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9908-177 (SFD)LICENSED CONTRACTOR DECLARATION ,Y -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 ca3 9aI i ul jrA/lv"1, D/e Ak CL7 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: ( ) I, as owner of the property, or my employees with wages asi their si le compensation, will do the work, and the structure is not intended or,offere 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 Owned . 1 � WORKER'S COMPENSATION DECLARATION I hereby affirm undepIpenalty 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. Sec( ) I have and will maintain workers' compensation insurance, as required by tion 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 Policy No. Co 0, r.- �tiv Y�'1`^Ie'1 PCIY!!'..anRCjFf• t'+n L- 1.4 INS. a<i ii �rlUa",NJV'VL (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 37 0 of the Labor Codp, I.s all forthwi comply with those provisio�ns-j / � Dae:" -C - !i Applicant Warning: Failure to secure Workers'. o pennsation 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 ffoor inspectio7 urposes. j Signature (Ow'nere�/Ag n).„"iC �i�Date PERMIT # BUILDING PERMIT 9�W_177 DATE VALUATION V `��-2.2f) LOT 2 TRACT 1117, ! j 1 ,,/4 JOB SITE �+.. ADDRESS .f?2^ ii1 Al 1N+Ti.#',l�i► I� JFK iR✓ APN . ' 7i3^'� 1 410 OWNER % CONTRACTOR / DESIGNER / ENGINEER fc{�'�4iFT>'7"?viii i i'i/S.'! l\ IA.I I,L �. A 11.1.4.\✓\./1.i f-'r1FiC9T�li:•T f'�ti'Af�^'f'I}�Yf''i'Yf�i�7 'v al s.la.{1 a[�aA V ara a-!\ v� 11 a'a LA.Q1JlNMA CA 92253 226; USE OF PERMIT 1 13fNG11R 17ANI1.LY Dliy`1 9.,1.W6 S kFdvAT DOES NOT JldC'"a,LiDE BLOCK WALLS (,it T1001. r � TRACT Cviv.,a a,.J., i .►vii �r�ti'�atvu"ri%�icrvR'T as3.i1�'5f� 5 FA', Wc OJJ FENC4 21)0.» LF z r., a nsa n si COST "\✓%F Ch"°1.nKA. a rsCfi (N% t JVr � PERMIT eFIR VtTWARY CONSI U4.'€'i.UAt FEE P1.4-0 Cf1fr1r1K TIT_f~ 1t16�()f1fJ^d30 (i: SR9a' S1 1 � 'PL UMVNC Rf8 101-000-41a } :11z�Nr n�OT"ON' 1 VIT . E21 `T0 141-000-2,a J --Ow. 41213-000 .; t7 1 DERVE-LOTIER IMPACT FEB $1,907.uif � PRECISE PLAN 101-006-441-34.5 Atilt' TW P1 Tt3T,.t� `�:, C4C� `: - RrMrl '701-MO-2,55AInf) 40/I.0 ; «; ' .F0Z D.1M03JT 1C7.^C1C`l x.:39-31:3 �.^_5St,0i; CTS SUR -'J'(7TAL E':'0_14W, RT?CM( N' A11411 PT AN (`:i'E.R.'K 69 .C..7,~I$�ua.�� L�-Y�P.��'1y,.y:�13 FITS 42-0.00 (.Y.+ p�(y p �9 [,1 �7, {�j� q� y' � $3,04.0 RECEIPT DATE BY DATE FI D INSPECTOR 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 S/– 4– OD ,S Exhaust Fans OX to Wrap S -S _ CID F.A.U. Framing 47WD Compressor Insulation – c¢O S 7 Vents Fireplace P.L. Grills Fireplace TO. 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 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 . yg Q, 5 3 –16 – v a S Encapsulation Gas Piping Gas Test a a� Appliances Final Final r Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Z_ q Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior, Receptacles G.F.I. 1 Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) Z 257 COMMENTS: WWI Building Address, �- Mailing Address City lZip P.O. 4BOX1504QK4 78-495 CALLE TAMPICO A2j5 _4__ LA QUINTA, CALIFORNIA 92253 Contractor CORONEL CONSTRUCTION Address P.O. !9O' X 389 State Lic. City & Classif. (B) 634981 Lic' # 2261 Arch., Engr., Designer Address City IZip -`N State I Lic. # LICENSED CONTRACTOR'S DECLARATION affirm that I am licensed under provisions -of -Chapter 9 (commencing with ivision 3 ousiness and Professions Code, and my licens�n fuiX, }id _ _ 0, \ °– ` OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 703.1!' 5, Business and Professions Code: Any city or county which requires a permit to construct, atter, 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 thathe 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). 