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0108-231 (SFD)LICENSEDI 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 Date,'- Signature of Contractor�Fi�+1"wµ 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 certificat:: 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. ;(yr,)} 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: Carrier A . Policy No. RATE FUND .1 $47921-00 (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(Galifornia, and agree tha; if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. fl�tc• t..d - i+•.. ..'.0 f Annlir�nT .4+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 orpursuant 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 cancellatidn:`�• 1 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 "''j construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection pU rposes. Signature (Owner/Agent);Datef, ,�41 �/91L,_._.BUILDING PERMIT PERMIT# DATE VALUATION LOT - TRACT - F i P 1107.. "K97., 70 19 "K ` 11;A 1 T 7A JOB SITE APN ADDRESS ' 140AVEN10A.4f VARIP-7. F7.4'#.W-007 OWNER CONTRACTOR /DESIGNER / EN INEER F-. £ 1T1ORIM1w. OORK.CCANTS1R{CTC3 1P0 BOX 1f. -W 8-150 C9XTpM -0 SVhl0.60 tA QPWITA, CA 92,233 Lk Q�Tn,,)TA CA, 92253 0160)564.4 cmut 22m, i USE OF PERMIT an-vau , waha i?''%mm xvCs4 SIMITE,I'MIT DJWAq-T MCl.1113E.ftcr1* Wft<1..IX, P001,10RIVEW.A.Y I'1'68C sC;f, 1 17> I� S, It I`1f4 `f'1rJ�d ME MR' i A. a §M4,5 &OR'WORK BEAU -14 WITHOUT B011.411140 Pleillu1`1`. TRACT CONSTRUCTION 1065.90, Sp Pl. RCI•.1i.PA TIG 11.�6.00 5F GA.RAOFICa°A'RPORT 504,00 SP tom. WOOD FM"X 309.013 L? �SS"�"11�A,` . COW O r VI01,°6�1�`1�:U�501"� 920M.70 PIEL" ' 1°C' 4n eSOMM,ARY �;C:'1��3'11 � K'1`IC71�i F1 si. 101 �4'�i1��313.001; $608.90 PLAIN CHECK V-02 $Scrl, 17 WC:'1 IOUCAL FRP 101 -000.421 -ow 03.S11 1I Y. AV11',p.1C.A.1. l+ZF. 101.000-420-0001 $165.56 PLtf.l,MMG F1I.I 101.000.4.19-00 0 S 110:7; S1`RONfCf F+iI OTI1.SN FEE * P:=0 101400-241-000 $9.31 MAMA F19 101-000-423-000 $20,00 1;.1 F,4..t7PbM�'t .l'APACT ME s1,10' io 1'.UTISE PWI $100.09 FRY DEPOSIT 101 ••fDfiQA439-318 4250.09, 1' �MS3'.§MTkON A1121 101-006-4,23-000 $08.00 ' � dJ4i.b.�✓4',f,` ►l.t.E6w �:y S101C 'fL`dLl P,d.si'9SV 0.r.HEMc -4,0 9.25 e a �. 95 PRE-PAWM. 29 -$2511.00 TIM, : � as r OCT 311MR9.245 1 9 2001 - A- , "�� OF(A QU11011q .DEPp RECEIPT DATE DATE FINALED INSPECTOR r � I` INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel _ Roof DeckZ/U_ �_ O.K. to Wrap d r� Combustion Air Exhaust Fans F.A.U. Framing ` —lam J /� ,�� Compressor Insulation �Z 7 Vents Fireplace P.L. _� / / Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final _ - v 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 Waste Lines 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 — �2 Appliances 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 FinalpZ Utility Notice (Perm) Feb' 6. 2002 11:00AM A C I+'Y 0'V: Q U IN TA ��� w•J•BUILDING & SAFETY DEPARTMENT �o 777-7012 INSPE9. -10N REQUEST LINE -7153 Owner CO>E tL ENTERPRISES contractor C )RNEL CONSTRUCTION Permit Number 01.08-231. POST ON JOB IN CONSPICUOUS PLACE INSPECTOR MUST SIGN ALL APPLICABLE SPACES JOB ADDRESS 54-140 AVENIDA JUA,REZ Sl;D - LOT 18, BLK 256 MASTER- ZE.KE1485, PPRP TI' DOES NOT.INCLUD.E BLOCX WALLS, POOIJSPA OR DRI'VEWAY APPROACH TYPE OF INSPECTION DATE INSP. FOUNDATION & SETBACK FOOTING STEEL MAIN GROUND SYSTEM GROUNp PLUMBING PRE-GUNITE DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED CONCRETE SLAB i JOISTS & GIRDERS ELECTRICAL GROUND WORK DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED ROUGH ELECTRIC: COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED DRYWALL INTERIOR J ��•� EXTERIOR LATH POOL PRE PLASTER POOL PENCE '& GATE SEWER SEPTIC TANK FINALS ELECTRICAL, PLUMBING G� = FINAL GAS TEST HEATING � A/C HOUSE NUMBERS J08 COMPLETED TEMP POWER ABOVE APPROVALS DO NOT INCLUDE RIGHT TO No•9996 P• 1 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 10/19/01 APN# 774-194-007 No. 22596 Jurisdiction La Quinta Owner NameCoronel Enterprises Permit # 0 108-23 1 No. 54-140 Street Avenida Juarez Log # City La Quinta zip 92253 Study Area Tract # BLK256U24 Lot # 18 Square Footage 1485 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 2.05 X 1,485 or $ 3,044.25 the property listed above and that'liuilding permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued Fees Paid By CCNalley Independent Bank - Ish Coronel Telephone 5644604 Name on the check -- By Dr. Doris Wilson Superintendent Fee collected /exempted by Juanita Green Signature Payment Received $3,044.25 Check No. 255682 NOTICE: Pursuant of A mbly Bill 3081 (CHAP 549, STATS. 