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SFD (0303-096)53300 Avenida Martinez 0303-096 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 andq,. Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date _ 'A'Date-4 '' - 2p Signature of Contractor__ OWNER -BUILDER DECLARATION a 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 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. '(y 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: Cartier fa°3'rTE FUMD Policy No. 1542937,03 (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} t Date:Applicant ✓' Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on: his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to. any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is • correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. Signature (Owner/Agent) . ? r --'' Date'LA " -BUILDING PERMIT PERMIT# DATE - VALUATION LOT " TRACT 22 ]`LX 212 JOB SITE aYn ADDRESS I .Pd1l b A % APN 7 4 2. y .r OWNER CONTRACTOR/DESIGNER/EN (NEER C:OTtOMT... FUMPRITSES COROMI L G"'0NST'1yl'.7MOJN' PC) :FILLY 389 'i6-1 50 C'MI Z TJVNM'".O OU9.'UW2E 40 i.a.C 'I iA CA 92253 I;A Q%17'?v°nk CA 92253 (760)564.4604 C-Slil 2u2 USE OF PERMIT alff 143) S.R. SM k}iY@tVIT EVL$ NUT INC4'.,131.'DE 8LOCK 'W't1.i:Y; POOL, OP, DUVIEW Y APPROACH, 7A MIJC.M.9 PLAN C1~IWX ;YZE FOR MUIPL Z MANS N S OF SAW4 TYPE 'Iii.AC! CO.93TRUC IO14 PORCHt'-'i ATIC3 94.30 SP 0ATiAQv1CA.1tp01kr 4`N'."1.330 OF k✓ ~ \ 'S •'i L'P!b-0.1C,M1JM. .1lWA wCF9"i+: utdd ,+ y q + t yi 7 { yt SAJ J.'3.CWl+t3A C.i CO13s:TRUC1ICM FEE 1.01-00043 8-000 $590,00 PLAN I',Fi'I^XK FrE 101-OM439-318 $1222.$9 FL, Z DEPOSIT 101-000.439.318 42solow MECHANICAL PEE 10 1 -000-42 1 - 000 $32.50 IiIrICc:TRIC.Ad. Fr% 101-000-420-000 $108.:12 PLU MBINO PER 101-000-419-00%) s t 1.I1." OTROkICIMOTION FIRM - SID 142.000-w41.000 58103 Qt3.AD11d0IFE" r 101.000-423-000 $15.00 D.r,,VEWPI},R IMPACT F74E SZ110SO PF ECIS PLA14 101-000-44 11-345 IQ0.00 t SUB -TOTAL r,014N .0 C ICAND PKAW C WCTC ;> a,12O. s9 a LESS T'R1~--AAD IBES 0 -$2;1E ,Do ..<.t 'C TAL PE10+. .1F IS DUE now $3,270.57 2 2 2003 ,APR. CITY OF LA QUINTA t: FINANCE D PT. _ _ RECIgPT DATE , ^_°r, , ' BY DAT FIN ED INSP T INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Roof Deck Combustion Air Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation J Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wali Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final BLOCKWALL APPROVALS Final POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines _ Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection _ J� ��_ Encapsulation Gas Piping Gas Test 7i�� C13 EYC Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS t Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: v 1'Ma r , 10 , 2003' 6 : 15PM RECORDING REQUESTED BY: First American Title Co 11B—W No. 4593a -Ce T$Ie Order No, 763697 When Recorded Mau Docurnont and Tax Statement To; Mr. Zeke Coronel 51105 Avenida Villa, x'101 La Quints, CA '92253 1C) 1 f r'IVELITY NATIONAL TITLE NO.1546 P 302 CIOC = 1'003 09g6 /16/2863 "'Oft Fee -to." Pe6ei Jfe 1 or 2 Ooe T Tax paid Ra Wrded inC94Orftotel Records mtY of Rtvarstde pese"Isr (krY L. or.o Count ION11,11y clerR & Rencorder "(Iill 4 !P.f +a a row , (c-::) fined prantor(s) 0 1. 