SFD (9803-148)LICENSED CONTRACTOR DECLARATION
1`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
/ j 981 B 1131100
.pat �r� iLs 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 tofthe 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 Policy No.
C_LI)RaN FAC> E INS., I`1W012189200
(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:, 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. 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.
VSignature (Owner/Agent) Date `std
BUILDING PERMIT PERMIT# CONTROL#
�=1 F` Y.
!
DATE VALUATION LOT 9803-148 . TRACT IQ
S89,413,S0 23 ,s.l✓ s
JOB SITE `t f "
APN -
ADDRESS
51-780 AV EiNIIDA11NAVARRO
1 773-184-002
'OWNER_-__—
CONTRACTOR / DESIGNER / ENGINEER
CORON L CONSTRUCTION
CORONEL CONb'T ucTioN.
P.O. BOX 389
P.O. BOX 389
LA. QUINT:: CA 922..53
LA. QUINTA Cts 922.53
(760)56-4-4604 CBLA 2261
y `�
USE OF PERMIT
t
a`FD - POMYr 13 ES WCC', bDP U0C,A WALLS OR POOL
APR 0 1. 1998
CITY
OF LA QU1NTA
C014STPUCTION t,421.00 SF
i-
PORMPKPIO 360) iSF r
GARAMCARPO.RT 514AO t
6 F'. 'V OOD FCNCE 200.00 IX,
,
t
F
Ft
F:,�'1'eMXfE D COST Of COMS`I':RI 1'tO J
+
�,� 1.11►
,PE? RART FEE S'LiI14M" '
-
CONSTRUCTION FEE 1011-000-418-000 $591.So
PL AN CHLGIs FIx. 101-{1E1Q-4359-318 $502.70
MECHAr WAW FH. .' $53.54
'___VLtC:WCAI. FEE 1.01-000420-000 $123-52
PLUNMIN( Fr --F, 1.01.=000-419-000 $133.50
$1'RONGMafION F"iM-'1RESID 101-1300-241-000 $0.44
GRADING M- 161-000.423-000 520.00
1NFRASTKUCIVRri FES: ?25-000-443-1.42 $1,962.79
PREC1311PL AN 101-000-4`11-345 $25.04
IrEE DEPOSIT 101-000=439-318 •$354.00
SUB-TOTt1L, CONSTRUCTION AND PLAN CHECK
$3.,124.44
1rESS PRE -PAID FEES
4250.00
TOTAL P1! RAUT FEF ' %DUEYVCIW
$3,174,44
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
7
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
9
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior lath
Drywall - Int. Lath
/lel 7
Final
Final
POOLS - SPAS
BLOCKWALL
APPROVALS
steel
Set Backs '
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APP VA LS
Gas Test
Electric Final
Waste Lines
_
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
0
Encapsulation
Gas Piping_
Gas Test
Appliances
L
Final
COMMENTS:
'
Final
Utility Notice (Gas)
ELECTRICAL APPROVAL
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
t
c
Final � _
Utility Notice (Perm) W
w.� i•�: - i.�.;isa:�:w�.:-0+i'--+-�...Yv�w7�,i'1+^.»r�.yti.�.:.�.+�t'ati.+�'%f.Krr ��+•`1r'''r"'"``3*k.*$:yx•"J'y'f11s4S.�Gt-'��r•av,�l.rr _..�(�,.,-.:.. �"•--: �•-r ��y ,
,A el „
• � �I�IGI�C(/ If
P.O. BOX 1504 APPLICATION ONLY
Building78-495 CALLE TAMPICO
Address IVa r rd LA QUINTA, CALIFORNIA 92253
Owner 0
Address LA QUINTA, CA 92253.
City Zip Tel. ,
Address LA QUINTA, CA 92253
ip I Tel.
State Lic.2 City
& Classif. 6J 1/y el Lic. # Z Z6 /
Arch., Engr., s rl
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (comme cin with Section
7000) of Divi` s ion.3of•the Business antl rofessions C de�and my licegs Is in ful o.� and
eflect.�, �• j
S NATU / '`�._J DATE
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
or 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).
