SFD (9903-103)52690 Avenida Martinez
9903-103
LICENSED -CONTRACTOR DECLARATION,
0i'ereby affirm under penalty of perjury that I am lic . ensed under provisions of
Chapter 6 (commencing with Section 7000) of Division 3.of the Business and
Piofessionalsi Code, and my License is in f6ll force 'and effect.
Licens4.#- Lic. Class Exp. Date
LO t " B ... I
:6 Z S*Contractor of
rZ tim
Zo 0.!
OWNER-BUILDER DECLARATION
Lu -, LU' i hereby affirm.under penalty.of perjury that I am exempt from the Contractor's
License Law.for the following reason:
.-Z .1,-as'owrier of the property, or my employees with wages as their sole
I
compensation j. will.do the work, and the structure is not intended or offered 'for
sale (Sec. 7044, Business & Professionals Code).
as
owner of tf4'p'r'ol56rty, am exclusively contracting with licensed
contractors to Construct the project (Sec. 7044, Business & Professionals
C6cle').
I .am under Section
U1 t'nB&P.C. for this reason
:-,CV Date,.- Signature of Owner
(\J
.01
EE Q WORKER'S COMPENSATION DECLARATION
Z
I hereby affirm under penalty 6f, perjury one of, the following declarations:
LO Cc
In2",_0 (, ) I W1'_LL compensation, have and will maintain 64rtificate of consent to self -insure for workers'
I ns , ,ation,- 'as provided for by Secti8'n n a '_ 3700. of the Labor Code, fdr the'
Qpqperformance rm ance 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
0
'
1 _ Code, for the performance of the work for which
-1 -..
.
Do' per - mif is issued. My Workers', compensation insurance carrier & policy no are:'
Z..
Cartier' Policy No.
ao )r4DJ7.14 EACAYS, INS".jDL
(This section need not be cbmplete d. if the permit valuation is for $100.000 r less).
cbrlify 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 sho6ld become
s b e t the w rkees' compensation"pr visions of Section 3700 of the Labor
'u to
0
1 11 forthwith
I ose provic i
Cod shall th h comp) th 'isions
tp'a-e (Applic,
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 petmitisubject to the conditions and restrictions set forth on his
aPbliqation.'
1 1 ..IEach 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 applica.ton agrees to, & shall, indemnify
& hold harmles . s 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
'Yer.mit, or cessation of work for 180 days will subject permit to cancellation.
1. ceftify 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
cbnstru6tiohi ,and hereby, authorize representatives of this City to enter upon
the Above- mentioned property for inspection purpo
rkDate gen 4j4 `tDat'
,Signature •(Owne
PERMIT#
BUILDING PERMIT.
9903-103
VALUATION TRACT
DATE LOT
%? '14
-JOBSITO' I
ADDRESS 52-WAVENIDAMARITNEX
APN
771-307-017
-OWNER
CONTRACTOR DESIGNER ENGINEER
i
CORoNrn coNsturn6N
.es1,*0Ufr.L
51-54b E181.;N140WRR DR.
51-540FISENKNOWER DPL
LA QUWA CA 92253
LA QUINTA CA 927-53
f,76(Y)564.4604
USE OF PERMIT
V00 - ffLGC.K WALLS. 0R-:PCxx
URAL ',T CONSIRUM-014 1,445A)S17
PbP.caPxT10 45.60 SF
GARAGE/CARPORT 403.00 &F
6 FT. WOOOFBI rCI3 aUU.C1U La'
"ST UCTION
ESTEMATED COST OF WIN R
100,96241P0,
put RMWIT FELSUNININRY
MNSTRUCTION 36115 101-000-418-000
taw c'lwx illE 1014*0439-318S1543-08
MECK"'Ict-A., VU, 101 -000421-00.U` S66.50
UL- ITMCAL FEE 101-00-420-000 1.*J. 3 4
..PIATA481NO FIX 10140-419-000 S.VZ7. 30
STR IDNO MOT 10M rM R5SID 01-000-2-4.?. - WOO
Orl-AMNO FIM 101-000-42.1-000 $k0.00
NFRASTRUCrURE FRE 225-000A41-342 52,213.96
PMCISE PLAN 101 -ON 441-345 s2s.00
APT INPUBLIC MACES _R.FSyr 7101 -W -25-5-01M 1.
FEEDEPOSI(T 10 1, 000-149-318
WWTOTAL CQN1,"UJCn0N_,AND PLAN CKCK
LESS PUPAID 1"'EES
250:0[3
W
Tal'AL PER.1MYUFF-3iS DIJJE,'N0'VV'
AA
DATE
BY
DATE FINALED
INSPECTOR
N- V
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.
