SFD (9909-179)LICENSED CONTRACTOR DECLARATION
l•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
ProfesgionalstCbde, and my License is in full force and effect.
License # Lia Class, Exp. Date
Date r ,t 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: l'
(.) . I, as owner of the property,.Or mytemployees 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).'4
( ) I, as owner of the ,property, am exclusively contracting with licensed
contractors to construct the project (Sec: 7044, ,Business & Professionals
Code). 4
O 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 t.
( ) 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• e ' �1 Policy No.
C w ,
i.�ea�.TSiri�.�y1.�.t
(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 C-alifornia, and agree -that if 'I should become.,
subject to the workers' compensation provisions of Section- 3700. of the Labor
Code; I shall forthwith complVwith those'provlslons: f
Dater- -"' '� Applicant / k "�Jf �.�. • ^'�
Warning: Failure to secure Workers' Co pensation 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, iriterest and attorney's fees:
IMPORTANT Application is hereby made to the Director of Building anis Safety
fora , 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- nu11 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-mentio ed'property for inspection purposes '
Signature (Ow(/Agent) - j f /: /fi/ Date '
PERMIT #
BUILDING PERMITa�y_:t
DATE VALLIATION {� � LOT, J TRACT .1l tcl o''i Ott
JOB SITE -
ADDRESS 552-S20 AVEMBA, NA'G'ARROc'
TAPN
T 771-3a5-001
jOWNER }
it"'+✓f1M131'l'Ri'�i
CONTRACTOR / DESIGNER / ENGINEER
l' J'nt'ivY
i\s. oy'C�t3lmc.....
w.,,,•ai,ttc .l,l.� 1,.3•Y 6 L.w-+lr, .tet .
t. fw .3l!A it 1.4..rta ! A�.k�!-•.kf - Ai
110 BOX 389
I CA %W3
LA Q';i4;dTA C.:k 42253
'
USE OF PERMIT
aiINOT ri PA tMILY L,ir1 ELLIbld
.19,11T -.PERMIT G+c"O NOT INCLUDE BLOCK t-H,r'ti'.i;, f a.1i0: L, 3
(wV NaA`i`Cl ft.�f9
V.
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RECEIPTDATE
BY,, /
DATE FINALED
INSPECTOR
� t,
INSPECTION RECORD
OPERATION
.,DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
` BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
terms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
— s %
Exhaust Fans
O.K. to Wrap
_s—QO
F.A.U.
Framing
g Z
Compressor
Insulation
,Z 60
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
POOLS - SPAS
BLOCKWAL APPROVALS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
6
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
Waste Lines
527
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
57
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Al
Utility Notice (Gas)
ELECTRICAL APPROVALS
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
1,0
Utility Notice (Perm)
3'
Buildinge
f�U�cv
n�^`
v ,�
P.O. BOX 1504 APPLI TI N NLY
78-495 CALLE TAMPICO
A..V JNa? J?A LA QUINTA, CALIFORNIA 92253
CORONEL ENTERPRISE INC.
Mailing
Address P.O.
R A
City Zip Tel.
LA QUINTA 92253 1564-4604
Contractor
CORONEL CONSTRUCTION
Address
AM 389
City Zip Tel.
LA QUINTA 92253 564-4604
State Lic. City
& Classif. ( B ) 634981 Lic. # 2261
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACjOR'S DECLARATION
I,heyeby affirm that I am licensed under pr isfons oyChapter;9�(commencing with
7400t
o(,Division 3 of the Bysingps and P;rofIfssions'Code, and my ficense'1stin full I,
OWN ER -BU ILDER`DECLARATION
I hereby afprm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec., 7031'. S, 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 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] 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
Of 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 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.)
1.1 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 it 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, 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
1 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 it work thereunder is suspended for 180 days.
I certify that I have read this application and slate 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 aQplicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE'CONST.
OCC. GRP.
A.P. Number_
(:)01
Legal Description 1 -c -a
ft V_ 04 -. uj i
Project Description��,,
Ft.
`'Stories
New U! Add ❑ Alter O
I
tstlmatea Valuation
No. Dw.
Units
Repair ❑ Demolition ❑
AUG 3 1 1999
v J
PERMIT AMOUNT
Plan Chk. Dep. i C
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
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 11/2/99
No. 19539
Desert Sands United School District
47-950 Dune Palms Road
La Quinta, CA 92253
760-771-8515
CERTIFICATE OF COMPLIANCE
Owner NameCoronel Enterprise Inc.
No. 52-520 Street Avenida Navarro
City La Quinta
APN # 773-305-001
Jurisdiction La Quinta
zip 92253
Permit # 9909-179
Log #
Study Area
Tract # BLK104U11 Lot # 2 Square Footage 1492
Type of Development Single Family Residence No. of Units 1
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 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
� f; .fix.
This certifies that school facility fees imposed pursuant to Government Code 53080 =4,r in
the amount of
1.93 X 1,492 or $ 2,879.56 the property listed above'and that-, uilding
permits and/or Certificates of Occupancy for this square footage in this proposed projOcv ay novV-beissued
Fees Paid By cc/VIB/Coronel Enterprises, Inc. fi Iephon ,T 564-4604
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Juanita Green Payment Received $2,879.56
Check No. 202517
Signature
NOTICE: Pursuant of Ablembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
above will begin to run Vbm the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the Distnct('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Lia mbossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
L�
'A4G-30.1999 10:26AM COMMONWEALTH NO.902 °.1i1
RECORDTNG REQUESTED Ear:
CHICAGO TITLE COMPANY COMPANY
99.9117KC 97057029
WHEN RECORDED MAIL THIS DEED APJD,
MISS OTHERwisiq SHOWN 9= =,
MAIL TAX STATEMENTS To.,
CORONEL ENTERPRISES, INC.
