SFD (9907-543)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
.4119,41 0V31/20(
D to !__' '4"1 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).
( ) 1, 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
Se'ciion 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.
LOON' IWIL, [fire. F��ayu'-fti2ijtSSt,�r^
(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,iand agree that if 1,should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Co Id all forthwith comply with: those'provision� l
/De: '�`'°;+Applicant �rning: Failure to secure Workers' 'C ompensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of.work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
constWction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes f,s'
signature (Owner/Agent) J Date _L i
PERMIT#
BUILDING PERMIT
01,4043
DATES VALUATION �eft LOT ¢$ TRACT
'JOB
ADDRE S _'7'60AVENIDA MLN.00
APN i�3-RlJx-Q�9Y
OWNER'
CONTRACTOR/ DESIGNER/ ENGINEER
i7tyt,"e�0'ft A fr d1/1'����SCr
"CAR.etlA�rr1" CCJX * i"rsTrf"T"'iAl
R 3A.�/1 1.. 1 JA `I k�I
LA QUINIA f:A 92253
I..A e 01 INTA C.A 922w3
2261
USE OF PERMIT
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INFRAICKUCTUXU FP -E 25-()tom-4i+-�34'ar
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IX&S PRE-t'AID I Uri
�10 ef)
101AL PERMIT :(1'@1PN Dille, NOW
.Vf.�•
RECEIPT
DATE
BY ,JCS';
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings Q(� ��
Slab Grade O �� -T
Ducts
Return Air
Steel
Combustion Air
Roof Deck -/ - /
Exhaust Fans
O.K to Wrap - (y - f
F.A.U.
Framing - — Q`j
Compressor
Insulation �'!�'_�77
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath p - - Q
Final
Final /
POOLS - SPAS
BLOCKWALL APOROVALS
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
Gas Piping
Gas Test 77 - -
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL PPROVALS
Temp. Power Pole KLU Kr 57
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) /62 , RI Q
Building) ,.
Address
leaning
Address
0
P.O. BOX 1504 � 01� s
18-495 CALLE TAMPICOLoq"" '
QUINTA, CALIFORNIA 92253 /�2��
.-,—.. �.. .... V {I
State Lic. City
& Classif. (C Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
that I art lice`hsed under rovisi ns of Chd"`°� apter 9 j oro encing with Section
3 ofjthe Busiq@ss�ndjessions Code, and my lice se is in9ull forog aqd
`'�....� i - \ 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).
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 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'] I am exempt under Sec. B. & P.C. for this reason
Date Owner e
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. 3900, Labor Code.)
Policy No. Company
F1 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 (5100) 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, 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.
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 properly for inspection purposes.
- Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE'CO!7NST. ./�
A.P. Number 7-5 /W �.K - I "L /��.J �
�
Legal Description tnQ119. t
• � J; ))—r Y
it! ik
rA _ C
Sq.
Size Ft. ��
Stories _.—
Units
New Q,--' Add ❑
Alter ❑
Repair ❑
Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.,
Grading
Driveway Enc.
Infrastructure
TOTAL
WHITE = FINANCE YELLOW = A
REMARKS
ZONE: BY:
Minimr Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Sid�t Setback from Center Line ,
t ck from Property Line
FINAL DATE 9RINSPE TOR
Issued by: 0 Dat����Permit
Validated by: h
Validation: O
J
PPLICANT PINK = BUILDING DIVISION -
Notice:
Document Cannot Be Duplicated
Date 7/21/99
No. 19055
Owner NameEsequiel M. Coronel
No. 51-760
City La Quinta
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Street Avenida Mendoza
Tract # B 119,U 12 Lot # 24
Type of Development Single Family Residence
Comments
APN # 773-182-001
Jurisdiction La Quinta
Permit #9907-543
Log #
zip 92253 Study Area
Square Footage 1,461
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 .min the amount of
1.93 X 1,461 or $ 2,819.73 the property listed above atf,, that building
Y.
