6564 (SFD)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
Pr!,)fessionals Code, and my License is in:full force and effect.
License # Lic. Class Exp. Date
634981 I,13 ji0D '.
.Dated` Signature of Contractor
:OWNER -BUILDER DECLARATION
I hereby affirm under, penalty of perjury that I am exempt,from the Contractors
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 isnot, 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.
()� 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 Policy No.
C -OLDEN EAGLE WS, 'WAR?4218920
(This section need not be completed if the permit valuation is for $100.00 or less):
O 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 provisions....—
Date l •. it Y Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall•subject an employer to criminal penalties and civil fines up to $100,000, in
-addition to the cost of compensation, damages as provided for .in Section 37015
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a. permit subject to the conditions and restrictions set forth on his
application. !
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold. harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not. commenced within 180 days from date of. issuance of such
.permit, or cessation of work for 180 days will subject: permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
kSignature (Owner/Agent)"`--°�""�'°"" Date
PERMIT# Y.
BUILDING PERMIT
CONTROL#
6564
DATE VALUATION LOT TRACT '
SS9 :1.J» 10 .. F3214 i.7j+ IT 21u
JOB SITE' } "�
APN
ADDRESS 53,445-AArENiDANAVAitRO
J.
774-1194-021
OWNER
CONTRACTOR/DESIGNER/ENGINEER
ESEQUI L CORONEL
CORONEL CONSTRUCnON
P.O, BOX 399
P.O. BOX 389
LA QL UNTA CA 921253
LA QUINTA
CA. 92253
(;Fx? 5t 1.: toO4
C'BLi; 226.1
USE OF rEnMIT
SC 13
"
A
y
SFD - ALAM, T :DOES NOT i?aC1.Lii F• RLOCK W J18 cyR PC,XDL. 79A N[.lily'
CRECK REDUCTION APDL TED FOR WLTIPLE S1013N41TTAL
PAILJ
TRACT CON S7•'ttW(1014 1,421,00 SF
PORCR AT1C) '36.00 SF ^}
LAQUI TX
(SARA MARPC�RT 514.00 3F VI
GFT. WOOD MT CE 201:00 LT'
4
t+:�i'11Nt1.t►'ft�D t�'i7i�'.f' illi' C`LCfai4a 1't$i-it."$'lt)1�'
?19,11 4 5U . "'
PERMIT FEE SiiA NURY
CC)N3TItC1GT•1t3'j7FEts 101-000-41.8-000 $594.50
.PL.W CHECK FEE 101-000-439-318 $502.1110
C HANWAL LER 101-000-421-000 $53.50
_ .ELECTRICAL FEE 101-060-420-000 $123"52
PLUMBING FEE 101-000-419-000 $133-50
.313xONC 1410TION .F'FE - RE -SID 101-•000-241-000
GRADING FEE 101-000-423-000 $20,00
1NFRA,S`t,`RUC PURE FEE 22:-000-4.41-342 $1.962,78
PRECISE PIAN 10.1-000-441-345 $24.00
1,`Di1Posrr -$250.00
PLAN CF FQK Fn' f01-000-439-318 431117.03
,f
SU#S•`1"��i#"15._!.,(Y:(,�R"(�r:d1�.t,.f��"'.l�(UIo1.11:1dn �'1.11"� Ci1�Cf� .
�3,4�'rd �i . .
LESS PIMPAID FEES
461,7111113
TOTAL Pr('{�ERMITYEESt DUE NOW
5.2,797.41
RECEIPT
DATE
BY I
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
Steel
Combustion Air
Roof Deck IV.Exhaust
Fans
O.K to Wrap
F.A.U.
Framing aL
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath 70
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
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 Y
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
Final
Utility Notice (Perm)
COMMENTS:
r,
P.O. BOX 1504 APPLICATION ONLY
Building 78-105 CALLE ESTADO
Address ? //Q f ro LA QUINTA, CALIFORNIA 92253
Owner / -7
BUILDING: TYPE CONST. OCC. G/ RP.
A.P. Number
Te. //
3 .l. 7�6 Lega1.Description LG f- /Ui
Project Description
Mailing
Address �0 3
City Zip
Contractor+ /�
Address
City Zip Tel
State Lic. City
& Classif. �'�Lic. #
Arch., Engr.,
Designer
Address �--� Tel.
City I
Zip I
State �r
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirmathat.l am licensed under pTavisions of Chapter 9 (commencin ,with Section
7000) of Division 3 of the Business and PSpfessions Code, and my license is in full forcerand.
effect.E C� 2 Z
SIGNATUR� DATE
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 rive hundred dollars ($500).
17 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 1, 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.)
17 1 am exempt under Sec. B. R 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
D 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 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 Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 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 Address
City, State, Zip
BUILDING DIVISION
TOTAL
REMARKS
ZONE:
BY:
Minimum Setback Distances:
Front Setback frcin Center Line
Sq. Ft. 412
Size 7
No.
Stories
No. Dw.
Units. !
New a, -Add ❑
Alter ❑ Repair ❑ Demolition ❑
F
FINAL DATE
�
Issued by:
Date Permit
Y'
Validation:
.IAN 2 6 1998
Estimated Valuation
PERMIT,
o.
C TY OF LA QUI
TA AMOUNT
Plan Chk. Dep. 7,—
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE:
BY:
Minimum Setback Distances:
Front Setback frcin Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback fron Property Line
FINAL DATE
IMSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. S0. FT. @ $UNITS
2ND FL. SO. FT. @
POR. SO. FT. @
GAR, SO. FT. @
CAR P. SO. FT.
