9802-014 (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 ,pivision 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
1/311/00
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 (SPr.. 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.
GOLLF33 EAGLE TNS. I4`iWG12189200
(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 provisions. -
%/Date: "'✓/ 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.
Signature (Owner/Agent) _ Date
BUILDINGPERMIT PERMIT# CONTROL#
^
DATE VALUATION LOT 911 ��'� TRACT h
/I 1/% Cts) ,41a $A 8 l -s, atti 10
JOB SITE
APN
ADDRESS 53-405AVENIDA tNA ARRO
774-49"1.9
OWNER
CONTRACTOR/DESIGNER/ENGINEER
ESEQUIEL CORONEL
CORONI L CONSMUC CON
P,O. Box 389
P.O. BOX 389
LA QIJINTA CA 92253
LA QUINTA. C:A 92253
( ,'60).X64-4104 CBL# 2261
USE OF PERMIT
SI
SFD - P RIN41T DOESNOT OT I'13.CLUDE BLCXX WALLS OR POOL.
Poll r%
AILJ
'MALT CON31 RUCTION 1,421.00 Sl:
PORCIWATTO X06 SF MAR
1 1 1998
0A1ZAGF/CtVU'10RT 514.00 Sr
6 FT. NVOOD WNCE 200.00 LF
CITY OF
LA QUNTA
EST[MAT:CD COST OF CONSTIttJM'IGN
89,411.50 x
PElir;N111T IEEE SiiAl"(ilARY
CONSTRUC TON FES 101-000-41R-000 5594.50
PLAN CHECK FEE 101-000-439-318 S502,Al l
NIF.`CHANICAL FEE 101»(1M421-000 $53.50
FILEC MfCAL F1~`E 101-000-420-000 $123.52
PLM413ING FEE 101-1100-4194M $13150
STRONG f4 I ION FEE - RESIU 101-000-24.1.000 $&w
GRADING FEE 101-000-423-000 MAO
INFIRAST RUCTif E FEE 225-000443-342 $1,9v_78
PRECISE PLAN 101-000-, W 1-345 $25.00
FEF DEPOSIT -$250.00
SUB-TMAL COWI RUC `CTON.AND PLAN CHECK
$3,42.1:14
LESS PIW-PAID FEES
4250,t)t1,
TOTA1, PEiRMT FEES DUE NOW
53,174.44
2
RECEIPT
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs 1AV A
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck /
Exhaust Fans
O.K. to Wrap 117
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
BLOCKWALL APPROVAIJS
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 Pi '
as Test
App iances
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:
P.O.,BOX 1504 APPLICATION 01�tY
Building lJ7) C,ds LA QUIN0TACF.ALLE p
DO
AddressCALIFORNIA 92253
Q I�Q I' ►'•'O
Owner
ORK � BUILDING: TYPE CONST. OCC. GRP. '
Mailing
Address ®o� A.P. Number
ip
City Za Tel. L
L • /ZZ 5� (o1f—!/�(yY Legal Description �d /1 OFi, A%` e 214 0121'74
121 74�
Contractor Project Description
AddrCORONEL CONSTRUCTION
cityLA QUINT ,OCA 92253Tel
State Lic.� City
& Classif. �3 Lic. # Sq. Ft. No. r No. Dw. /
Arch., Engr., Size I ! Stories , • Units
Designer New tom• Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby afff rim thaYVam licensed under provisions -of Chapter 9 (commencing with(Section
7000) of D'vlsion 3 of the Business and Professions Code, and my license is in full force d :,
effect
/ ��f
SIGNATURE // / - c. / DATE
1.
l.�
OWNER -BUILDER DECLARATION Estimated Valuation r
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 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 the basis .Plan Chk. De SU
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit p
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
17 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.
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, Mech.
provided that suchimprovements 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 Electrical
of proving that he did not build or improve for the purpose of sale.)
I 1 I, as owner of the property, am 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 of property 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.)
Grading
17 I am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
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. 0 Certified copy is hereby furnished.
