9912-152 (SFD)LICENSED CONTRACTOR DECLARATION.
Lk I hereby affirm urider 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
Date. 7:u Signature of Contractor i
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).
( ) 1, 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.
( ) 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:
Cartier Policy No.
00.1.1)ENEAGUE INS.
IVIV 11.D3Z"s
(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 l5rovis9ns;. /J , / N
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
r
the above-mentioned property for inspection purposes.
Signature (Ow er/Agent)' — Lei``",Date---9
BUILDING PERMIT' PERMIT�w+'
'
ryJOB
DATE VALUATION LOT LOT TRACT 5
ADDRESS A9''ENMA RAIV41} L
125-0
OWNER -i r
CONTRACTOR
CONTRACTOR/DESIGNER/ENGINEER f
TiSI QXJTCL CORONE ,
31-510 EISENHOWER UR.
51-540 E15i1i1`II1O`dL'M DR.
LA QUIMI'.A C'A 92253
LA Q1JiNTA. CA 91M3
r,60.1364-11604 CB1,f{., 2261
'
USE OF PERMIT
S.It+►i: LE r.ALIOLLY L1bi/Eu,fly: 6
• . J
TRZAC'.i CONSTRUCTION 1,301.W S:F
�x
POR43 10 58.06 S1
(_7ARA(ai IJARPORT •ifiY.E3t) ;fY'
��."
5 FF. WOOD f L;NCE 200.00 UF
t
4
..
1t vTMIATt;D CWT �s ; �i1`•r�'� ai�4"a.BIZ
� � � e33._fi}�.`"sti.�;p
CCJN8't'.fcUC1'1QN HEL 101-000-418-UU:? fid) E..>t►
r i Vii; r r
P1, AN c 4f,(K r f; . 10t -000-439-3f S
i ;ti 1 r f t �, Ail
rri.Cfe�atil+.:�rS�. 4LE
x.
.N t,1 ECTIdWAI. FEE i01 -000 -420 -OW
--l-)PLUMBING FEET 101-000-419-000
s; t'it( m.,i hin,now i izi7,, _ Rrumi Ityl_01t o-^41-00) `b9.31
G:x ALV-fG I Ur, 101-000-423-000 $120?il,`
7 .
LA3V:ttt.,C!!1L1f.11VIPAC F FDE $1,Eti1i.iii.)
1>12Et_"ISE; ELAN 101 -WO -441-345
t F1? 31EnrlKl'r 101-00()-439 3l�c 47.50.00
'
ti( i)1. TCi1;A l:, (`(jjlJ �;1'k f If' �'►1 )Rr AND PLAN ('"F;rX
, �; t 4t5rt; 'l
7_
a.,ES?S 4 yRIE--iiAID FEES-
425 0.o*
TE3°@AL 1'Et2f4M' FEV: S DUE NOW
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR it
INSPECTION RECORD
OPERATION,
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts '
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
?,- �-7- _j7
exhaust Fans
O.K. to Wrap
3J f pc S
F.A.U. o
Framing
. io
Compressor
Insulation
Do
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 i
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
_ c.(_490m s T
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
Waste Lines
Water Piping
Heater Final
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
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole S7
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)
COMMENTS:
-
Building
Address
mailing
Address i2.
4Q9
P.O. BOX 1504
78-495 CALLE TAMPICO
7%i,//?6 x„ LA QUINTA, CALIFORNIA 92253
`��I2-ISZ
Sri LY
LDING: TYPE'CONST. OCC. GRP.
. Number 7-7-3 5
— /-9- Q/&
al DescriptionZ677 L/ /31 if 7 5 1 OA) /T
t,oniracror
Project Description
//11
Address
City
Zip
Tel
State Lic.
& Class C,
%,; � -�
f 3J lc toIF 1 �.
City
Lic. # �'� 76
r ca
Sq. Ft. /� No.
J
—4 No. Dw.
Size __ t,J Stories
,.-- Units
Designer
Address TeL
I NewLE; —" Add ❑ Alter ❑ Repair ❑ Demolition ❑
CityI Zip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
that I am licensed under priivisions,ofoChapter.9 (commencing with Section
3 of in as a G Professions Code; and m"'fj.licens is i fuPorce`a d
I OWNER.BUILDER DECLARATION
I hereby alit) that I am exempt Irom 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 (5500).
l: 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 of 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 11, 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.)