WALL SO. FT.
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION 8
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
SO. FT. Q c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11A c
SEWAGE DISPOSAL
SO.FT.GAR ® 3l.c
HOUSE SEWER
REMARKS:
VENTILATION
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 d 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 APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
CU. yd.
$
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
GARDEN WALL FINAL
OR'S blUNAIUNES/INITIALS
Desert Sands Unified School District
Notice: 82-879 Highway 1.11
92201- `
Document Cannot Be Duplicated K 619-77Indio, C5-3500 AA
CERTIFICATE OF COMPLIANCE
Date 3/11/98 APN # 774-094-021
No. 16712 Jurisdiction La Quinta
Owner NameEsequiel Coronel Permit #
No. 53-445 Street Avenida Navarro L.)g #
city La Quinta zip 92253 Study Area
Tract # Lot # Square Footage 1421 -
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 garEges/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 tie'amOu' n+6f f
y� J
1.93 X 1,421 or $ 2,742.53 the property listed above and'that'building : }-
F
permits and/or Certificates of Occupancy for this. square footage in this proposed project may rioi�6_rbe Issued t {'
Fees Paid By CCNalley Independent Bank Telephone '564-4604
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Rosita Jones ,Payment Received $2,742.53
Check No: 158201
Signatur
NOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may prolestthe fees or other payment idenl�ed
above will begin to run from the dale on which the building or installation permit for this project is sssued or on which they are paid to the Dislrict(s) or to another public entity authorized to
collect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or.city plan check application form to district copy for all wai%ers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
02/06/98 FRI 09:3.5 FAX 16195689610 PACIFIC COAST
X007
PaCMC Coast ESCROW CORPwati®n
74.920 HIGHWAY 111 INDIAN WELLS, CA. 92210
ESCROW INSTRUCTIONS TELEPHONE (619) 698-0344
Cindy Burgin
Escrow Officer Escrow No. 1751I .
Date: February 02, 1998
This e9cr6w company holds Department
963-04173. of Corporations Escrow License No.
CASH THROUGH ESCROW......
TOTAL CONSIDERATION, ..............•.• •.••• .•. •••.•.••• .•......5 16,500.00
.. .........$ 16,500.00
Buyer shall deliver to you any instruments and/or funds required from 3uyer to enable you
to comply with these instructions, all of which you are authorized to .lse and/or deliver
on or before 03/04/98, and when you are in a position to obtain a standard Policy of
Title Insurance through CHICAGO TITLE INSURANCE COMPANY, provided that said policy has a
liability of at least the amount of the above total consideration, covering the following
described property in the City of La 8uinta, County of Riverside, State of California:
LOT 10 IN BLOCK 214 OF SANTA CARMELITA AT VALE LA QUINTA, UNIT NO. 20 AS
ON FILE IN BOOK 19 PAGES 38 OF MAPS, RESHOWN BY MAP
CORDS OF RIVERSIDE COUNTY, CALIFORNIl1
PRO_PERTYiADDRESS -47-09-4 -2 y, -a Quints CA 922's311
SHOWING TITLE VESTED IN: Esequiel M. Coronel, a ;narried man as his sole and separate
property
FREE FROM ENCUMBRANCES EXCEPT:
General and Special Taxes for current fiscal year, including any special levies, payments
for which are included therein and collected therewith. Covenants, conditions, -
restrictions, reservations, easements, rights of way, of record, if any; also exception
or reservations of cil,gas or mineral rights, if any.
1). Buyer herein will pay All Cash for subject property and shall deposit into escrow
prior to the close of escrow, the balance of total purchase price plus buyer's portion of
escrow and recording fees as required in the form of a Cashier's Check or Wire. Transfer.
2). The parties herein agree that the closing of this escrow is:subject to the Buyer's
approval of Preliminary Title Report., CC&R's, if applicable within 3 daps of receipt of
same. Buyer's failure to notify Escrow Holder of any disapproval, in writing, within
specified time limit, is deemed to be Buyer's approval of same and this contingency
eliminated.
3). Covenants, conditions, reservations (including exception of oil, gas, minerals,,
hydrocarbons, and/or lease without right of surface entry), restrictions, rights of -way,
and easements for public utilities, districts, water companies, alleys, and streets. '.
4). Buyer is aware and acknowledges and accepts and holds Seller harmless for isaid
property in regards to geological, flood hazard, seismic hazard and any special studies
zones. Buyer has.satisfied himself as to making any further inquiries at appropriate
government agencies, lenders, insurance agents, or other appropriate entities concerning
use of the Property under local building, zoning, fire health and safety codes as may be
applicable under the Special Studies zone act, seismic Hazards mapping azt, ani local
geological ordinance(s).
5). Buyer and Seller acknowledge that state laws prohibit this eocrow from closing
(recordation of Deed) until buyer's funds, including new loan proceeds, have began
collected, as defined by law. The undersigned Bayer (Borzower) understands that: it is
their responsibility to determined from lender of their choice what type of funding
instrument will be used. Also per diem interest will be charged to buyer- and seller by
their.respective lenders while Pacific Coast Escrow Corporation determines that: all funds
required to close have been legally collected. It is recommended that Buyer have all
funds wire transferred to close escrow without delay or additional interest expense.
6). SPECIAL CLOSING INSTRUCTIONS AND RELEASE FROM BLANKET ENCUMBRANCE: 'this eE:crow shall
not close and funds shall not be released from impound until title to the lot has been
conveyed to ,the purchaser free and clear of any blanket encumbrance(.e).