6 WZ-V 1 /'-APALt Abuvt 1 nia ulve ,.N`" tro'w The undersl declare(s) Documentary transfer tax is b 198.00 C ( X 1 computed on full value of property conveyed, or ( i ) computed on full value fess value of liens or encumbr Unincorporated Aree antes remaining at time of sale, FOR A VALUA9LE CONSIDERAa - Cirec f La Quints q0 ^ Trustee of The Henryf whi7 ch Is hereby acknowled ed, F ry Griswold Living Trust dated June 19, 1995 g rank Myr( Griswold, Successor 1 hereby GRANTS) to Coronal Enterprises, Inc., a California Corporation the following described real prop" Coahty of Alverside p per' In the City of La Quanta Lots 14, 20, 21 & 22 Smote °f California: Page 14 of M Block 212 of Santa Carmelita at Vale La Qulnta Alla, in the Office of the County Recorder of said County. -Unit 20, as per map recorded in Book 19, DATED: January 9, 2003 STATE OF CALIFORNIA COUNTY OF ON " before me, Personally smeared ts■.s Personally known to me (or proved to me on the basis Of satisfactory evidence) to be the' Whose namei%;s/8V subscribed to the wlth n ins um nt and acknowledged to me that he/sly/thby executed the same in his/h%bVtl'tq}r authorized capecity(k, and that by his/'h"*/thk signature on the instrument the persona(, or the entity upon behalf Of which the person(kacted, executed the instrument. Witness my hand and official seal. Signature FO.213 fi c / g :1 prop - RV:2003 00095666 Frank Myrl Griswold, Successor Trustee of The Henry Griswold Living Trust dated June 1 799 QY: Frank Myrl Griswold, us A. Commis3,,,l O1 rj^'pry i `,blic • C2i:a nia • 0-Mnoe County s -,)mm Fxp: rr. s .!u►1 3.:'1k75 MAIL TAX STA71MEfVrS AS DIRECTED A601rE C3RANT DEEq 1 of 2 us 1'Mar,10. 2003' 6:15PM FIDELITY NATIONAL TITLE 10.1546 P. 403 Under the provisions of Government Code 27361.7, 1 certify under penalty of perjury that the notary sea, on the document to whicl, this statement is a reads as follows; ttached Name of notary: Commission #; Place of execution: Date commission expires: V DG—:) Date.. FES 10 2003 Signature: el prop - RV:2003 00095666 2 of 2 i ` 2 4 13 1 2 4 O eb 1 3 1 r , 2 4 O m 13 1 rc n m TRA 020-089 m 100 IBD 30 30 n — B— — lno 30 30 10B 10b 3C 30 TRA 028-076 23 29 14 2 I 23 O 14 2 N 23 ( J 14 2 TRA 020-076 020-096 22 O 15 3 J 22 : j 3 22 3 3 TRA 020-089 2l O is 4 k 21 40 416 4 21 O 15 4 I TRA _ i 16 5 20 O 17 5 20 0 1% 5 20 5 O TRA 020-069 Y N m V O o 19 O la 6 " 19 O 1a 6 19 17 6 N U -- C) N J N La m m m to J J 7 ( O 1 m 1e O 19 m le O 19 7 1.e 18 TRA 020 69O 20 9 17 O 20 6 17 O 19 s Q 1 s 25 21 s Is O 21 9 ,1— 16 0 20 9 N O O O mLd La i— — — 10 15 22 10 15 10 15 10 2 l0 21 Q 14 11 23 11 t 14 11 23 11 I ' " 14 11 24 it 1 IRB 100 100 IC0 100 100 — — TRA 020-062 m 30 30 30 30 m 13 O 24 12 30 30 13 12 24 12 , 13 12 m 12 ``m 12 N . • , 'rA 80 •r 80 80 a I _260 eAE -E 1 _ 260 S99 -58 -DOE 260 e „t ai 30 1 30 I c D 00 2 4 1 , 80 )i .r 1 a 0 108 — —)Be — 26 2 N 23 O 22 O 15 3 4 . 21 O TRA ON -662 20 O 16 5 Y 1g O C) 6 N J m 18 O N 7 17 O 19 8 1s O 20 9 15 iQ 21 10 TRA 020-089 Ln 14 25 11 n _ 100 m 13 r so 1C0 m 24 12 s n` 265.83 MB 19/38 SANTA CARMELITA AT VALLE 1.A QUINTA UNIT NO 20 m m B m Feb 1998 CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road Date 4/21/03 La Quinta, CA 92253 No. 24345 (760) 771-8515 Owner Coronel Enterprises APN # Address P O Box 389 Jurisdiction City La Quinta Zip 92253 Permit # Tract # BLK212 Study Area Type Single Family Residence No. of Units Lot # Unit 1 22 Unit 2 Unit 3 Unit 4 Unit 5 Comments No. Street 53300 Avenida Martinez S.F. 1431 Unit 6 Unit 7 Unit 8 Unit 9 Unit 10 7R N_ o Q BERMUDA DUNES r RANCHO MIRAGE d INDIAN WELLS i PALM DESERT ,y t}(% LA QUINTA ,.: VO INDIO r1i © J 774-092-003 La Quinta 1 Lot # No. Street S.F. 