SFD (0012-146)53800 Avenida Martinez
0012-146
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
15:49131 { 1 r a /V
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm junder 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.
( ) 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 STATE TFUNT1 Policy No 15 437••U0
(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.
Date: ' t 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)- Date {
BUILDING PERMIT PERMIT#
DATE VALUATION LOT GOM-146 TRACT
/a1 w.r
JOB SITE
APN
ADDRESS 534M, AFKMA TU)NEZ
, '774-772403
OWNER
Y
CONTRACTOR / DESIGNER / ENGINEER
C:ORC)NFI , CONSTIZ130aIDN'
co.Rowf& co)'IEr``mumou
78-350 CALIX'.S'ill ; O.00SMTYW&i30 -
W-1 50
1A C U7.NTA, CA 92253
LA Q1.373UA, CA 92253
1VU)iri4o44!(i4CB 2261 .
USE OF PERMIT
BIRGIT3VAJbW1']DVeT1v.3.3_1W4
'
SM-.PRRMIT DOES 14011' Ddf:f,.iPt7' i31 CJC l .c ,l, ' . G! er1 RlVluttft4 Y
. PPRO."X114
TItACT C:'ON11TRUCTION 1,421.00•11F
PORCKI''M1110 36.00 3?
5 ITT. WOOD MC E 200.00 5,R
7 5" 1k 1 d ?, 4Ae ' C23F C:ommucr3.O7N
)PKRAUT Yt''09:"N NUhMA1t Y
CONT- IRUC ION W, 161-00(1-419-000 W94,30
1P I, 4 CHWIC ME 1, 0 -(94.43.9-319 0001 12
MECHANICAL FGF: I 01-Q,00421 OV 90100
" LEC.'.('RiiL11,.1., InPIE ' 101-tir'3n 0420.000 $I24,4A
PT,.IXh'ftTHOra l0i•GQt b'19 f iS3 11d.'7,S
=10NtROiIMTft W -SID I0;1-000-te a -00
0_ $9.93
Rf yyAyyINO KK $20.00
DEVEL OPER HAPACT PIM $1,90'7,W
fr'RWNSF,1 L&H 1011.000.441.345 910010
FFK DEPOSIT IT s 101-WO.439-318 424—.0.00
A
SILM.•Ta.I.X'e6 AND 1.ALAW Ck3IWY
$3,430.74
M0NOW
JAN 03 2001
ur
RECEIPT
DATE/ J
i/U
BY¢
+ &11,
DATE FINALED
INSPECTOR
c?
.
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
-Q j
Exhaust Fans
O.K. to Wrap
��
F.A.U.
Framing
Insulation
_
°2
Compressor
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
_ _>
3 C
Final
Final _1010/ 1 ::,/,
BLOC KWAI 1'4 PPROVALS
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
Water Piping
_ / �-1
Heater Final
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
—O
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APP OVALS
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) p
COMMENTS:
ra
I,. # ^ A7¢!, R^s-p = -' tr.$1 i•' w ..-. a +, ..^a*i...- + r .,-' a. ..p ._yar-r•7.-rte. -+ :. :,T.. .. '`
v
t.
P.O. BOX 1504 APPLICA ONLY
Building/ 78-495 CALLE TAMPICO
AddresfU c.l LA oUINTA, CALIFORNIA 92253
Owner
C—C ( L..•...\
Mailing . Cl
Address t C
City Zip Tel.
\_, b 'A 1-2
Contractor
Address
Pic , 41",
City ( Zip Tel.( {
State Lic. City
& Classif. ( C Q1' t,,l.ti Lic. #
Arch., Engr.,
Designer
Address Tel.
City IZip I State
----%I
--% Lic. #
LICENSED CONTRACTbR'S DECLARATION
affirm that I am licensed unper p.ovisions of Chapter 9 (commencing with Section
Ivlsiop,3 oft=` eus. ine§s and Pro ssions Code, and rdy license is fn.full fp a and
OWNER -BUILDER DECLARATION
I hereby affirm t `at I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Susiness 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).
f: I, as oner of the property, or my employees with wages as their sole compensation, will
do the wowrk, 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
doesnot 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. & 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
r7 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WO R K ERS' 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: It, 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 sof this city to enter the above.
mentioned property for inspection purposes.
Signature of adplicant Date
Mailing Address
City, State, Zip
.DING: TYPE'CONST. OCC. GRP.
Number t-'1 —
I Description 1L i y L. 7 •
:ct Description `" . •
/r
1 \ \ t,
y
`'
( VN
Sq. Ft. No. l No. Dw.
Size Stories t Units
New IQ Add ❑ Alter ❑ Repair ❑
14-2.1
Demolition ❑
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
1PAW
-
MT 2 7 2000
3timated Valuation
PERMIT
'
1
AMOUNT
Plan Chk. Dep.
