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SFD (0303-073)
53320 Avenida Martinez 0303-073 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 and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date -til ,,00Date1--* >. ` Signature of Contractor. 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. (, o) 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 3 -TATE E FUND Policy No. IWkq-©;/ (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'iflshould become subject to the workers' compensation• -provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ✓ ,D'a`te: '" Applicant ^ , --n- t 'x -t / 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 foroinspection purposes. Signature (Owner/Agent) —- - ^. - Date'-! PERMIT # BUILDING PERMIT t3.0:ri DATE /VALUATION %,45:s5.w LOT 21 TRACT BILK a 12 JOB SITE ADDRESS 53-320fAIMMc.DA.MWME ; APN 714-•0::2-004 OWNER CONTRACTOR / DESIGNER / EN (NEER t' ORONYM ESTEW-V110 (:O CO.Nr "'I'MU C`z10M PC/ BOX 389 78-150 C;:J1,C,,TA?, I'AN1BTCt') :3UZE01..230 Ld'e,QUOr.D. C.I+'.!L' 0221 i u 43i rri. Cit`9. 92.s1,•5 (760)564- 4604 CTAVI 2261 USE OF PERMIT Slev. 1411 sglerL.IVn'I.T.iiiY: Y: RMZ.I' lr VZ'' l. e,PUT jANL;tU!'J1'' CJt4 D6 y nr • .1"1.Wl .i.' ly.r, ,I'fCi.L. I'i'',+ .7`(..c oil. i lf . !i. s4 FyJ i fi h c i', 'F'E lW.!. '2 Sir ? k ?nrYRt I) FOR DIATIL?WP.Y'.4P?]`R0AQA 1*I.10M THE PU'BI. iC: WORK S tWARTflJl3P.-t• T. 3F WIN V I Mm 9ETIAMARY t:O NwTRUCTION '1:1"•x; 101 -000-418-000 w0 P r.N CHECK IYi `,I °• i 01-000=4139-31 8 YFE. DLCI'081T 1.01.00 -4;JP-318 4219100 Itfii+.C:1fiA141C=,A1.. IFi!Y, 10 If •-000.471-000 $90.00 V.-IM1'I` IC -U. Mx.• M0.4 Pt,Lt.MBIWO 01 Ctt►C1' s 5 -0r d7 Ik? tf 9TRON0 MO TION ), FF' - [iV-ND 101 -OCU -24.1-00 4]q AV,1140 FRE, NNF:L01'PR I,h4t AC"T Ftk. IaPECISE FLAN 101-00-0-441-345 •r SM-IMTX CUNW.K4 0TIC;14.ANDPLAttC :a"'tti lr10I PF.F•"F:AIDI'Rear p Q p 1 a .. 40Nvy 53,701.57 .11MATY APR 2 2 1003 CITY OF LA QUINTA ' • . FI at • ' RECEIPT 1 BY.' f DATE FINALED INSPE TOJ INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms 8 Footings Slab Grade S Ducts Return Air Steel Combustion Air Roof Deck - Exhaust Fans O.K to WrapF.A.U. Framing ell Compressor Insulation - p_57 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 Steel POOLS - SPAS 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 , C2a4f Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection 2 dT Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Law Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) _ Q� COMMENTS: . Building rr\\ Address Tihf 4 " P.O. BOX 1504 APPLICATION ONLY 78-495 CALLE TAMPICO = rr`.LZ LA QUINTA, CALIFORNIA 92253 Mailing Address a _ pj Cit Zip Tel. SO4 U-) -k Addres f? - City va ti vo s Z_l 2-ZS Tel. State Ljc.City % (( L'Ic. # • & Classif. Arch., Engr., Designer Address Tel. City Zjp/ State / j I Lic. q that I 1 e under rovisions of Chapter 9 ( ommanc 3 of h si and P fr;. ns CodeAand my I cense Is OWNER -BUILDER DECLARATION I hereb affirm hat I am exempt from the Contractor's License law for the following reason: (Sec 7 .5, Business and Professions Code: Any city or county which requires a permit to construct, atter, 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 five hundred dollars ($500). I'll I, as owner of the property, or my employees with wages as their sole compensation, will do the work, antl 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'I 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 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 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 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, alter 