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 (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It has been determined that 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 Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.14X 1,431 S.F. or $3,062.34 have been paid for 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 CC/Valley Independent Bank - Ish Cornel Check No. 277716 Name on the check Telephone 760/564-4604 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Sharon McGilvrey $3,062.34 So.00 Payment Recd Over/Under Signature C , " NOTICE: Pursuant to Government Code Section 66020(d)(1), 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 issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting V% Information r Xb Build On Engineering • Gonsuldng • Teslgng. REPOR— OF FIELD COMPACTION TESTS TESTED FOR: CORONEL CONSTRUCTION PROJECT: 53-300 AVE MARTINEZ PO BOX 389 LA QUTNTA, CA LA QUINTA, CA 92253 DATE: April 30, 2003 OUR REPORT NO.: 073-30152-2 TEST DATA: (1) Medium to coarse grained sand. OPT. MOIST. = 11.0g TEST NO. TEST DEPTH ELEVATION SOIL ID NUMBER MAXIMUM LAB DRY ,t DENSITY WATER CONTENT WET DENSITY DRY DENSITY PERCENT COMPACTION COMMENTS" Spec. 90k Min 1 8" FG 1 124.0 14.4 136-9 119.7 96.5 1 - A 2 9" FG Z 124-0 12.6 129.2 114.7 92.5 1 - A 3 8" FG12-4.0 11-7 132.4 118.5 95.6 1 - A 4 8" FG 14 124-0 10.6 133.4 120.6 97-3 1 - A TEST LOCATION: Buildin ' pad. 1 NW corner 2 ME corner 3 SE corner 4 SST corner i i NOTES: TESTS PERFORMED PER ASTM D2022-96 $ ASTM 03017-96 'COMMENTS: 1, FILL MATERIAL A TEST RESULTS COMPLY WITH SPECIFICATIONS DENSITIES SHOWN' Lbs. per Cubic foot 2. BACKFILL B. PERCENT COMPACTION DOES NOT COMPLY WATER CONTENT: Percent of dry weight3. BASE COURSE WIT SP CIFICATIONS PERCENT COMPACTION; Based on maximum dry 4. SUBBA E C. R EST F PREVIOUS TEST density obtained on sample Indicated by 6. IL CEMENT D. MOISTURE IN EXCESS OF SPECIFICATIONS soil ICY number. 6. OTHER E. MOISTURE BELOW SPECIFICATIONS * (1) ASTM D1557-.00 METHOD A TEST INSTRUMENT: STANDARD COUNT M; D: REMARKS: PSI did not monitor the mati:rial placement. ADJUSTMENT DATA `M: D: Respectfully submitted, TECHNICIAN: Vinnie De Souza Professional Service lndustrles, Inc. THESE TEST RESULTS APPLY ONLY TO YNE SPECIFIC LOCATIONS NOTED AND MAY NOT R :PRESENT ANY OYTIER LOCATION$ OR ELEVATIONS. REPORT$ MAY NOT BE REPRODUCED, ExcEFY IN PULL, wIYmoUT WRITTEN PERMISSION . W PROFESSIONAL SERVICE INDUSTRIES. INC. Professional Service Industries, Inc, • 42-240 Green Way, Suite C Palm Desert, CA 92211 • Phone 760/341-5790 • Fax 760/341-5794 PSI A-1 00-2 (4)P E d 069£' ON NdZ l : Z l £OOZ A 'AEN • 09dificate o -f Oangy ccup o Buildin '& Safety Department This Certificate is issued pursuant ito the .requirements of Section 109 of .the California Building . -Code, certifying that, at : the time of issuance, this structure, was in compliance with the, ' provisions of the -Building Code and, the various ordinances of the- City regulating •building - •construction anal/or use.. - ,BUILDING ADDRESS: 53-300 AVENIDA MARTINEZ . V Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0303-096 •Occupancy Group: R-3 - r Type of Construction: VN, >, _ Land Use•Zone: RC Owner of Building:.CORONEL ENTERPRISES Address: P.O. BOX 389 - City, ST, ZIP: LA QUINTA, CA 92253Mr_= ____ __ - ===I , - KIRK KIRKLAND • - =' Date: AUGUST 7, 2003 _ Building Official POST IN A CONSPICUOUS PLACE • 09dificate o -f Oangy ccup o Buildin '& Safety Department This Certificate is issued pursuant ito the .requirements of Section 109 of .the California Building . -Code, certifying that, at : the time of issuance, this structure, was in compliance with the, ' provisions of the -Building Code and, the various ordinances of the- City regulating •building - •construction anal/or use.. - ,BUILDING ADDRESS: 53-300 AVENIDA MARTINEZ . V Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0303-096 •Occupancy Group: R-3 - r Type of Construction: VN, >, _ Land Use•Zone: RC Owner of Building:.CORONEL ENTERPRISES Address: P.O. BOX 389 - City, ST, ZIP: LA QUINTA, CA 92253Mr_= ____ __ - ===I ,