9809-102 (SFD)LICENSED CONTRACTOR DECLARATION
U) 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
04 LUU)
. Professionals Code, and my License is in full force and effect.
C) M License # Lic. Class Exp. Date
r-_ LO 6-14 SI 8 1/3 Vol
�'
LU �� 7;
or
e
C:) Z I- /Date S ignature of Contractor
7'. 5 ir,� I 'Lll - -_
P: C:) OWNER -BUILDER DECLARATION
L)
„tt
LLJ LU I hereby affirm under penalty of perjury that I am exempt from the Contractors
License Law for the following reason:
Z, ( ) 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, Business & Professionals Code).
1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
co I am exempt under Section —, B&P.C. for this reason
LO
C\i Date Signature of Owner
0 C\J
rn
WORKER'S COMPENSATION DECLARATION
Z
CD cc I hereby affirm under penalty of perjury one of the following declarations:
Lo <
0 have and will maintain a certificate of consent to self -insure for workers'
X LU � Compensation, as provided for by Section 3700 of the Labor Code, for the
0 _J _J performance of the work for which this permit is issued
Cal :J < -4
< 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
11. L,6 H permit is issued. My workers' compensation insurance carrier & policy no. are:
It Z CarrierPolicy No.
ob Z)
GOLD,2714 EAGLE [INS. 1189VA
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,
niand adree th6i-if I should become
ei Z. -L
subje(ct to the workers' compensation of S ction 3700 of -the bor
Code, ehall- rthw'thn-Icomply with those prdvisiohs.
Uate: Applicant
�o
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
4 1
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
constPuction, and hereby authorize representatives of this City to enterrupon
,)
the"above-mentioned property/for inspection purposes:— ' t
)
/Signature (Owner/Agent) '111 --,/Date
PERMIT# CONTROL#
BUILDING PERMIT 984W-102
DATE VALUATION S89,413.51) LOT 7 TRACT 181,22H
fib
JOB SITE_5111-14APN
5 AV ENI RAMI RrlZ
773-06.1-0.14
.IDA
ADDRESS
OWNER
CONTRACTOR / DESIGNER ENGINEER
ESEQUIF1. CORONEL
CORONFEL CON1,1URUMON.
51-540 UISEN HOWER DR.
51-5,10 EISEN' HOWFR R.
LA QUIN'l-A CA 92253
LA QLJIMrA CA 92253
f.76015644604 CBTA 2261
USE OF PERMIT
S TN ds L.R, F A. M i 1, Y D Wr EL L N G
SFD - PERMIT DOES NOT INCL. WE GLOCK WALL OR. POOL. CORONEL
MA'31'F12 01 swmiTrAL
TRACT C0NS71V%JCTX)N 1,42103 Sr,
PORCI VPATIO 36;.00 SF
(.'YARA0EqC.ARpo.K'r 50.00 3F
G FT. WOOD FENCE 2W.00 LF
M M CONT OF CONSTR I ICTIM, I
s 4 13, 5 119
PEWVHT FEE &UMKAWV
0)1N.8,TRVCr10N FEE 101-0010-418-000 $594.50
P1.! N (11iFICK $502.70
MECHANICAL Fffi-- 101-OM.421-000
IMEECTRICAL FEE lot -000.4,11-0-000 $123.52
PLUA,f6fNG FEE 101-000-419-000 $133.50
STRONG M(YFIC)IN 113F - RETD 1.01 -000 -241 -OW "w9d
GRADING FIX 101 -OW -423-000
I14FRAS'rRfJUI'URL FFE 225-000-443-342 $1,962.78
PRECISh PLAN 1011-000-441-345 S211510
FFE DhPOSIT 101-00()-439-311 425A.00
$3,424 44
LESS PRE-PAJD 1,7EES
-$2.50.00
'10 T A t, I' E R, M f'17 F FN W E N ONV
$�%174.44
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
A
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
1A�_
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
A
Combustion Air
Roof Deck
��
Exhaust Fans
O.K to Wrap
F.A.U.
