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0112-151 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of I•-fi Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 04 LU - Professionals Code, and my License is in full force and effect. 0Cf) License # 1 Lic. Class Exp. Date ryryLo q981 j r� LLJ cZ r, mate / Signature of Contractor- ` �Q,,C I { �� ca 0 1 I- OWNER -BUILDER DECLARATION LU LU I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: Z_ ( ) 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). - LO ( ) I am exempt under Section , B&P.C. for this reason O N Date - Signature of Owner 0)d Q WORKER'S COMPENSATION DECLARATION C:) 'e -Cc I hereby affirm under penalty of perjury one of the following declarations: LO O ( ) I have and will maintain a certificate of consent to self -insure for workers' X W �= compensation, as. provided 'fo.r by Section 3700 of the Labor Code, for the m� Q performance of the work for which this permit is issued. Q U () I have and will maintain workers' compensation insurance, as required by O Section 3700 of the Labor Code, for the performance of the work for which this rn H permit is issued. My workers' compensation insurance carrier & policy no. are: It Z Carrier 0,TATF, FUND ND Policy No. 154293" -00 co 5 r,0 (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 Section3700of the Labor Code,shall forthwith°•comply with those•provisions'., r a /Date:. �,., r,' • 4pplicant 1'-` r 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) r C ` ( Date f BUILDING PERMIT PERMIT# 0112-1511 DATEVALUATION . e.���.��,� 10 LOT 10 TRACT BLK56 56 JOB ADDRESS • 52-701 AV�`�i�M�aQ. L�.���6.E�FM- . APN 773424.0,22 OWNER 03-RDNIal VM. MUM 1'© B0X 389 U1 Q'UJRrA CONTRACTOR/DESIGNER/ENGINEER co-tzo1*l.[ , C01�1 *1`R77�i'it7 ' CA. 922M Uk {eUWA ok 922 5:1), C161D)SC-44604• Cl'F3IA 2261 - USE �yyO�F PERMIT f AMIt y y y G W,ALIA int' 0t , SPA C* DWi+;1.�1AY APPROACH. "i'StACTCOA1s`7`y'ROCT'.ION I,431M OF PORC;I•If}+ATIO 36100 S• �4 Yt WOOD TPE.NC.Y, 3tio.00 b? FS'nMN1: D COST 01-C CC3F11NIM67:t•:SflN VYWArr Me 911I�.1af., ai�Z% C.tJNSTRUCI104 It?L 101 -MO -416-000 PLAN CHECK. MM 101-000-439-318 $500.42 MI C> AMICA1, F9111 .101-000.421.000 U0.00 I t,EC°TR CAiL1r ? 1131-000-420-000 $14.44 MIMING FXE 101-1100-•419.000 R ONO MCTIDW PF..F - RESID 101-000-241-01751 B.?3 - di:'tiM;7 NO ITT )01-000-41-3-000 $'atA.4t0 DF,V1,1WPZ9 I.!1+SP�,4:.7+ E 1,rtti.tfa 1'' rIcc"Iff, xlAlq '1 1011.000.441-345 $100.00 FEE DEPOSIT '.101-.000-4.39-316 4250.00 sN. t 211B- JX Mr' fitiC`� i s" + �?�:: C 3 i' AND P'3.,t!I,tA1 C'1'11�X—Y. $3,43034 TRAJP--,1MW.f ":FES Inat Now taAKX74 INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs 2_ Underground Ducts Forms & Footings Ducts Slab Grade _ r/ - Return Air Steel Combustion Air Roof Deck U Exhaust Fans O.K. to Wrap ) F.A.U. Framing ' { Compressor Insulation �� Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wail insulation Condensate Lines Party Wall Firewall Exterior Lath , G Z Drywall - Int. Lath L. Final Final _ POOLS - SPAS BLOCKWALL APPROVALS steel Set Backs Electric Bond Footings 424 _ Main Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines _ C 2 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 _ Appliances Final COMMENTS: Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole �Q Underground Conduit Rough Wiring Low Voltage Wiring Fixtures ! Maih Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power '�'�oy Final Utility Notice (Perm) 37CZ, . �Z j 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 per Section 9.50.090 of the Zoning Code. Its purpose is to determine: 1) that the proposed house design does not duplicate the same architectural style of any house within 200 feet of the applicant, and/or 2) if there is a need for the applicant to file for Master Design Guidelines. If the applicant does need to file a Master Design Guideline, please transmitted this information to the Building and Safety Department as part of your correction list. Please attach additional explanations as necessary. APPLICANT CORONEL CONSTRUCTION SITE ADDRESS 51-701 Avenida Carranza APN 773 _ �`f . - 022 CASE NO.: 2001-592 LEGAL: LOT 10 BLOCK 56 UNIT 5 S.C.@V.L.Q. CHECK AND APPROVED BY: Greg Trousdell 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 Verify legal and APN.information Consistent with MDG on file jas applicable MDG filing required (5 filings since 9/3/98) Architectural variety. within 200 feet of the surrounding area: Colors Materials Architectural design features Q P Other Requirements: GPS. Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 1/25/02 No. 22857 owner NameCoronel Enterprises CERTIFICATE OF COMPLIANCE APN# 773-124-022 Jurisdiction La Quinta No, 51701 Street Avenida Carranza City La Quinta Zip 92253 Tract # BLK56 . Lot # 10 Permit #0112-151 Log # Study Area ' Square Footage 1421 Type of Development Single Family Residence No. of Units 1 Comments Family Dwelling Tract Construction 1421 sq.ft. Paid in combination with Cert.#22858 Total Check amount 5957.30 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 - Hazany Corn`e'Vr. Telephone , E. Name on the check ' By Dr. Doris Wilson Superintendent ti Fee collected /exempted by Nicola Wong, Payment Received 15,957.30 Check No. 261950 Signature NOTICE: Pursuant to 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 ,11-157!2401 10:11am From -COMMONWEALTH LAND TITLE +7603413215 T-858 P.002/003 F-984 `ommonwealth Land Title Company '2855 Fred Wari.aQ Dr., Suite A5, Palm Desert, _CA 92260 .stimated Buyer's Settlement Statement Escrow No.: 11166KY iuyer: Coronel Enterprises, Inc., a California Corporation 'roperty: APN#773-124-022 (Ave. Carranza), La Quinta, California 92253 :scrow Officer: KATHY M. YASI )ate: November 15, 2001 DEBIT CREDIT TOTAL CONSIDERATION $33,000.00 PRORATIONS/ADJUSTMENTS -OUNTY TAXES .................. 28.95 11/16/01 01/01/02 7.24 45 days @.16083 per diem ESCROW FEES, TITLE CHARGES Settlement Charge RECORDING FEES, TRANSFER TAXES Record Grant'Deed ADDITIONAL CHARGES Refundable Buffer RECEIPT DUE FROM BUYER BUYER(S) SIGNATURE: Coronel Enterprises, Inc. Esequiel Coronel,President 11/15/01 009:09:57/KMY 250.00 29.00 50.00 33,336.24 $33,336.24 $33,336.24 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: 51-701 AVENIDA CARRANZA Use Classification: SFD Bldg. Permit No. Occupancy Group: R-3 Type of Construction: VN Land Use Zone Owner of Building: CORONEL ENTERPRISES -dot Building Official 0112-151 RC Address: P.O. BOX 389 City: LA QUINTA, CA- 92253 By: RICHARD KIRKLAND Date: 05-03-02 POST IN A CONSPICUOUS PLACE