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 Ihereby 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 slate laws relating to building construction, and hereby authorize representatives -of this city to enter the above. mentioned property for inspection purposes. Signature of aQplicant Date Mailing Address City, State, Zip BUILDING: TYPE•CONST. OCC. GRP. A.P. Number --%-/'4 "o q Z --Gol-t Legal Description, ,,V ^fl V-- Project Description . J Sq. Ft. Size New ),S No., No. Dw. Stories Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ stimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical ®rA Plumbing 1 11S.M.I.Grading Driveway Enc.cg!pf It, U Infrastructure j gNCE TOTAL 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: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION 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 (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 $2.14 X 1,421 S.F. or $3,040.94 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. 277720 Name on the check Telephone 760/564-4604 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Sharon McGilvrey $3,040.94 $0.00 Payment Recd Over/Under Signature I 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 Districtfs) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road z4 cs o Q BERMUDA DUNES r Date 4/21/03 La Quinta CA 92253 Quinta, RANCHOIANWE LS CJ INDIAN WELLS No. 24348 (760) 771-8515 ' dd PALM LA QUINTAT y 3QINDIO . 0 Owner Coronel Enterprises APN # 774-092-004 Address P O Box 389 Jurisdiction La Quinta City La Quinta Zip 92253 Permit # Tract # BLK212 Study Area Type Single Family Residence No. of Units 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 21 53320 Avenida Martinez 1421 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 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 (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 $2.14 X 1,421 S.F. or $3,040.94 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. 277720 Name on the check Telephone 760/564-4604 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Sharon McGilvrey $3,040.94 $0.00 Payment Recd Over/Under Signature I 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 Districtfs) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting ` Vo,J.'Ma r .10. 2003' 6 :15PM - RECORDING REQUESTED By; First American Title Co t=swew No. 4593a.Ce This Order No, 763697 When Recorded Mail Doaament and Tax Statement To: Mr. Zeke Coronel 51105 Avenida Villa, # 101 La Quinta, CA 92253 C•\J \sari _._.. e + 1 wAvI TWAY. IDELIN Nkibi AL TITLE No • 1546 P. 302 CIOC p 2003 09S66B 62/16/2aa3 es:61W Fu:16.e8 RP49* 1 Of 2 Doe T Tax Pa/d In offiotat Rocorda' qty of River -61" affis"44'r Gary L. crag County Clark i 11 eOrdarMEWSl l PbE r.._. !! I APALt a bUVt i ni a -tic rvn The un4XI9ned grantor(si declare(s) Documentary transfer tax is $198.00 l ( X 1 computed on full value of property conveyed, or r ( ) computed on full value less value of liens l ) Unincorporated Area ens or encumbrances remainins et time of sale, FOR A VALUABLE City Of La Quinta ,qQ 7 Trustee of The Henry Griswold fat of which is hereby acknowied ed, F Living Trust dated June 19, 1995 9 rank Myri Griswold, Successor hereby GIRANT(S) to Coronel Enterpri ses, Inc., s California Corporation the fopowing described r County of Alverside, State eal ofproperty Ih the City of La Quinta California: Lots 14, 20,-21,& 22, i&ock 212 of Santa Page 38 of M Carmelite at of a d Quinta, Unit 20, as per map recorded in spa, in the Office of the County Recorder of said County.