Framing
Compressor
Insulation
//dZ
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
BLOCKWALL APPROVALS
POOLS - SPAS
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
If
Gas Test
Electric Final
Waste Lines
6 _
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer LateralPool
Cover
Sewer Connection
/XI�6
Encapsulation
Gas Piping
Gas Test
Appliances
Final
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
t
c
Final
Utility Notice (Perm)
COMMENTS:
,
P.O. BOX 11604 APPLICATION ONLY
..
.�, 78-495 CALLE TAMPICO '
R LA WIN% CALIFORNIA 9=1
1 ' oo�� BUILDING: TYPE'CONST:' •_OCC. GRP. '
p,
JC3 5 A.P. Number I �,��"
CI Zip Tel.�^.. �� Vr7 i >�'..� ....
Legal Descriptlon
Coy�ractor ,:. , .: ProJec� D criptlon ...
v ^ l
Ad ase
CI Zip Tel r .y
v.
'-State Lic. City
d Clasalf. l l Lfc. M FL No. No. DW.
63 �� �e �zL Vie::. /Ll 1 $tD111e8 Unita ?
Arch., Engr.,
Designer New fia� . ` Add O' Alter" O Repair .O ' Demolition 0= t_ j
Address Tel.
CityZfp State
Lic. #
UCEN CONYRACTOR' t�RAT10N _
I her Itlrm that l Ilcen under Drool one o1 9 (commencing with Section
ton 3 0l Bual and Profeealone Code II a In full f
ML
OWNEWBUILDER DECLARATION "
Estimated Valuation
' I hereby e111rm that 1 am exempt from the. Contractors License law for the following*
reason: (sec. 703 1. 5.8ushsss and PrWeaslons Cods: Arty city or sourly which. requires a
n� s construct.
e appoccent for such Permit to'or repair a any
KKrt ttMt. he b �«ftIssuance Afto
raed pursuent to PERMIT
the provisions of the Camactorb License law, Chapter D (eornmeneMp with Section 7000) of. -
Division ] of the Business and Professions Code, Of that. he 13 exempt dlerefNm, and the Dealt s
lir the ~ exemption. Any rlofetlon of Section 7091.3 by 'airy appscant rot a perm). Plan Chk. Dep.
sulrects the appsceu to a dos penally or not mon than Ove hundred dosera ftso0). Plan Chk. Bal.
1': I. u owner of the property, or my employees with wages as their sole compensation, will
do IM work, and the structure Is not Intended or offered for sale. (sec. 7044, sureness end' Const:
Professions Code: The Contrector's License Law does not apply to an owner of prgoeny who
Alps or :pro es thereon and who daft L such. wwk himself or through res own employees.
Provided that such improvements aro not attended or offered for saps. h, 'however, the didtp Mach. `•-'? :;:3i
or improvement is sold within. one year of completion. Me owner-Dusder will. have the burden Electrical
of eowrp that he did not bred or improve for the purpose of safe.)
1 1 1, as owner of the property, am exclusively contracting with licensed contractors to con: Plumbing
atruct the project. (Sec. •7044. Business and Professions Code: The Contractor's License law - •. � ��
does nor apply to an owner of pfoperty who builds or improves thereon, and who contracts for S.M.I.
such projects with a connactor(s) licensed pursuant to the Contractor's License Law.)
'Grading
i 1 I am exempt under Sec. B. 3 P.C. for this reason a c
Driveway Enc. }'=
Date Owner Infrastru tU
! WORKERS' COMPENSATION DECLARATION''}'`'
1 hereby affirm that 1 have a certificate of consent to self -Insure, ora certificate or
Workers Compensation
.1nsurance, or a certified copy thereof. (Sec. 9800, Labor Code.)