TOTAL 0
CERTIFICATE OF EXEMPTION FROM REMARKS
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 ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith .Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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.) Side Setback.fron Property Line
Lender's Name -
Lender's Address FINAL DATE INSPECTORThis 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. 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 applicant Date y
Mailing Address Validation:
City, State, Zip
CIA L
BUILDING DIVISION
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. 0 $
2ND FL, SO. FT. C
POR. SQ. FT.
GAR. SO. FT. @
CAR P. SO. FT. GD
WALL SO. FT. @
SO. FT. Ca
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.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
I ` f
GARAAGE DISPOSE=
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
1 LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
} KITCHEN' SINK o t.
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. @ 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 & 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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
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
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Desert Sands Unified School District
Notice• 82-879 Highway 111
• Indio, CA 92201
Document Cannot Be Duplicated
619-775-3500
CERTIFICATE OF COMPLIANCE
Date 3/11/98' APN # 774-094-019
No. 16710 Jurisdiction La Quinta'
Owner NameEsequiel Coronel Permit #
No. 53-405 • 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
1
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 w 5
J�
? �� G
p, rt
This certifies that school facility fees imposed pursuant to Government Code 53080 in the amo>u Po `y
1.93 X 1,421 or $ .2,742.53. 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 CCNalley Independent Bank Telephone 564-4604
Name on the check
By 'Dr. Doris Wilson
Superintendent
Fee collected /exempted by Rosita Jones Payment Received $2,742.53
Check No. 158201
Signature
Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -da a roval eriod in which ou may protest.the
[NOTICE:
bove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another publicentity authorizedtoed
ollect them on the District('s)(s') behalf, whichever is earlier.
Collector: Attach a -copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
C
02/06/98 FRI 12:57 FAX 16195689610 PACIFIC COAST 110 002
Pacific Coast Cscnow CoRp®Ration
74920 HIGHWAY 111 INDIAN WELLS, CA. 92210
TELEPHONE (619) 568-0544
ESCROW INSTRUCTIONS
Cindy Burgin Escrow No. 17512
Escrow Officer. Date: February 02, 1998
This escrow company holds Department of Corporations Escrow LiCenl9e No.
963
-0473.
CASHTHROUGH ESCROW ...............................................$ 16,500.00
TOTALCONSIDERATION .................... .........................$ 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 use and/cr deliver
on or before 04/03/98, 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 Quints, County of Riverside, State of California:
LOT 8 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
PROPER -T -Y ADDRESS -Lo-TV,$ APN#774-094-019,La Quinta,CA 92"25'3
SHOWING TITLE VESTED IN: Esequiel M. Coronel, a married man as his sole and seoarate
property
FREE FROM ENCUMBRANCES IEXCEPT:
General and Special Taxes for current fiscal -year, including any special.levie;a, payments
for which are included therein and collected therewith. Covenants, conditions,
restrictions, reservations, easements, rights of way, of record, if any;- also *xception
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 Checks= 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 days 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 continc;ency
eliminated.
3). Covenants, conditions,. reservations (including exception of oil, gash mine:-als,
hydrocarbons, and/or lease without right of surface entry), restrictions;, rights of way,
and easements for public utilities, districts, water companies, alleys, and st::eets.
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 a_ appropriate
government agencies, lenders, insurance agents, or other appropriate entLties 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, and local
geological ordinance(s).
5). Buyer and Seller acknowledge that state laws prohibit this escrow from closing
(recordation of Deed) until buyer's funds, including new loan proceeds, have been
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 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). SPSCIAL CLOSING INSTRUCTIONS AND RELEASE FROM BLANKET ENCUMBRANCE:. ?his escrow shall
not close and funds shall not be released from impound until title to the lot liar been
conveyed to the purchaser free and clear of any blanket encumbrance(s).
Certificate of Occupanc" X0�
Cit -'Of La'Quinta,.,'F'
r. 'y
V�
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=405 AVENIDA NAVARRO
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9802-014
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 z
By: DANIEL P. CRAWFORD JR.
Date: 5/21/98
Building Official
POST IN A CONSPICUOUS PLACE
I