I1 I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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
r7 Copy is filed with the city. O 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 (5100) 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, atter 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
Ihereby 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 - If
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspende;se or 1 s.
I certify that I have read this appli a d t to at the above information is correct.
I agree to comply with all city and d c and state laws relating to building
construction, and hereby authorize ep 1 i .of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address— DEC 10 i9909
City, State, Zip
r— LA '
Valuation
PERMIT j j ef— AMOUNT
Plan Chk. Dep
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
b a?
Desert SandsiUnified School District
• . 47 95QaDune`Pa1ms:Road
Notice: La 0,uika; •CA• 92253
Document Cannot' Be Duplicated r 760 771;8515,
CERTIFICATE 'OF COMPLIANCE
Date 1/20/00 APN #. 773425-016
No. 19924 jurisdiction :....La Quinta
Owner NameEsequiel,Coronel Permit #
No, 51-565 Sheet. Avenida Ramirez
City U'Quinta zip 92253.
Tract # Lot # Square Footage
Type of Development 'Single•FamilyResiderice '
Comments
Log #
Study Area
r,
`1501
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 SOO squarer -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 19501 or.$ 2,•896.93 the property listed: above and ;that -building;
permits and/or Certificates of Occupancyfor this square footage in this proposed project may 'now b' i sued
Fees Paid By CCNalley Independent=Bank/Esequiel Coronel ,, Telephone =X760 -`5b4-4604
Name ;on the check
By Dr. Doris Wilson -- -
Superintendent
Fee collected /exempted by Ohvia Aguirre Payment•Received " $2,896.93
Check No:. 209578 .
Signature
NOTICE: Pursuant lof Assembly Bill 3081 (CHAP 549 STATS. 1996) this will serve to -notify; you that the 90iday approval penod in which you rn ypiotest the fees or other payment identified above willbegin:to run from the date on which the building of 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 oftounty.or city.plan check_applicatioo form -to district copy for all waivers.
Embossed Original- Building Dept]Applicant Copy Applicant/Receipt' . Copy - 'Accounting
3-
DEC. 7.1'399 12:08PM CTC SLIDDIVIISION FIND Prr1YC)F7S N -D,8_54 P.1
RECORDING REOUFSTED
& `,; T, -*1 e-->
ANO WHEN RBEC90ED, MAIL TOD
i
I
1
Caronel Arttespri.ses, Inc.
P.O. Bax 89 }
La Quinta, CA 92a5z
__ 7X j4 &)df ~Ci/(,
ASSESSOR'S P:9RM NO,:
TITLE_ ORDER No.;
-7�- 12.s., Z—o
7�3�• 125E s�Ia��2-
11aDra�al� of document Recorded
on m}as Na. SZ lk r
Has not !seen compara-d with original.
GARY I.. 01150
County Recorder
RIVERSIDE COUNTY, CAWFORNIA
TMI-'; SPACE FOR gscotIDsR 8 LMF o.n.1
The undar9!gned Grantor() declaraet(S) that the DOCUMENT TFtlawSFER
TAX IS:
$ 44. W COUnty S city
ESCROW NO.: 19203-004 _ XX cOmptrtOd 0!1 th8 full value Of the Intareat of ,property 0onveyeC, or
`— — corr►pUTOd on the full value less the value of Items or ahcumbrances
GRANT rernxina'ng thereon ant the t!fre of sale
DEED
OR transfer is EXEMPT from tax for the toliowing reason,
_
FOR A VALUABLE CONSIDERATION reoelpt of which is hereby aci r"Wedged,
Henry c. Griswold, as txustge of the Henry Griewoid Living Trust 2sta3blizhed pursuant to
that certain document entitlgd "declaration of Trus k".dated June 19, 1995, and executed by
herebg GRAA!T(S) tolHatry C• Gr iswold as .Trustor and Truatee
Coronel EA-texprisesi Inc.
