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9702-067 (SFD)U� N W �; ::) M r-dLO W Z r O� W W f— 11 U) Z co to N ON U °) a Q T a� Ix 0 LL X W — mU O U tl rn H Z_ co 5 �O J 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 63;1381 }i f 1131/98 / Dat%� r f torin g� Signature o Co ntra c 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 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. ( 1 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: Carter Policy No. C:01, Dt.;v VAGLT; IN,;. (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 rthat if I should become subject to the workers' compensatiggn provisions of Section 3700 of the Labbo Code,'I Fiall f rthwith- omply with 4hose provisions. Date: 7pplica t- �� t 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 he above-mentioned g27, for inspection purposes. /Signature (Owner/Agent) )/ 11 - /r_ Date — A-1 7 BUILDING PERMIT PERMIT# CO�iROL# 704167 4 814 p DATE Q VALUATION I2E}.Z.�t� LOT ILll i� - TRACT /f /� APN ADDRESS., SZ_ A5 elVENJIM (ARRANZA "OWNER, CONTRACTOR /*DE(SIIG{NE/R / ENGINEER 9 {' ( {� { (� j 1*SEQt F`1 yii fyC.JI111 114 �rl I f j CYi.�l�.f�`��l.. f.s `.. iJt�ig m I��r 11 jm 11.C). BOX qtr) 51 k4t0 EUS I"NTf0WER UR. E.A (;)ll11` IIA ('A 92451 LA QI.JftT('A (.'F1 0225i €Ml�liif�4-A1C-�O:S t'13l.N :�ta1 USE OF PERMIT SI'0 - MJ;RItit t Lit- ws N01 fNt.:Lt )t: t4t,(XK WALLSOR I' X)L. IiUf iii WS (NCIAAA3 B)tl t..V , G' WCK)ts 1+1:N(21,' 'M'A(7r t'C.)isilRUCTIC)N 1,,-m iiti ,, 1+(_�Itt'JuE'A"i1U 30.t)U 3F 0AXA(; K*ARt°0 KT 510AM S)' 1W1,11MATY11) C ST OFWN.10:Rt3i"E'ION !�tiRISlS.�t} f VkMI t' FEIIj; SIIMMARl' t'r NV:S`00_tC1'ft.�N f i fs ii)l. C+�KJ alti-(li>tJ �S+Kr trl !-If ON114 lits("ts Ti:fr ilil•{lfjfl..Yi9-�ifi 'S5(1f.4$ Voif) 00 R•ifct'1),�.N#t.:�iJ. f fst: 101-000-4114}t)i) V#0,00 1011 -MV -4104K10 ��I tYR•fl•11C�(Ct):{ar fE11_(�)O,,t•1t;`.dl1Fi) x1� 7S I'rl(iv,t't 101 (xi() 211 Est)() xv (13 tfItht,11tVt f't;fs iiJl iftltW21.00 $&)is 2."l-000-4,13-342 51,931 79 fRttt.+•t f?tYt qt:l 16!.4".4.11•"W5 1"nIti utairn-.c•t� P,ts 10 [±r J�.`. 1)[Z1 1`1:1.13.lit!' � 'E"t�}'A1,PERMIT 1?VES OtIV NOW �3.zU�.ttii 15' 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 St Combustion Air Exhaust Fans OX to Wrap If —1- F.A.U. FramingCompressor Insulation — 4— 2 '% Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Pa II en Drywall - Int. Lath 012 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 APPROVALS. Gas Test Electric Final aste Lines Heater Final e Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection - 2 Encapsulation Ga Gas Test Final COMMENTS: Final 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 Utility Notice (Perm) r Building Address c&t 4 ui,tc� P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO 01rt,gJA LA QUINTA, CALIFORNIA 92253. Own�er.r X. / 1 Mailing ` Address U2W CityZipqz .5 Tel. Co/ntract��or U fe(�< �� Address`. Cj7,4- ry IZip State Ljc.City � ✓> Lic. # z2 Arch., Engr., Designer Address Tel. CityI Zip I State I Lic. # I h rrelf affirm hat I am Ifcensed under provisions of Chapter 9 (commencing with Section D00) gf Divisio 3 of the Business and Profests�'ons Code, and my licgn a is ip,(u fore o) r 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, 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 or completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) "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 contractors) licensed pursuant to the Contractor's License Law.) 0 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 0 Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 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., 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 ame 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 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 applicant -Date- Mailing ateMailing Address City, State, Zip BUILDING DIVISION BUILDING: TYPE CONST. .C_ �7 OCC. GRP. A.P. Number ! -7 95 —' ?)