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 7�
Final
Final :
BLOCKWALL APPROVALS
POOLS - SPAS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Pibg. 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 IF
Appliances
Final
Final 49 zz
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole /
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels .
Exterior Receptacles
G. F.1.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm) I.
COMMENTS:
P.O. BOX 1504
7UINT CALLE TAMPICO AP I ATION O LY
Building O
Address LA QUINTA, CALIFORNIA 92253
Mailing
BUILDING: TYPE'CONST. OCC. GRP.
Address C-111
{'j
A.P. Number —7 -73—, -7" 7
City
L ( l J► t
Zip
,a , J k-lb
y y
t 1
Legal Description l t t " 1 ,LK `q t _,) t,3 a
Contracttorrr]
Project Description 1 I
Address
City
UA I t ` '
Zip
.r`a
Tel.
t 7 t L1
State Lic.
City
& Classif.
Lic. #
Sq. Ft. 1 No. No. DW.
l=
Arch., Engr.,
Size i Stories — Units
Designer
New Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City IZip I State L
Lic. #
, 1 LICENSED CONTRACTOR'S DECLARATION
I.hereby affirm that 1 am.licensed under provisions of Chapter 9 (commencing with Section
7000) of'Division 3 of the Business and Professions Code, and my license is in full force, and
effect. i _ _ i •` ..., . ( L' ` r
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,8
usiness 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 thealleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than live hundred dollars ($500).
I-! 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
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving fhat he did not build or improve for the purpose of sale.)
I 1 1, 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'! 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. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 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
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
1 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 aOplicant Date
Mailing Address
City, State, Zip
valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
AMOUNT
REMARKS
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: P, I }• Date Permit
Validated 1 g lclQQ
Validation:
y 'r='tet► i is
t'
ti
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Notice:
Document Cannot Be Duplicated
Date 4/13/99
No. 18569
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Owner NameEsequiel Coronel
No. 52-690 Street Avenida Martinez
APN # 773-302-027
Jurisdiction La Quinta
city. La Quinta zip 92253
Tract # Lot # 14 Square Footage
Type of Development Single Family Residence
Comments
Permit #
Log #
Study Area
1,645
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
%y
th4 amount of = in '
This certifies that school facility fees imposed pursuant to Government Code 53080 .. T ;
1.93 X 1,645 or $ 3,174.85 the property listed abovean'd that building
permits and/or Certificates of Occupancy for this square footage in this proposed project,inay now lie issued
Fees Paid By CCNalley Independent Bank/Coronel Enterprises Telephon j-,�64- 4.604` ,
Name on the check k
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green Payment Received $3,174.85
Check No. 183289
Signature �-�11ji� /p��
NOTICE: Pursuant of Kssembly 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
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 Dislrict('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
SALE ESCROW INSTRUCTIONS
CAIS DOCUMENT WILL AFFECT YOUR LEGAL RIGHTS - READ IT CAREFULLY!
FO: COMMONWEALTH LAND TITLE COMPANY
72855 Fred Waring Dr.
Suite A5
Palm Desert, CA 92260.
(760.) 836-3726
Escrow Officer: Kelly Collier
Escrow No.: 99.8370KC
Date: 01/27/99
Page: 1
'TIIE ESCROW HOLDER IS COMMONWEALTII LAND TITLE COMPANY WHICH IS LICENSED
RY TI•IE CALIFORNIA DEPARTMENT OF INSURANCE.
3uyer, or his agent, will hand you or cause to be handed you upon signing of
these instructions a deposit in the amount of.. .. .......... .........E 2.000.00
iuyer will hand you additional funds prior to closing in the amount of .......... $ 15.500.00
FOTAL CONSIDERATION
$ 17.500.00
jnd any additional funds and instruments required from me to enable you to comply with these
instructions, which you are to use on or before February 22, 1999, and when ORANGE COAST TITLE
;OMPANY can issue a Standard Policy of Title Insurance Owners form, with liability of
617,500.00, on real property in City of LA QUINTA, County of Riverside, State of CALIFORNIA v,i.z.:
,omnonly known as: APN 773-302-027-7, LA QUINTA, CALIFORNIA 92253
I.
_OT 14 AND THE SOUTH HALF OF LOT 15, BLOCK 143 OF SANTA CARMELITA AT VALE LA
)UINTA, UNIT NO. 15, AS PER MAP RECORDED IN BOOK 92, PAGE 18 OF MAPS, RECORDS OF
U VERSIDE COUNTY, CALIFORNIA
.xcept any reservations of record of minerals -oil, gas, water, carbons and hydrocarbons.
;kioWi.ng title vested i n :
.ORONEL,E:NTERPRISES, INC., A CALIFORNIA CORPORATION
-ree 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 of
record.
P _
4
)eller Buyer .'