Policy No. Company
n Copy Is filed with the city. O Certified copy la hereby furnished.-:'':�•
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE R A K$ �
(This section need not be eompfeted ff the ponnt Is for arra hondrod doses (f 1001 valunuon �
or Nes.)�1' : :.-•: �'-i
j I certity that in the performance of ting work -for which this permit Is issued, I shall not
employ any ppeer
Lawornla son in any manner so as to become subject to the Workers' Compensation
s of Calll
NOTICE TO APPLICANT: ff, after maU1g this Cerfffcate of- Exemption you ah&W Broome ZONE BY: r
suaect to the WbraM' Compensation pnvisbms of the Labor Code, you must I&Mwltlm
comply with such provision or trot perm* &heti b/ deemed revoked: Minimum Setback Distances:.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY „<r j
i Side Street Setback from Center Line
1 hereby affirm that there Is a construction lending agency for the performance of. the
work for which this permit Is Issued. (Sec. 9097, CNs code.) Side Setback from Property Line -
' Lenders Name .. •. i,kf= .:,.
\LanMre Address - FINAL DATE INSPECTOR
i This Is a building permit when property filled out. signed and validated, and is subject to
expiration if work Iherounder is suspended for. 180 days.
I certify that I have read this application and state that the above information 'is correct Issued by: Date Perm x,
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. nbae
mentioned property for inspection purposes .Validated by: . .
s,
Slprutun of aQpllunl pate + �•��^�
Mailing Address Validation:
�... City, State, Zip e a 3 ins tm !
I WNRE o FINANCE YELLOW . APPLICANT ` PINK. BUILDING DIVISION
p
Notice:
Document Cannot Be Duplicated
Desert Sands Unified SchooPDistrict
47-950 Dune Palms Road
La Quints, CA792253
760=77178515
CERTIFICATE :OF .COIVIPLIANCE
Date 9/21/98
APN # 773-061-018
No. 17775 Jurisdieiion La Quinta
Owner NameEsequiel Coronet Permit #
No. 51-145 Street Ave .R`atni,rez; Log #
City La Quinta Zip 92253 Study Area
Tract # Lot # Square Footage 1421 -
Type of Development Single Family Residence No. of Units
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 thi's time due to the following
reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Gover•.nment Code 53080 in the amount of
1.93 X 1,421 or $ < 2,742.53 the 'p,roperty 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 CC/Zeke Coronel Telephone. 564-4604
Name.on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Ellen Patino Payment Received $2,; 42.53.
Cheek No., 176819 '
—�
Signature
lOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify,,youthat the,90-�ay approval period in which you may protest the fees or other payment identified
above will begin to run from the date on which the building or installation permit forthis project is sssued or on which they arepaid to lhe'District(s) or to another public entity authorized to
:.Ilett them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original -'Building Dept./Applicant Copy - Applicant/Receipt, Copy - Accounting
SALKESCROW;INS.TRUCTIONS r
1 Y �• i
THIS DOCUMENT WILL AFFECTYOUR LEGAL RIGHTS - RE, A, IT CARE,FULLYr
TO!GOMMONWEALTH_LAND'TITLE COMPANY 1-i Escr:owkNo.:
9876571
.72855-,.Fred Waring .Dr. Date: 06/15%,98•
Suite A5 ; Page: ' 1-
Pa l:mD.es,e,rt , CA 92260 -
{;
(7G0) 8.36,-372:6
s'
Escrow. Offi cer - Kelly "Col 1 i er
4,
—THE
THE ESCROW HOLDER IS COMMONWEALTH. LAND TITLE COMPANY WHICH
IS LIC
131' THE CALIFORNIA DEPARTMENT-OF INSURANCE.
Buyer,will hand you.additi.onal funds prior.to closing in .theamount
TOTAL EON$IDERATION
and any additional funds and instruments required from me to' enable you;to
comply w
instructions, which you'are to use on or before July 15, 1998, and when=:OLD
REPUBLI.�
' COMPANY can issue a Standard Policy of Title Insurance Owners form, .with liability,`!
$16,000.00, on real property in City of LA QUINTA, County of-Aiverside{�State
of :CAI
Commonly known as: APN 773-0:61=018, LA QULNTA, CALIFORNIA 92253
9
LOT-7—BLOCK 78 ��UNIT,rN4,, ,� ,SANTA CARMEL:ITA ATthVAI�E LA QUIN�CA;, ASS,@+�3'k'�
uPERMAQr RECORDEQ;tIN BO,QK 18 OF MAPS R CQRDs OF ;RIVERS
;,
!a
Y �
„PAGE,69.