1.: 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 of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) I 1 I, as owner of the property, amexclusivelycontracting 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.) 17 1 am exempt under Sec. B. & P.C. for this reason I 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 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 if 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 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 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 a0plicant —Date— Mailing ateMailing Address City, State, Zip APPLI ION ONLY 'BUILDING: TYYPE'CCONST^ (0c" C1 GRP. A. P. Number t� J J � "7(0c"i" C1 Legal Description r Project Description Sq. Ft. No. No. Dw. 'f Size Stories �— Units New Cy Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. '—s a 0 Plan Chk. Bal. i 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 T - INSPECTOR .. -1 oaf 1.., i •... r .. .. Issued by: Date Permit Validated by: 4 _'" t fs•i Validation: µ WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION i Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 1/24/00 APN # 773-281-001 No. 19947 Jurisdiction La Quinta Owner NameCoronel Enterprises, Inc. Permit #9908-177 No. 52-510 Street Avenida Juarez Log # City La Quinta zip 92253 Study Area Tract # B17, U1 Lot # 2 Square Footage 1978 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 1.93 X 1,978 or $ 3,817.54 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 CC/Union Bank Of California/Hazany Coronel Telephone ,760-564-4604. Name on the check By Dr. Doris Wilson � Superintendent r Fee collected /exempted by Mary Ann L. Borja Payment Received $3,817:54. Check No. 6529001 Signature INOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you :hat the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to collect them on the District('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting -4U--ording Reques.ed Rv CHICAGO flTLt C0;V-.PA.-NY FECO$DIiw ItSOMSTSD BYs CHXCAGO TILE COMPANY COMPANY 99.8686Kc 97055513 WMN RECORDED MAIL THIS DBED TUfD, UNWSS OTN3R'WZSE SHOWN BELOW, MUL TAX STATEbUMTS TO s i�78En B. KELLOGG, TRUSTEE 200 XAZBOR DRIVE #3802 SAN DIrGO, CA 92101 02- C> - O%i DOC a 1990-234803 The undersigned grantor (s) declare (s) ! Docucreatary transfer tax is $36.50 (XXX) Computed on full value of property conveyed, or ( ) Computed on full value,I ss liens and encu, rances remaining at time of sale. ( ) Unincorporated area: ( ) City of rte) , and FOR VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, TRUDI SHERMAN, A MARRIED WOMAN AS HER S(.,L13 AND SEPARATE PROPERTY hereby GRANT(S) to ROBERT B. KELLOGG, TRUSTEE of the Kellogg Revocable Family Trust the real property in the City of LA QUINTA., County of Riverside, State of California, described as: ,Lot 2, Blc.ck 17 of Unit No. 1, Tract Santa Carmelita at Vale La Quinta, as per map recorded in Book 18, Page(s) 46-97 inclusive of maps, in the office of the County Recorder cf said County. .d-nd as :.m� ndea by Cer t.,i f ica.r' ' . of >7cr_'t c•. qn', r0c f)nI..-a! bjj C?' :3 , :e 86 as InetruMeat NO. S8295, Official Records, Dated May 24, 1999 � i Stati& of California , County of Riverside _ j S.S. TR Y SH .AN On ___May 27. 