1998) 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 f m 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 Dis ict('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 a•�m,......r�,a.�,.l..-.-F v►•-w�« s�...v-,fji•.�'aT1�°M�.a+..n.•�•�+r'�7•�*+a]�7arcgFr•s�� •as�j�,.• . w P.O. BOX 1504 APPLICATION ONLY Building 7CALLE O Address :Z,1C.t 2�LA QUINTA, CALIFORNIA 92253 O� ' Owner BUILDING: TYPE•CONST. OCC. GRP. O Mailing G} `, Address • i4j �, ;�� 1 A.P. Number t^tet l� `1 't % City \ Zip Tel. 1 V,_ U ...� \ v G`� C9 1501_L` �-I Legal Description�c+� `i �� 51, Contraacctor\ Project Description ` `+ , a Address City (� Zip Tel._ ( t r f `•A 4 ,;;k s, State Lic. ` ! & Classif. , J(I (� Lic. ! Sq. Ft. �� No. No. Dw. Arch., Engr., Size ) Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. G ' rz S t) City Zip State .11__\ Lic. # LICENSED CONTRACTOR",SUECLARATION I hereby affirm that I -am licensed•under.,provisio of Chapter 9 (commencing with Section 7000)�of Division,3of the Bus'�^ass and Pratesio``� Code, and my license is in full foie and SIGNATURE I "•-tr„ moi, -r �/ ""�^' PATE i --OWNER-BUILDER DECLARATION Estimated Valuation 1 hereby affirm tf�at 1 am exempt from the Contractor's License Law for the following - reason: (Sec. 7031.a Busfnes8 and Professions Code: Any city or county which requires a permit to construct, alt rove, 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 PERMIT AMOUNT 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 Me basis: for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. G Jr%J:Em. subjects the applicant to a civil penalty of not more than five hundred dollars !3500). l: I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.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. Mach pro . provided that such improvements are not intended or offered for sale. If, however, the buildfng f or improvement is sold. within one year of completion, the owner -builder will have the burden Electrical of proving that he did not build or improve for the purpose of sale.) 1'1'I, as owner of the property, amt exclusively contracting with licensed contractors to con- Plumbing ,,. strucl. the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law 'does not apply to an owner ofproperty who builds or improves thereon, and who contracts for S.M,I, such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - -1 I am exempt under Sec - B. & P.C. for this reason Grading ewt or Driveway Enc. 1Ap Date Owner Infrastructure 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 n Copy is filed with the city. O Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE — �3 (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 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: 8, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Set back Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line Ihereby affirm that there is a construction lending agency for the performance of the F - work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR ' expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. Issued by: Date Permit 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. Validated by: Signature of a0plicant Date Mailing Address Validation: City, State, Zip WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION Al 08/,'„8/01 18:18 FAX 17608049062 I�I Commonwealth CoMNi ONWRALTH LAND TUL£ COMPANY COMMONWEALTH TITLE _ 4 ZEKE rA 002/007 5120 Avenida arlsbad SCA Suite 92008 (i 60) 804-88201(800) 887-7497 SALE ESCROW INSTRUCTIONS THIS DOCUMENT WILL AFFECT YOUR LEGAL RIGHTS - READ IT CAREFULLY! ESCROW NO: 0153536 -KC - Kelly Collier DATE; August 1, 2001 Certified Sr. Escvow Officer 760 804-8820 rt. 6723 /800 887-7497 =. FA): 760-804-9062 / _ THE ESCROW HOLDER IS COMMONWEALTH LAND TITLE CO VIPANY WHICH IS LICENSED BY THE CALIFORNIA DEPARTMENT OF INSURANCE. Buyer has handl,d you initial deposit in the amount of ......... • • • . • . . • • ........ $1,000.00 Prior to close of escrow, Buyer will deposit an additional amount of ...................31,500.00 $32,500.00 TOTAL COINSIDERATION ..............•••............ ... ........... s . LIS- ee handed additio ial .funds and/or instruments required to F . > enable Esorow (Holder to comply with these instructions, which Escrow Holl or is instructed to use when in a position to procure a usual OWNER'S Policy of Title Insurance (see Title Insurance 1 aragraph below) issued by SOUTHLAND TITLE CO. with a liability of $32,500.00, covering the following described pi :)perty located, in the City of LA QUINTA, County of RIVERSIDE, State of California: Lot 18, Block 256, Unit No. 24, Santa Carmelita at Vale La Quinta as sho vn by Map on file in Book 19 Page 44 of $' Maps in the office of the County Recorder of RIVERSIDE County, Cal'iforni k. SELLER/TRANSFEROR STATES THAT PROPERTY ADDRESS: APN 774-194-007, LA QUINTA, CA 92253 SHOWING TITTLE VESTED IN: CORONEL ENTERPRISES, INC., a Califor da Corporation 3 ' FREE FROM ENCUMBRANCES EXCEPT: _ (1) Current general and special taxes for the fiscal year in which this escrc w closes, and taxes for the ensuing year, if any, a lion not yet due and payable. (2) The lien of supplemental taxes, if any, assessed pursuant to the pro isions of Chapter 3.5 (commencing with r__at: Section 715) of the Revenue and Taxation Code of the State of Califor iia. = =' (2) Special improvements assessments, if any. =.") ';5 (4) Easements, rights, rights of way, covenants, conditions, restrictions ; nd reservations of record. A. PRELIMINARY TITLE REPORT: The closing of this escrow is contingei t upon Buyer's approval of the preliminary , title report within 5 days of receipt (receipt to be Construed as three 13) business days after datc of cover letter Y from Escrow Holder). Buyer's failure to deliver written disapproval of s aid report to Escrow Holder within the time period specified shall be deemed their approval of some and this esc .-ow shall continue as otherwise set -forth'.'.-,-" herein. 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. JECENE ; Iy� APPLICANT Coronel Construction '- , SITE ADDRESS 54-140 APN 774 - 194 -007 CASE NO.: _2()()1-942 LEGAL: LOT CHECK AND APPROVED BY: BLOCK 256 UNIT 24 Wally Nesbit CITY OF LAQUINTA I—P'L�CivivTiata�B€�ART�v"t€ivi� S.C.@V.L.Q. 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 vE40-eo' � vw,�szs�rr,� Consistent with MDG on file (as applicable MDG filing required (5 filings since 9/3/98) Architectural variety within 200 feet of the'surrounding area: Colors Materials Architectural es�gVeggures VA 'l j i/�+- A�/� tlfD �oz,a2S tri /vast 7D € �r ST. lFu� £S' e o O Planning Comn Other Requirements: p City Council: fitCommunity De initials Case No. 66 © Exhibit 0 With Condition issio v. Dept. I ----- ---- 9 ° _.-.-- -2 .�.--- ,---- ._.-----• tuJ3z- FROM Feiro Engineering, Inc. FAX NO. 760 346-2548 Jan. 24 2002 11:13AM P1 CORNIER RECORD Document Number City of County Of I It''Ocl California Brief Le gal Description , 8 L Y010r45kz y r16 /1 AW L 5> (include: Sec.. Twp.,Rge..and Meridian or Raneho)S8Irh APN 27S� --/ 9 9-002– CORNER TYPE COORDINATES (Optional! I Government Corner ❑ Control ❑ N. E Meander ❑ Property E9 Zone NAD27❑ NA083❑ Rancho ❑ Other ❑ NAD83 EPOCH Date of Survey JJL"f� Elev. Vert.Datum: NGVD29❑ NAVD880 Meas. Units: Metric ❑ Imperial ❑ Corner — Left as found ❑ Found and tagged ❑ Established ❑ Reestablished JZ Rebuilt{] Identification and type of corner found: Evidence used to identity or procedure used to establish the corner: A description of the physical condition of the monument as, found and as set or reset: ti SURVEYOR'S STATEWIENT This Corner Record was prepared by me 6r -under my direction in conformance with the Land Surveyors' Act on 040. 9:8 20�- Signed R.C.E. Number ' COUNTY SURVEYOR'S STATEMENT This Corner Record was received 20— and examined and fite!d 20— Signed Title County Surveyor's Comment Page 1 Of 2 n k\DGN\CHARTSWORMS.DGN (5/00) A. Ntk24176 �S � t2131/01 � w\lF,��vrt~ FROM : Feiro Engineering, Inc. FAX NO. : 760 346-2548 Jan. 24 2002 11:14AM P2 Page 2 of 2 �CAL*t .7 I r 11, .'1._ �g I %9 i b� ICS I I O 511 T9 T- q, u 4 -- . . . . . . . . . . t—t 6 Ti I I I L 4LL! BARN 4 A 7rS SEIr 12117f, T4G, 1AP14ATES 1 1. I& �L�G w 0*1 4 P�q I R4,F tj I TT 41 . ... . .... 7-7 -Ij Page 2 of 2 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: 54-140 AVENIDA JUAREZ Use Classification: SINGLE FAMILY DWELLING Occupancy Group: R-3, U-1 Type of Construction: Owner of Building: CORONEL ENTERPRISES Building Official Bldg. Permit No.: 0108-231 VN Land Use Zone: RC Address: PO. BOX 389 City: LA QUINTA CA 92253 By: KIRK KIRKLAND Date: FEBRUARY &, 2002 - POST IN A CONSPICUOUS PLACE