Ra'co]WER•S USE
GRANT DEED Aru: 773,,305-003.-2
The undersigned grantor(a) deolare(s);
Documentary transfer tax is
(XXX) Computed on full value Of property conveyed, or
(...) Computed on full value less liens and encumbrances remaining at time of sal@a.
{ } unincorporated area: ( ) City of and
FOR A VALUABLE CONSIDERATION, receipt of which is he-reby acknowledged,
PHILIP D. CRONEMILLER and VIRGINIA•$, CRONEMILLER, TRUSTEES, CRONEMILLER FAMILY TRUST
U/D/T DATED JANUARY 25, 1979
hereby GIJWT(S) to
CORONEL ENTERPRISES, INC., A CALIFORNIA CORPORATION
the real property in the City of LXQUIYdTA, County of Riverside, State of California,
described as:
Lot 2, Block 104, Unit No. 11; Tract Santa Carmeli_a at Vale La Quinta,.aa per map
recorded in Book 18, rage(s) 75 inclusive of maps, in the office of the County Recorder
of said County.
Dated August 30, 1999
State of California
County of } S,S. PHILIE'D. CRCNENILLER,TRuSTEE
On
before me,
Personally appeared VIRGINIA s, CRONimzLLER,TRus,rEE
personally known to me (or proved to rie an
the basis of satisfactory evidence] to be
the person($) 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 signatures) on the
instrument the person(s), or the,entity upon
behalf of which the person(s)-acted, ex6cuted
the -instrument.
WITNESS. my hand and official seal.
Signature
This area for. official notE;rial seal)
MAIL TAX STATEMENTS TO: CORONEL ENTERPRISES, -INC.
s
r
RC District - Plannino 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 applicabitity of compatibility issues or 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 �2 ob*
ADDRESS: 52-520 Avenida Navarro
APN:. 773-305-001.
LEGAL: LOT 2 , BLOCK 104 , UNIT . S. C. @ V.L.Q.
CK'D BY: r_rAn X-ro sdal1
BIN NO:.�C CASE NO. 99-118 CHECK -DATE:
'Inform- the assigned -Building -plan- checker :upon.yo.ur_assigntnent to this case. The CDD
Executive Secretary maintains a log book -to track applications -and -assign case numbers.
REQUIRED ITEM
Y
-N�
COMMENT/CO ION
..., ... •n:;. tir '.}\..�..`�. .4,,.. x:\:.;.... :•:v. y, :...:v}'i"• ..\^:\ ••'T'i:{{ti:.C;:t::: n�{.:�.}:.\�':.{:.: �`pY4�}f •"<:'\
: i•ti; �n: .\t\L�• \'F ���. C� \ �,'P1:}.�C} \�w\ � �O`�`.'�•�\
Case logged and number assigned
_ Z�
Verify legal and APN information
PQ
Consistent with MDG on file las applicable)
MDG filing required 15+ filings since 9/3/98)
8 \�
C goi
Consistericy -with-street/sur-rounding area:-
Colors
Materials
Archi�c ire
OTHER REQUIREMENTS:'
��% 7S . Z
The zoning code, architectural and landscaping manuals, and/or assigned inspector should
be consulted where :uncertainties arise. The complete ch cklist shall be -maintained -in the
Building '& Safety address file.
s
• �.•"� � ° ' � �
�+FLAN�SN®VVS 8��/ENTS
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_ LENDEL: EXCEMY DOCS\CALMATTIC B1
`
`
10%6/99
' DESFC;RIPTI®N �^
f .VOLTS '"
CKT
AMPS ,
N"®®
UNITS
�/�®i S=AMPS
��PER UNIT
TOTi4L ;� "
vOLT�S mlas-
;....
120 V. MOLT OUTLET CK TS
GEN. LTG @ 3 W PSF " .�
120 1.5 ".,1,475,1,
.3
.4;425
SM APPLIANCE CKTS-
120 .20 2 ,,
1;500
. ` :3;0.00
GRI CKTS
120 20 . ;, . 1
1,500
1 150
w SUBTOTAL,
8,925
120,V SGL OUTLET CKTS
DISPOSAL
,120 ''20 = 1
2;400
2;40.0
DISHWASHER
120. } - 201'
2;400-.:.
2;400
LAUNDRY
120 20 1 .
2,400
2;400
HOOD',
120 3 1
'360,
360
SUBTOTAL
, .
7;560;;
FIRST 10;000 V=A @ 100%
101000;,
BAL -V-A. @A0%
` SUBTOTAL
12;594
RANGE
.230 -,4011-l' 1
9,200`
9,200
A/C (LARGEST FAU OR A/C)
1 '230. 30 .` 1
'>
6;900
6,900.
TOTAL V-A
2 94
8, 6
SELECT�SERVICESIZE
TOTA�V�A '" " '�'�28�69�4 z
�� 1�24�8 <AMPS