/•_
t
o
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
FramingCompressor
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
Final
BLOCKWALL APPROVALS
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 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
Ga in
Gas Tes
pprances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVAL
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Frdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
P:O.'BOX 1504 APPLICATION ONLY
/ 7&105 CALLE ESTADO
Addrress V j I e/U LA QUINTA, CALIFORNIA 92253
Owner
BUILDING: TYPE CONST. OCC. GRP:
Mailing -7 7 — e/) S OL
Address
A.P. Number
City Zip > Tel.
Legal Description
Contractorr Project Description S
Address
City Zip Tel
State Lic. -3f- City 1 Z- /
& Classif. ( / Lic. # G (P
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
. I hereby affirm that I am licensed under provisions of Chapter 9 (commenc)'ng with Section
7000) of Division.3•ofthe Business and Professions Code• and•mv.license i3infull force and
l 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).
1 1, 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
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.) .,
I.1 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 1 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
0 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 lass.)
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
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 Address
City, State, Zip
BUILDING DIVISION
Sq. Ft. /7 21
Size -7
New Add ❑
uallon
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
No. / No. Dw. /
Stories Units
Alter ❑ Repair ❑ Demolition ❑
AMOUNT
ZONE: BY:
"Minimum Setback Distances:
Front Setback fromliCenter Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
MkSWAMetback from Property Line
FINAL DATE INSPECTOR
Issued by: 9Qate Permit
Validated by:
f
Validation.-tV-
Com%
CONSTRUCTION ESTIMATE
NO, ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. g $
2ND FL. . SO. FT, @
POR. SO. FT. @
GAR. SO, FT, @
CAR P. SO. FT. @
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
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.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
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 @ IIA c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
1PERMITEE
[=I
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
GARDEN WALL FINAL
TOR'S SRiNATURES/INITIALS
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Date 1/28/98 -
No. 16580
Owner Name Esequiel Coronel
Jurisdiction
APN # 774-034-007
La Quints
Permit # `
No. 53380 Street Avenida Madero Log #
City La Quinta Zip 92253 Study Area
Tract # Lot # 18 Square Footage 1421
Type of Development Single Family Residence ' No. of Units 1
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 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 1,421 or $ 2,614.64 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 Construction Telephone
cr
564-4604
Name on the check's -,
'A .
' .. 'fir" '
By Dr. Doris Wilson Y
T
Superintendent
ji ,.
Fee collected /exempted by Pauline Pearson Payment Received $2 6:14.64
n Check No. 158066 .
1 n1 1
Signature ,(1iQ,t a X9nn0. ICQR A.t1S8/1 ._.
r
10TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
ollect them on the District('s)(s') behatf, whichever is earlier.
4 Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy, Accounting
0
,%✓ Pacific Coast escRow . CoRponation r
is `'.. .
74920 HIGHWAY 111 INDIAN WELLS, CA. 92210 1Ti , '
TELEPHONE (619) 568-0344"
ESCROW INSTRUCTIONS
Cindy Burgin
Escrow .No. 1.741,4!*
3` ~ '
Dates January 113.;.. 1.998
Escrow Officer ':»•
This escrow company holds Department of Corporations Escrow License
9.63-0473.
CASHTHROUGH ESCROW................. ............................$ 16,500:00
TOTALCONSIDERATION...............................................$ 16,500.0.0
Buyer shall deliver to you any instruments and/or funds required from Buyer to eriable`you
to comply with these instructions, all of which you are authorized to use and/or.deliver,
on or before 02/12/98,'and when you are in a position to obtain a standard Policy-of
Title Insurance through CHICAGO TITLE INSURANCE COMPANY, provided that said policy has a
liability.of at least the amount of the above total consideration, covering the following
described property in the City of La Quinta, County of Riverside, State of California .:'•"
LOT 18 IN BLOCK 182 OF SANTA CARMELITA AT VALE LA QUINTA, UNIT NO. 18 AS SHOWN BY MAP:
ON, FILE IN BOOR 19 -PAGES 31 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA
4 Y`PROPERTY ADDRESS LOT 18 APN177-4=034=007 CA. 92253 L—a Qu'inta-,-CA 92253
- - - _
SHOWING TITLE VESTED IN: Esequiel M. Coronel,`a married man as his sole and separate}£` `
property?ter}
' ' FREES FROM ENCUMBRANCES EXCEPT:
General and Special Taxes for current fiscal year, including any special levies payments
•kM f .. a
for which are included therein and collected therewith. Covenants, conditions, -,
restrictions," reservations, easements, rights of way, of record, if any; also exception..,
or'°reservations of oil,gas or mineral rights, if any.
y l.). Buyer
r herein will pay All Cash for subject property and shall deposit into'escrow .
prior he close of escrow, the balance of total purchase price plus buyer's portion of
: escrow and recording fees as required in the form of a Cashier's Check or Wire Transfer.
The artier herein agree that the closing of this escrow is subject to the'Buyer'sy
P
l 4 ta1proval of Preliminary Title Report, CC&R's, if applicable within 3 days of receipt of
,(,.Buyer's failure to notify Escrow Holder of any disapproval, in writing, within
` specified time limit, is deemed to be Buyer's approval of same and this contingency
f,
reliminated.
Covenants, conditions, reservations (including exception of oil, gas, minerals;5
4. hydrocarbons, and/or lease without right of surface entry), restrictions, rights. of way,
and easements for public utilities, districts, water companies, alleys, and streets....
E
4);. Buyer is aware and acknowledges and accepts and holds Seller harmless for 'said"
property in regards to geological, flood hazard, seismic hazard and any special studies.
zones. Buyer has satisfied himself as to making any further inquiries at appropriate ,
government agencies, lenders, insurance agents, or other appropriate entities concerning
use of the Property under local building, zoning, fire health and safety codes.as maybe
f
'.,applicable under the Special Studies zone act, seismic Hazards mapping act'; and local:
geological ordinance (s) .' E Y'
.. N'nLfsT1R 4
,gas 5) Buyer and Seller acknowledge that state laws prohibit this escrow from closing
(-recordation of Deed) until buyer's funds, including new loan proceeds, have been
16F5,'collected,. as defined by law. The undersigned.Buyer (Borrower) understands that it is
} :,i:. their responsibility to determined from lender of their.choice what type of funding
!,,Instrument will be used. Also per diem interest will be charged to buyer and seller by:,
their respective lenders while Pacific Coast Escrow Corporation determines that all'`funde
rer:., :.-oma *r% i aQ' t, ve been leoally collected. It is recommended that Buyer have all