�- 2 Legal Description j_ C/ ��� • /�� Project Description l Sq. Ft. Size New ❑ No. Stories No. Dw. Units Add ❑ Alter ❑ Repair ❑ Demolition ❑ itimated Valuation PERMIT AMOUNT Plan Chk. Dep. 2J�0 ao 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 t Side Setback from Property 6jae FINAL DATE INSPECTO Issued by: Date 1997 Validated by: Validation: CITY OF LA rm;; CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMtIIN 1ST FL. SO. FT. @ $ UNITS SLAB GRADE 2ND FL. SO. FT. @ BONDING YARD SPKLR SYSTEM r POR. SO. FT. @ MOSILEHOME SVC. BAR SINK GAR. SO. FT. @ POWER OUTLET ROOF DRAINS - CAR P. SO. FT. @ GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. @ OTHER APPJEQUIP. DRINKING FOUNTAIN SO. FT. @ TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation t FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)IDISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B,T_U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY FIRE ZONE ROOFING HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 1 Y. c SEWAGE DISPOSAL SO.FT.GAR @ 14c HOUSE SEWER t GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING R AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ pius xb =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION ' CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 01/01/1994 18:07 6195644202 CORONEL CONSTRUCTION CITY OF LA OUINTA tMdeUuTNG & SAFETY DEPARTMENT y 777-701 �N%N �� SP ON REQUEST LINE 777-7169 L CORONEL Owi>rx Corhr=W PO"ot N»ndw 9702-067 POST b IN NSPICUOUS PU4CE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 52-685 AVENIDA CARRANZA SFD - PERMIT TOES NOT INCLUDE BLOCK WALLS OR POOL,BUT DOES INCLUDE 200 XT -Nr z TYPE of Powec im DATE INBP. FOUNDATION a �'TBAGK P00.1 NO STEEL � a!R UNO NVVMM DO NOT POUR CONCRETE UNTIL ALL O 14AS BE N SIGNED CONCRETE 84AB DO NOY POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED GAS TEST - - BOND BEAM O.K. TO WRAP GROUT O 4' ❑ V 1 FRAMING F 11 I I I T - d AWK APPROVALS 00 NOT INCLUDE RIGHT TO 7/96 TURN ON UTILITIE8 OR OCCUPY BUILDING PAGE 05 i JAMES O. WALLACE Agricultural Commissioner Director of Weights & Measures OFFICE OF THE AGRICULTURAL COMMISSIONER P.O. BOX 1089 RIVERSIDE CA 92502-1089 PHONE (909) 275.3000 FAX (909) 275.3012 46-209 OASIS STREET, ROOM 14 INDIO, CA 92201 (619) 863-8391 CALVIN C. KAMINSKAS Assistant Commissioner DAN RILEY Sealer, Weights & Measures (909) 275-3030 FAX (909) 276-4728 DATE- c7 �' % CASE NO. �)C. C(3 O Q'_/ / ` DEVELOPER'S NAME: C-0 'CC kA eA C101. c i L ADDRESS: CJ, �Q 357 �tlk Qy�� Co' TELEPHONE: Dear Developeri. After reviewing your landscaping plants, all plant material listed is not in violation of quarantine laws governing the Coachella Valley. If substitutions do occur and they differ from plant material listed, this office must be notified immediately. Thank you for protecting and preserving the Coachella Valley's pest -free environment. Agricultural ommissioner's Office cc: Indio and Riverside i Notice: Document Cannot Be Duplicated Date 3/13/97 No. 15325 Owner Name Esequiel Coronel Desert Sands Unified School District 82-879 Highway 111 Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE No. 52685 Street Avenida Carranza City La Quinta APN # 773-285-022 Jurisdiction La Quinta Permit # zip 92253 Log # Study Area 112 Tract # Lot # Square Footage 1438 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 This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.84 X 1,438 or $ 2,645.92 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 BankNIB CLA Tele p`ti 564=4604 - Name on the check By Dr. Carol McGrew iY Administrator in Charge ' Fee collected /exempted by Pauline Pearson Payment Received $2,645:92 Check No. 137615 Signature - 10TICE: 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 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 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