- - Book 19, DATED: January 9, 2003 STATE OF CALIFORNIA COUNTY OF ON before me, Personally appeared Personally known to me (or proved of satisfactory evidence to me on the basis name( 1is/ ) to be the person(4kWhose @ subscribed to the within instrument and acknowledged to me that he/sht/they executed the same in his/h /tftr authorized capacity(k, and that by his//ih s;gnature'( on the instrument the person?N. or the entity upon behalf of which the Person(kaCted, executed the instrument. Witness my hand and official seal. Signature FD•213 rRev 11ggh ;2 prop - RV:2003 00095666 Frank Myrl Gris%vold, Successor Trustee of The Henry Griswold Living Trruus t dated June 1 199 Frank MyrI Griswold, us S'tTi i LIN 4 A%. Commia7 ion4 ;31?79J rh - .cry i•`upliC • C., i, `„, O nge C•nunn s MAIL TAXSTATEMENTS AS DIRECTED A801rE GRANT DEeo I of 2 ' u.s "Ma r.10. 2003' 6:15PM FIDELITY NATIONAL TITLE No.1546 P. 403 Under the provisions of Government Code 27361,7, Y certify under penalty of P*rjury that the notary seal on the document to which this statement is attached reads As follows: Name of notary: Commission is. Place of execution: M -n rl,2 to Date commission expires: L J Date: FEB I o zoa Signature: el prop - RV:2003 00095666 2 of 2 May. 8. 2003 2:39PM No•3713 P, 2 ~moi ,In, 0 aoli n W ,To B>aild On Engineering • consulting • Testing REPORT OF FIELD COMPACTIO,V TESTS TESTED FOR: CORONtL CONSTRUCTION PROJECT: 53-320 AVENIDA MARTINEZ PO BOX 389 LA QUINTA, CA LA QUINTAr CA 92253 DATE: April 30, 2003 OUR REPORT NO.: 073-30153-2 TEST DATA: (1) Medium to coarse grained sand- OPT.. MOIST. = 11.0t TEST TEST, DEPTH ELEVATION SOIL ID NUMBER MAXIMUM LAB DRY * OENSrrY WATER CONTENT W=T DENiTTY DRY DENSITY PERCENT COMPACTION COMMENTS, Spec. 90� MinNO. 1 811 FG 1 124.0 10.4 127.8 115.8 93.4 1 - A 2 3 '61f 8" FG FG 1 1 124.0 124.0 15.8 11.6 132.1 135.4 114.1 121.3 92.0. 97.8 1 - A 1 - A 4 811 FG 1 124.0 11.9 129.1 115-4 93.1 1 - A TEST LOCATION: Building pad. 1 NW corner 2 NE corner 3 SE cornea' 4 SW Corner VOTES: 1 t5I5 YtHrVFtMFO PER A5TM 02922-86 & ASTM 03017-96 "COMMENTS: 1. FILL MATER AL A. TEST RESULTS COMPLY WITH SPECIFICATIONS DENSITIEg SHAWN: Lbs. ! Cubic foot 2. BACKFILL g. PERCENT COMPACTION ODES NOT COMPLY WATER CONTENT: PerceAtof dry weight 3. BASE COURSE WITH SPECIFICATIONS PERCENT COMPACTION: Beseu on maxhmum dry 4. SUBBASE C RETEST OF PREVIOUS TEST density obtained on Semple indicated by S.SOIL CEMEPT D; MOISTURE IN EXCESS OF SPECIFICATIONS soil ICY number. 6, OTHER E, MOISTURE BELOW SPECIFICATIONS * (1) ASTM D1557-00 METHOD A FEST INSTRUMENT: STANDARD COUNT M: D; *.EMARKS: PSI did not monitor the material placement. ADJUSTMENT DATA M: D: Respectfully submitted, TECHNICIAN: Vinnie De Souza Professional Service Industries, Inc. HERE TEBT RESULTS APPLY ONLY TO THE SPECIFIC LOCATIONS NOTED AND MAY NOT REPRESENT ANY OTHER LOCATIONS OR ELEVATIONS. :SPORTS MAY NOT BE REPRODUCED, EXCEPT IN FULL, WITHOUT wRITTEN-PERMISSION BY PROFESSIONAL 5E9ZVICE INDUSTRIES, INC. 81 A•100•2 (4)FPTOfOSSional Service Industries, Inc. 42-240 Green Way, Suite C • Palm Desert, CA 92211 • Phone 760/341-5790 • Fax 760/341-5794 a ` •c -- Certificate of Occu ancy- lp RAMD G OF Buildin- & Safety Department 9► Y p This Certificate is, issued,pursuant to 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 f construction and/or use. . BUILDING ADDRESS: 53-320 "ENIDA MARTINEZ Use classification: SINGLE FAMILY DWELLING Building Permit No.: 0303-073 Occupancy Group: R-3 _ Type of Construction: VN Land Use Zone: RC Owner of Building: CORONEL ENTERPRISES Address: P.O. BOX 389 City, ,ST, ZIP: LA QUINTA, CA' 92253 By: KIRK KIRKLAND , a Date: AUGUST 7, 2003 Building Official r POST IN A CONSPICUOUS PLACE