19990 before me, Kel.ly•Collier personally appeared 10AX S'ue-rman personally known to me. (or .proved to me on the basis of satisfactory evidence) to be the person -(s) 10hose. name (s) is/ are subscribed to the within instrument and acknowledg&d.to rte that h(r/she/they executed the same in his/her//the :" authorized capacity(ies) , an'.3 that by h'.s/her/rheif' ignature(s) on'the i nst mens: the person ) , or th.e entity .upon b'e; al -f of which/ -he' rson � acted, P.xeci ted the instz�tment / i? ,/% WITNESS MAIL � :tTAT�NT�'l�, SAME AS .ABODE' C4.XFu C }' ��3� 1QS7Z17 (This area far official notarial seal) ' :ii. „�r0 N 5' 9_'i SIN0!; ATVLg0.1N31.10D W'V9G: ; i 6E,.6! .�,� j�jr 05/28/1999 08:00A Fee:16.00 Page 1 of l Doc T Taut Paid Recorded in Official Records I County of Riverside j Gary 1. Ora* Assessor, Caunly Clerk a Recorder -�-.-�----_-�.-� I Illlil 11 II(!I IIII! 1(1!11 III(II III IIIIII(I!I IIII((�I IIII . -. L L COPY LONG REFUND NONO EXAM .ap>i: GRANT DIE ED . ��s-asl-o t The undersigned grantor (s) declare (s) ! Docucreatary transfer tax is $36.50 (XXX) Computed on full value of property conveyed, or ( ) Computed on full value,I ss liens and encu, rances remaining at time of sale. ( ) Unincorporated area: ( ) City of rte) , and FOR VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, TRUDI SHERMAN, A MARRIED WOMAN AS HER S(.,L13 AND SEPARATE PROPERTY hereby GRANT(S) to ROBERT B. KELLOGG, TRUSTEE of the Kellogg Revocable Family Trust the real property in the City of LA QUINTA., County of Riverside, State of California, described as: ,Lot 2, Blc.ck 17 of Unit No. 1, Tract Santa Carmelita at Vale La Quinta, as per map recorded in Book 18, Page(s) 46-97 inclusive of maps, in the office of the County Recorder cf said County. .d-nd as :.m� ndea by Cer t.,i f ica.r' ' . of >7cr_'t c•. qn', r0c f)nI..-a! bjj C?' :3 , :e 86 as InetruMeat NO. S8295, Official Records, Dated May 24, 1999 � i Stati& of California , County of Riverside _ j S.S. TR Y SH .AN On ___May 27. 19990 before me, Kel.ly•Collier personally appeared 10AX S'ue-rman personally known to me. (or .proved to me on the basis of satisfactory evidence) to be the person -(s) 10hose. name (s) is/ are subscribed to the within instrument and acknowledg&d.to rte that h(r/she/they executed the same in his/her//the :" authorized capacity(ies) , an'.3 that by h'.s/her/rheif' ignature(s) on'the i nst mens: the person ) , or th.e entity .upon b'e; al -f of which/ -he' rson � acted, P.xeci ted the instz�tment / i? ,/% WITNESS MAIL � :tTAT�NT�'l�, SAME AS .ABODE' C4.XFu C }' ��3� 1QS7Z17 (This area far official notarial seal) ' :ii. „�r0 N 5' 9_'i SIN0!; ATVLg0.1N31.10D W'V9G: ; i 6E,.6! .�,� j�jr CITY OF l -A O. U! STA AUG 17 RECD f`r BUILDING hijU SAFETY .RC District - Plannin4 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 ADDRESS: 52-510 Avenida Juarez APN: 773-281-001 ��e,� LEGAL: LOT 2 , BLOCK 117 , UNIT . S.C. @ V.L.Q. CK'D BY: Greg Trousdell 81N N0:. CASE NO. 99-108 _ ..CHECK -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 ME 11211011 mll� WX SO Case logged and number assigned .Verify legal and APN information �QC(1E Consistent with MDG on file las applicable) M MDG filing required 15+ filings since 9/3/98) p,P Consistency -W -.street/surrounding area:- 8 �Z Colors t`I` �Vh�% "IAA- Materials Architecture OTHREQUIREMENT o o " \� \ The zoning code, architectural and landscaping manuals, .and/or assigned inspector should be consulted where uncertainties arise: The completed checklist shall be maintained in the Building: & Safety address file. � � (�v6 2 c'61 `c 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:. -52-510 AVENIDA JUAREZ Use Classification:, SFD Bldg. Permit No.: 9908-177 Occupancy Group: R 3 Type of. Construction: VN Land.Use Zone: RC Owner :of Building: ROBERT KELLOGG o Building Offic al Address: : . City: By: STEVE TRAXEL Date: 12 -13 -00 - POST IN A CONSPICUOUS PLACE