O C U
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
r'
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
Notice:
Document Cannot Be Duplicated
Date 1/2/01
No. 21428
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
APN # 774-772-003
Jurisdiction La Ouinta
Owner NameCoronel Construction
No, 53-800 Street Avenida Martinez
City La Quinta zip 92253
Tract # Lot #
Type of Development Single Family Residence
Comments
Permit #
Log #
Study Area
Square Footage 1421
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
2.05 X 1,421 or $ 2,913.05 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 - Ismael Telephone 564-4604
Name on the check '
B Dr. Doris Wilson -
y
Superintendent
/. ' • 4
Fee collected /exempted by Ellen Patino Payment Received 92;'913.50
Check No. 235139
Signature
10TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) 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
53: oo P av
RECORDING REQUESTED BY:
CHICAGO TITLE COMPANY COMPANY.
10248KC 207057176
WH NLRE
MA LO AXRRIM ENTSD QOWND'
CORONEL'ENTERPRISES, INC.
P.O. BOX 389'
LA QUINTA, CA 92253
DOC a 2000-353569
09/08/2000 08:00A Fee:6.00
Page 1 of 1 Doc T Tax Paid
Recorded in Official Records
County of Riverside
Gary L. Orso
Assessor, County Clerk 8 Recorder
i IIIIII IIIIII IIII
VIII IIIIIII II IIIIIIII I
_ II VIII IIII IIII
M I , I U. II PAGE I SIZE I DA PCOR NOCOR SMF I MISC.
A R L COPY LONG REFUND NCHG EXAM
— P' 4_
GRANT DEED
The undersigned grantor (s) declare(s):
U
Documentary transfer tax is $18.70
(XXX) Computed on full value of property conveyed, or
( ) Computed ..on. full. value less....1.i--.n.G:
..ac.
nd :enumbranc.e.s remaining_ at time of sale.1:L]
( ) Unincorporated area: ( r) City of and SF
FOR' A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
FRITZ B. BURNS FOUNDATION, A NEVADA NON -STOCK, NON-PROFIT CHARITABLE CORPORATION
hereby GRANT(S) to
CORONEL ENTERPRISES, INC., A CALIFORNIA CORPORATION
the real property in the City of LA QUINTA, County of Riverside, State of California,
described as:
Lot 22, Block 248, Unit No. 23„ Tract Santa Carmelita at Vale La Quinta, as per map
recorded.in Book 20, Page(s) 25 inclusive of maps, in the office.of the County Recorder
of said County.
Dated August 3. 2000
State of California
County of LOS ANGELES } S.S.
On August 24., 2000
before me, L.J. RAWLINSON, Notary
Public personally appeared
JOSEPH. E. RAWLINSON and
W.K. SKINNER
personally known to me (or proved to me on
the basis of satisfactory evidence) to be
the person(s) whose name(s) Ax/are subscribed
to the within instrument and acknowledged to
me that 11" they executed the same in
=S>,fX R/their authorized capacity(ies), and
that by A'Dix$hn r/their signature (s) on the
instrument the person(s), or the entity upon
behalf of which the person(s) acted, executed
the instrument.
WITNESS my hand and official seal.
Signature
MAIL TAX STATE ENTS T0: SAME AS ABOVE
FRITZ B. BURNS FOUNDATION
A NEVADA NON -STOCK, NON-PROFIT
CHARITABLE CORPORATION
BY !ra
d6me/'`Title JOSEPH E. RAWLINSON, President
Name/Titld W.K. SKINNER, Secretary
L J. RAWUNSON
C nwnhdon # 1234106
caftmb
ArgNa LOMW
My C'•orf tet. Bq>ties Nlor2 4
(This area for official notarial seal)
i
i
RC DISTRICT - PLANNING REVIEW FORM
This form is to be used by CDD staff for review of single family dwellings in the RC (Cove Residential)
District, in order to determine the applicability .of compatibility issues or need to require the filing of Master
Design Guidelines by the applicant. It shall be transmitted to the Building and Safety Department as your
correction list. Please attach additional explanations as necessary.
APPLICANT
CORONEL
SITE ADDRESS 53-800 Avenida Martinez
APN 774 _ 172 _ 0 W3 BIN NO.: o CASE NO.:
LEGAL: LOT 22 BLOCK 248 UNIT 2 3
CHECKED BY
Waly':Nesbit
DATE:
2000-336
S.C.@V.L.Q.
Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive
Secretary maintains a log book to track applications and assign case numbers.
REQUIRED ITEM
Y
N
COMMENT/CORRECTION
Compatibility Review
Case logged and number assigned
Verify legal and APN information
4.trT 1,0V IV40-Vt vp 1q4/re_ 49L04 -IS
/Fy G✓rZ/rifi /T Ow ✓fiGt srs
Consistent with MDG on file (as.applicable
MDG filing required (5 filing `since 9/3/98)
Consistency with street/surrounding area:
Z CO f S Colors
CivxT dct< '00w—,) Materials
Architecture
,s.64 6w Pl *%'s
e. « f/
Gw. l 7 S
VLe., Oct.*-
cazCres 775 dL vs 90
E3
❑
In
gro
ed by:
Commission
Council
munityBev. Sept. .4 7 /7 7/Ash
-.
Planning
City
Com
iais
\Exhibit
With Conditions