all that real propefty_e9tuated In the jCity of La Quinta
County ofR _ rets de State of Cahfomi.% described as:
LOSS 4 A4FDy6 IIt 81 OCIC 5� OF 'SAN'TA
8.r �,�._: < + CP,RMtiI,ITA AT V11T.LTI.l,Q[T-1.ITA, UNIT NO,5 .A<.,S SNOWN BY MAP
Or! Y1LS 1N SOOXKILg LPa>;Gss .,3• OF MAPS, RECORDS or RIVBR5ID.E COMM, CALTPO2. 1A
i
Dated—A-el,tember os, 1999f
r
STATE OF CALIFORNIA, '?
C.DUNTY OF_ Riverside SS.
On ?Jecem.te 2, 1999 _, before me Cin. uz to
Notary public, personally appeared
-- Henr.y C. ^arae^4ro3d . trus�®e
b^-x'y Gzi�rweld, taR,�,c ea
personally "nwrf to me (or proved tto me on the basis at
satisfactory vAdence) to be the Person(s) whose name(s)
CSV
is/era subscribed to the within instrument and acknowledged
to me that he,/ahtfthery
aguR�Iry
a' coatlln. s t:soaaa
executed th® same In his/bep�thelr
N oTokowFWLr�'�ftl1A
authorized eapselty(lee). and that b' hls/11eFfaftetr signature(z)
y
pne�sroaoay.^ry Q,
mycon�.,e,>�,.,.yazczaax
on the Inelrurrent the person(a), or t entity upon behatf of
which the acts
person(s) , exaeuted th�lnstrurrent.
WITNESS my fiend a 1,
Slgnawre
MAIL TAX ST<,TEMENTS •T
SME AS MOVE -
A AF"r.ES
i
Ory. STATS 6 Zip
7000: TCV0'1 1TZT'1MJ nT00 On!! nnl T vV.• nr n� r.nT nn ... .-�
b
This form is to..,be. used by CDD staff for review,of single family dwellings in the RC (Cove
Residential) District, i'n order.to determine tFe' applicabiiity,of` compatibility issues or need
to require the filing of:Mdst.er Design°quid'elines by°the,applic'ant. It shall be transmitted to .
Building & Safety as your.:correction list: Please attach 'additional explanations as necessary.
APPLICANT: CORONEL CONSTRUCTIOIN'
PROJECT
ADDRESS: 51-.565 Avenida Ramirez .
a:.
APN 77.3-12.5.-016'
LEGAL: LOT 4 BLOCK 55 ' , UNIT 5 S.C. @ V.L.Q.
Fred Baker
CVD BY: a
CASE NO,. 99-1BIN NO:
.67 _.Y`.CHECK'DATE:
,
Inform the assigned Building plan checker upon..yo.ur,!_as.signment'to this case. The CDD
Executiye Secr'etaryrmaintains a`log book id,%track applications and assign case numbers.
The zoning code, architectural and landscaping manuals, :and/or assigned inspector should
be consulted where uncertainties arise The c"ompleted;: checklistahall be maintained in the
Building .& Safety address file. :.
;j
Certificate of Occupancy
Cityof:.L�a Q�un�ta
cs .
s,
Buildn: an SafetyDpp. artment
g
ThisCertificate-issued pursuant to ,.ttie requiremen#s ;of..Section 109 of. the Uniform Bui/ding Code,
f ,
certifying that, at the � time of issuance, this structure was ,inr comp/iauce wiith. the various o.'rdinances
_
o'f the City-regu/ating:bui/ding constru`cton::or use. For the fo/%wing: '
;. .BUILDING ADDRESS: 51-5.65 A — f -M -DA RAMERIZ�
�>„
Use.,Classification: , SFD Bldg. Permit No.:. 9.91.2-152
Occupcan cy,'Group:: ` R`3 Type of'Construction: VN Land'Use Zone:, -,RC
Owner of Building: ESEQUIEL CORONEL. Address: 51=54Q EISENHOWER DRIVE
City: LA QUINTA; -CA.92253 "
�By: STEVE- TRAM
Date: 0.5-30-00
Building Official
POST IN A CONSPICUOUS PLACE