1'_ 1, 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 o! property who
.I'd" 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 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 contractors) licensed pursuant to the Contractor's License Law.)
i 7 1 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
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 thq 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 f
NOTICE TO APPLICANT: IL 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 td
expiration if work thereunder is suspended for 180 days.
I certify that 1 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 -of this city to enter the above-
mentioned property for inspection purposes.
Signature of a0plicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE'CONST. OCC. GRP.
A.P. Number 7-73 " /L41— e!20 Z_
Legal Description Za 41 a23,
Project Description • �• ®.
Sq. Ft. [f ! NO.! No. Dw.
_Size �7,�/ .;_,(Storjes Units
New Add ❑ Alter ❑ Repair ❑ Demolition ❑�
PERMIT AMOUNT
Plan Chk. Dep. J. 150-
/s
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
I
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
' Side Street Setback fro ' Center Line
i back from Property Line
"77 % i
klc'�DATE INSPECTOR
y: cn�� 3 199
ed b ate Permit
Validated by:
QUINTA t
Valid,iLT. Y OF L
.111
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Desert Sands Unified School District
Notice: 82-879 Highway 111
Document Cannot Be Duplicated Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Date 4/1/98 APN # 773-184-002
No. 16837 Jurisdiction La Quinta
Owner NameCoronel Construction Permit #
No. 51-780 Street Avenida Navarro Log #
City La Quinta Zip 92253 Study Area
Tract # Lot # Square Footage 1421
Type of Development Single Family Residence
Comments
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
1.93 X 1,421 or $ 2,742.53 the property listed above and that building
permits and/or Certificates of Occupancy for this square footage in this proposed project maX noV,,be ►sued
Fees Paid By Cashier Check/Coronel Construction
Teleplione- 5644
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green
Signature
"4N
Payment Received $2;142353
Check No. 158279
INOTICE: Pursuant of Ass#fnbly 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 I
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
MAR.24.199e 8:56PM
COMMONWEALTH
SALE ESCROW INSTRUCTIONS
NO. 006 P.1%1
THIS DOCUMENT WILL AFFECT YOUR LEGAL RIGHTS - READ IT CAREFULLY!
TO: COMMONWEALTH LAND TITLE COMPANY. Escrow No.; 98.7390KC
72855 Fred Flaring D^. Date: 03/24/98
Suite A5 Page: 1
Palm Desert, CA 92260
(760) 836-3726
Escrow Officer: Kelly Collier
THE ESCROW HOLDER IS COMMONWEALTH LAND TITLE COMPANY WHICH IS L1:CEI�TSED
BY THE CALIFORNIA DEPARTMENT OF INSURANCE.
Buyer, or his agent, will hand you or cause to be handed you upon signing of
these instructions a deposit in the amount of ................
Buyer will hand you additional funds prior to closing in the amount.of....,,,.,.g 11,000.00
TOTAL CONSIDERATION $ 11,500.00
and any additional funds and instruments required from me to enable you to comply with these
instructions, which you are to use on or before April 20, 1996, p
Ap and when OLD REPUBLIC TITLE
COMPANY can issue a Standard Policy of Title Insurance Owners form, with liability.of
$11,500.00, on real property in City of LA QUINTA, County of Riverside, State of CALIFORNIA viz:.
Commonly known asZk-Pfl 773:184_00.2.,_LA-. QUINTA, CALIFORNIA 92253
LOT 23, BLOCK 121, UNIT.NO, 12. SANTA CARMELITA AT VALE LA QUINTA, AS
PER MAP RECORDED IN BOOK 18, PAGE 79-80 OF MAPS, RECORDS OF RIVERSIDE
COUNTY, CALIFORNIA
Showing title -vested in:
ESEQUIEL M, CORONEL, A SINGLE MAN
Free from encumbrance except:
a
A. Current general and special taxes for the fiscal.year in which this escrow c:los'es, 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.
M
Certificate of Occupancy
City of La Quintal
Building. and Safety Department OFN`sem
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Bui/ding Code,
certifying that, ate 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: 51-780 AVENIDA NAVARRO
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9803-148
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RC
Owner of Building: CORONEL CONSTRUCTION Address: PO BOX 389
City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 6/29/98
Building Official
1
POST IN A CONSPICUOUS PLACE