permits and/or Certificates of Occupancy for this square footage in this proposed project ay now be35issued
Fees Paid By ccNIB/Esequiel Coronel
11: lephon•e', 564 4604 „- '
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green Payment Received . $2,819.73
Check No. 195210
Signature
NOTICE: 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
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 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
A-ARDING REQUESTED BY:
D WHEN RECORDED, MAIL TO:
ilE t �]R
ESEQUIEL M. CORONEL
P.O. BOX 389
LA QUINTA, CA. 92253
OW -01
385256
RECEIVED FOR RECORD
AT ti:00AM
-SEP 10 1996
tAefbrdad in Ofi'cW Reoorda
of Riverside County. California
Reorder
Few $ �__
THIS SPACE FOR RECORDER'S USE ONLY
ASSESSOR'S PARCEL NO.: The undersigned Grantor(s) declare(s) that the DOCUMENT TRANSFER
TAX IS:
TITLE ORDER NO.: 87009501 $ _ County $ City
ESCROW NO.: 18112-002 — computed on the full value of the interest of property conveyed, or
-- — computed on the full value less the value of liens or encumbrances
Q U 1 TC LA I M DEED remaining thereon at the time of sale
— OR transfer is EXEMPT from tax for the following reason:
FORA VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
HAZANY CORONEL, WIFE OF GRANTEE
hereby REMISES, RELEASES and QUITCLAIMS to
ESEQUIEL M. CORONEL, A MARRIED MAN AS HIS SOLE AND SEPARATE PROPERTY
all that real property situated in the City of LA QUINTA
County of Riverside , State of California, described as:
LOTS 23 AND 24 OF BLOCK 119, UNIT NO 12 OF SANTA CARMELITA AT VALE LA QUINTA, AS SHOWN BY
MAP ON FILE IN BOOK 18, PAGES 79-80 OF MAPS, RECORDS OF RIVERSIDE COUNTY STATE OF
CALIFORNIA
THE GRANTOR IS EXECUTING THISINSTRUMENT FOR THE PURPOSE OF RELINQUISHING ALL OF GRANTORS
RIGHTS TITLE AND INTEREST INCLUDING, BUT NOT LIMITED TO ANY COMMUNITY PROPERTY INTEREST IN
AND TO THE LAND DESCRIBED HEREIN AND PLACE TITLE IN THE NAME OF THE GRANTEE AS HIS SOLE AND
SEPARATE PROPERTY
Dated August 21, 1998
STATE OF CALIFORNIA, } HAZAUYI CORONEL
COUNTY OF Riverside ) ss.
On 9/4/98 , before me Constance
Gorsuch
Notary Public, personally appeared
Hazany Coronel
personally known to me (or proved to me on the basis of
satisfactory evidence) to be the person(s) whose name(s)
is/are subscribed to the within instrument and acknowledged
to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s)
on the instrum t the person(s), or the entity upon behalf of
which the per s) acted executed the ins ument.
WITNESS m d and ic' I eal.
Signature
MAIL TAX STATEMENTS TO:
A Cot, iALICEGORSUCH
4' COMM. #1187728
,.:•.
NOTAHYPUSLIC-CALIFORNIA
RIVEP.`;;IDE COUNTY
My Comm. 9x iros June 20, 2002
ESEQUIEL M. CORONEL - P.O. BOX 389, LA QUINTA, CA. 92253
NAMEADDRESS
(This area for official notary seal)
CITY. STATE & ZIP
l
RC District - Plannin4 Review Form U
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 applicabitity of compatibility issues -6r need
to require the filing of Master Design Guidelines by the applicant. It shall be transmitted to
Building & Safety as your correction list. Please attach additional explanations as necessary.
APPLICANT: Coronel Construction )�
PROJECT
ADDRESS:
APN:
51-760 Avenida Mendoza
773-182-001
LEGAL: LOT, 24 , BLOCK 119_ , UNIT 12-_, S.C. @ V.L.Q. `
CK'D BY: Leslie Mouriquand
BIN NO:. CASE NO.
CHECK DATE:
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
I
...,? \....•.�t,•::4,\� '2:.,4: >,\r. yiG ``' \.JJo�^ti."+`:?:^o-'ti::`,., .Jt n �:.i•:., '.i+.C•:\ti �tiQ�:4i.io:}}..,�,.,}..: i,`.••., •.r'?. `.,'a ,�,. S .
�4'•`),.: \`'� 4::�}„!,$\..:\' }',\. t ,}„\' • No \'\\ \\� ., 3.. ^,\`i�,a'kYv 3; i. x• •1.'\n;'Sh`�:}`,.f�,
'�.}�. tµ`., .y •��•}��(•Qn}i'•(,'}`'v\�ti`\::�'v?'.vC^,\`i,•.}.54..�q�YiSYN>.iritiiti:?S:\\:iZ',`?"•\�{::?�?::k:C:•T•'``Y.,'4^T.
Case logged and number assigned
Verify legal and APN information.
Consistent with MDG on file las applicable)
MDG filing required 15+ filings since 9/3/98)
Consistency--- ith-street/surrounding area: -
Colors
Materials
Architecture
®a
'
OTHER REQUIREMENTS:
The Toningcode, architectural and landscaping manuals, and/or assigned inspector should
be consulted where uncertainties arise. The completed checklist shall be maintained in the
Building & Safety address file.
Certificate of Occupancy
City of La Quinta
Building and Safety Department
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,
certifying that, at the time of issuance, this structure was in compliance with the various ordinances
of the' City regulating building construction or use. For the following:
BUILDING ADDRESS: 51-760 AVENIDA MENDOZA
Use Classification: SFD Bldg. Permit No.: 9907-543
Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC
Owner of Building: ESEQUIEL M. CORONEL Address: 51-540 EISENHOWER DR.
Building Official
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 12-16-99
POST IN A CONSPICUOUS PLACE