9801-150 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000),gf Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
i
�`349R 1
1/31/00 _
!Date ` 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 as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec: 7044, Business & Professionals Comp).
( ) 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.
X) I have and will maintain workers' compensation insurance, as required by
Sec ion 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.
(JOLMN EAt".INS. NWC421i iXi
(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 shallnot 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: ,:._ _ —
Oate: 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 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 for inspection purposes. .
77
Signalure (Owner/Agent) Date
BUILDINGPERMIT PERMIT# CONTROL#
DATE VALUATION LOT 98(11-1:5p TRACT
UNTr 20
JOB SITE
APN
ADDRESS
33-425 AWNIDA NAVARRO
774-094.020
OWNER
CONTRACTOR/DESIGNER/ENGINEER
ESEQUIEL CORONEL
CORONEL CONSTRUCTION
P.0, BOX 389
P.O. BOX 380,
LA QUR4TA CA 92253
LA QUINITA CA 92.253
(760)5&1-4604 CBLf: 2261
I ICF OF DFpneIT
11,
1 e
i
til
SFD - PF.RI+'ilT 1 C)GS'NOT INCLUDE BLOCK W. IIS ORStPCX)L
�
'11712ACT CONSTRUC FION 1,4'31.00 SF MAR
111998
PORCWPAT.10 .36.00 SF
GARAGE/CARPORT 514.{x0 S1<
6 FT. WOOD FENCE 2200.00 LF C1 !
LA .QUJl l41
:o
�L
t
ESTUNIAl'ED COST O1+ CONSTRUCTION
89,413.50
PERMIT FEE 81—INiMNRY
INSTRUCTION F fsli 101-000-4.18-000 $..59.1.50
I"LAN Ckl3 r`1i F►yts i1J1 fN )•�I::�tl.319 $5+(12."0
WCHANiCAL FEE 101-Ut3(i-121-U,ril $53.50
E1XC .R1C AL FF.E 101-000-4211-00(0 S123.32
PLUNf3 0 FEE 101-000-419-000 5133.50
iMRONO NICY ION FEE - .RES1D 101-000-241.000 $8.94
GRAD fNG FOP, 101-000-423-000 520.00
1N1V 1tA8TR0CI'1JRE F l;E 225•-040413-m2 $1,962.78
PRE SE PIAN 101 -000 -MI -345 $25,00
EEE .DEPOSIT 4250.00
SUB -TOTAL CONSMUC 1ON AND IRLAN CHECK
$3,424.44
LESS PRE-PALD FEES
-19250,00
TOTAL PERMIT FEES DUE NOW
$3,174.44
A116.
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
I INSPECTOR
OPERATION
DATE
INSPECTOR
' BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
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
Final
Final
POOLS - SPAS
BLOCKWALL APPROV LS
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 LateralOf
Pool Cover
Sewer Connection 1117 fEncapsulation
Gas Piping
Gas Test /
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.1.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
. • .. - . %u�l'I,I tit/ . _ -,%�Dt •. - .
P.O. BOX 1504 APPLICATION ONLY
Building 78-105 CALLE ESTADO
Address To� Q i%Q r- tr U LA QUINTA, CALIFORNIA 92253
Owner
-Z:�s <!� / e, ox Oki
Mailing e BUILDING: TYPE CONST. OCC. GRP.
Address IP6_,5 7 J` A.P. Number 77 / "- OW— O ZO
City / Z � ,) Zip Tel. / O f 9 ,L/ cr (-)/V,(-)/V,f- ZO
(,I' -l��j ;kS3 Legal Description G ,� �1
'
Contractors Project Description '
C pkv c� e � !��✓ S
Address
City Zip Tel
State Lic. City
& Classif. 3 y��� Lic. # z Z Sq. Ft. jj No. NO. DW.
Size /Z f Stories ✓ Units
Arch., Engr.,
Designer — New Add O Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division`3 of the Business and Professions Code, and my licens is In full force and
/ •-f
effect. _ r��_�. 77/
SIGNATURE �&2r a 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 0! 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 ($500).
f7 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'
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 contractors) licensed pursuant to the Contractor's License Law.)
1-7 1 am exempt under Sec. B. & 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
17 Copy is filed with the city. 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it 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.
I certify that I have read this application and state that the above information is correct.