CQUNTY, C-ALFORNLA
,
Except any reservations of record of minerals, oil, gas, water,
carbons ' and
hydroca
Showing title vested in:
k,
J
f
;
ESEQQIEL'.M. CORONEL, A SINGLE MAN"`
`i '
?
'Tt_
''
4
•1) L f4 .l - , 1.
f
' Free from encumbrance except
�
I�
-�.
'a
j . .°;
. V" 'Current general and special' taxes' for the ,fiscal yealr-I
i n which .this
escrow e
-taxes .;for 'the ensuing year , i f any,' a lien not yet due
or-payable.
B The lien of supplemental taxes, if -any, 'assessed pursuant to the provisions-
rovisions
3.5
3.5 (commencing°with Section 75) of the Revenue and
Taxation-Code of the Sta
'Cali-fornia.
i
1
C:Spec.al ` mpro.vement-.;assessments , i f any
�9
:DEasements ; rights rights of way, covenants , condi ti ons , restrictions
} l'
a,nd, re
' record I If
�- 12/21/98
CITY�OF LA QUINTA
1
INSPECTION` SUMMARY REPORT -
Address 51-145 AVENIDA RAMIREZ .
Permit Number 9809-102
Site
Rereference Number
Sitee'City
Location of Project '
Date Applied -for 9/1'6/98
Date Approved
Owner Name ESEQUIEL• CORONEL'
Issued 9/21/98
51-540 EISENHOWER DR:
.Date
Date Finaled 12/17/98
LA Q.UINTA _
CA 92253
e
'Date Ekpired
Contractor • Name CORONEL-.CONSTRUCTION
Valuation $89,413
51-540 EISENHOWER DR• `
Fees 3,424.44.
LA,,QUINTA
CA 92253
Description of,Permit SFD - PBRNIIT.DOES-NOT INCLUDE BLOCK WALL OR POOL ,CORONEL MASTER # I SUBMITTAL
I N S, P' E C`T.
I O N S S C H E D U `L E D .O,R
C'O M P L E T E D
Scheduled Completed
Dafe Date Time
Inspection Type .Insoctr Irisprection Result
Inspectors Comments
-
10/1/98 10/ 1/98,!,:
AT'P=GND ' "DPC PP:SS `,' :.
10/1/98 —IOP -1/98 '
6. -,§EWER; DPC PASS -
10/ 6/98 10/ 6/98
AO'EDN DPC PASS.
' 11/2/98 11/ 2/98.,
'
,1357ROOF DPC "' PASS
B7=.WRAP DPC .. PA$S' .
OK TO INSULATE. FRAMING
11/9/98 11/9/98
CORRECTIONS PENDING
]1/]0/98 11/10/98
BME8=FRADPC . PASS
11/12/98 11/12/98.
B9.INSUL -DPC. PASS ,
11/16/98 11/16/98
CO=D.WN DPC PASS
1]116/98 11/16/98
Cl -LATH =.. ' DPC PASS
12/14/98 12/14/98
-B21`G-TEST...• ,- DPC PASS
12/16/98 12/16/98
. DO=E -FINAL DPC PASS
12/17!98 12/17/98
'D2 -COMP** DPC PASS
12 Inspections completed:
1=
ifCertific*a'te_ of Occupancy �� ,
City of La Quin'ta- ICE
Building -and Safety. epartment �-'OF
�TM ~
This Certificate issue%d purs'"uant to the requirements ,of Section 109 of; the Uniform, , Bui/ding `Code;
certifying that, at thea tune. of issuance, this structure. was. in compliance with the carious ordinances
of.ahe. _City regulating building -construction, or use. -For the fol%wing
BUILDING ADDRESS::. > :. 51-145 AVENIDA
sRAMIREZ
a:.
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9809-1021- .
Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RC
Owner of Building: CORONEL CONSTRUCTION Address:51=540-,EISENHOWER DR:
City: LA'QUINTA, CA, 92253
By: DANIEL P. CRAWFORD JR.
Date: 12719/98
Building Official
POST IN A CONSPICUOUS PLACE