1 agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant -Date-
Mailing
ateMailing Address
City, State, Zip
BUILDING DIVISION
9
>timated Valuation!
PERMIT
' r AMOUNT
Plan Chk. Dep.
Distances:
Plan Chk.. Bal.
Front Setback from Center Line
Const.
Rear Setback from Rear Prop. Line
Mech.
Side Street Setback -from Center Line
Electrical
Plumbing
S.M.I.
INSPECTOR
Grading
Date Permit
Driveway Enc.
Infrastructure
Validation:
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 frcm Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
�t ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
2ND FL. SO. FT. (ry
POR. SO. FT. @
GAR. SO. FT. @
CAR P. I SO. FT.
WALL SO. FT. @
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
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.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
SQ. FT. .@ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1'A c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
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 R 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./EOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x8
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
82-879 Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Date 3/11/98 APN # 774-094-020
No. 16711 Jurisdiction La Quinta:
Owner NameEsequiel Coronel Permit #
No. 53-425 Street Avenida Navarro.. Log #
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 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
_A
This certifies that school facility fees imposed pursuant to Government Code 53080 in >the E � ount of i 'v
1.93 X 1,421 or $ 2,742.53 the property listed above and that buildingf{
permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued°°
Fees Paid By CCNalley Independent Bank Telephone 564-4604,.
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Rosita Jones
Signature
Payment Received $2,742.53
Check No. 158201
INOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
collect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting "
t
02/06/98 FRI 09:34 FAX 16195689610 PACIFIC COAST
Pacific Cast ESCROW CoapoRa,t(®n
74-920 HIGHWAY t 11 INDIAN WELLS, CA. 92210
ESCROW INSTRUCTIONS TELEPHONE (819) 668.0344
Cindy Burgin
2006
Escrow Officer Escrow No. 17510
Date: February 02, 1,998
This escrow company holds Department of.
963-0473. Corporations FSSaroW License No.
CASH THROUGH ESCROW.......
TOTAL CONSIDERATION.... •••••• •$ 16,500.00
.........$ 16,500.00
Buyer shall deliver to you any instruments and/or funds required from Buyer to enable you
to comply with these instructions, all of which you are authorized to 99e and•(or d
on or before 03104/98, and when you are in.a eliver
o:Liey el
position to obtain a standard P
Title Insurance through CHICAGO TITLE INSURANCE COMPANYof
, provided thatsaid PolicOlioy has a
liability of at least the amount of the above total consideration, covering the following
described property in the City of La Quints,
LOT 9 County of Riverside, State of Californiat
IN BLOCK 214,OF SANTA CARMELITA AT VALE.LA QUINTA, UNIT NO. 20 AS SHOWN BY MAP
ON FILE IN BOOK 19 PAGES 38 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA
PROPERTY ADDRESS.iLQTe9_, APN,*774-494-02O,La Quinta,CA:9'2'25'3
SHOWING TITLE VESTED IN: Esequiel M. Coronel, a married man as his solei and eeiparate
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, condLtions,
restrictions, reservations, easements; rights of way, of record, if anyl also exception
or reservations of oil,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&R19, '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 said
property in regards to geological., flood hazard,seismic hazard and any special studies
zones. Buyer has satisfied himself as to making any further inquiries art 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 act, and local
geological ordinance(s).
5). Buyer and Seller acknowledge that state laws prohibit this escrow frim cloj9ing
(recordation of Deed) until buyer's funds, including new loan proceeds, nave bimn
collected, as defined by law. The undersigned Buyer (Borrower) 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 soller by
their respective lenders while Pacific Coast Escrow Corporation determines that: all funds
required to close have been legally collected. It is recommended that Bu?er have all
funds wire transferred to close escrow without delay or additional interest expense.
6). SPECIAL CLOSING INSTRUCTIONS AND RELEASE FROM BLANKET ENCUMBRANCES This evcrow 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(s).
Certificate Occupancy*,.-
City, of La-Quinta
Building and Safety Department*.OF
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: 53-425 AVENIDA NAVARRO
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9801-150
Occupancy Group: R-3 -Type of Construction: VN Land Use Zone: RC
Owner of Building: ESEQUIEL CORONEL Address: PO BOX 389
-- City: LA QUINTA, CA., 92253
By: DANIEL P. CRAWFORD JR.
Date: 6/15/98
Building Official
POST IN A CONSPICUOUS PLACE