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9803-149 (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 Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date f rrW j 3 634481 Wate ' 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 tfie 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 urider 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. (� f 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 ; Gaal 13N:EAGLE'INS. NWC4218nW (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 3700o� f the Labor__ ode,,I shall forthwith comply with those prpadsions. 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,relatingto 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 r / VALUATION LOT "03-149 TRACT it 9 JOB SITE ADDRESS _ 53-315A'VMl<DAiiiAVARRO. 773-0402 OWNER CONTRACTOR / DESIGNER / ENGINEER C ORON"EL CONSTRUC.Y WN COR.(7Ni L. CONSTRUCTION P.O. BOX 389 P.C). BOX W Lel QUIWA CA 92253 LA t: VINTt1 CA .92253 '; y (760}--%4-4604- C8L# 2261 USE OF PERMIT SF0 - PrT2AAIT DOES NOT i1dGT,i7UE AI.C3CA Wrn1.;1.5 O12POf3.. ?S0/. PLANPAO CHrA- 'K. R1~ UCTTON APPLTI) APR 01 1958 .; TRAi C T CONSTRUC.'rION 1,421.0(► S.F' , PORC IST PATiO 3t 00 3F .� OARAGWCARP0Wf -5141 06`3F CI OF LAC. UINT 5 F1'. WOOD FENCt 200:00.1,(' ,, n � rt e• ESTIMATED COST OF CONSTRI[XTfON SQ),d13:S1t PERMIT FEF, SUMMARY CONSTIRLIC:ION FFE 101-000-418-000 $59=i.50 PLAN CIi6G'1 FEE 101.000-439-318 $502.70 ---V— 1ECHANTCAL FEE 101-000-421-000 553.50 . ELECTRICAL RICAL FE % 101-000-420-000 $123.52 PLUNGING FEE',' 101-0004,19-000 $133.50 STRONG NIOTION FEE - RFSID 101-000.141-000 $8.94 GRADING FEE 101.-000-423-000 $20.00 V 1NF'12Ab` 1ZUC,-rl1J RIE :225-00Q443-342 $1,962.75 PRECISE PLAN 1.01-000-44.1.-345 $25.00 V6.E DEPOSIT 101-000-439-318 • 4250.00 PLAN CHECK FFE 141-000=439-3:18 4377.0'? SUB-1'O"t'AL C0NS'TR0Cn0N AND PLAN CHUCK $3,4174,44 LESS PRJ-PA1131 EES -W.7.02 TCiTE1L,17T'Rh l'f FC1!,S IDlJ1f:Now $2,797,4'2 f 13 RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APP OVALS MECHANICAL APPROVALS Set BacksUnderground Ducts Forms 8 Footings / Ducts Slab Grade j_r Return Air _ Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap8 _ F.A.U. Framing//l/ _ Compressor Insulation 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 BLOCKWA I APPROV S Steel POOLS-SPAS Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APP OVALS 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 ,/� Sewer Connection Pool Cover Encapsulation Gas Piping Gas Test _S Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fbctures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power c Fina Utility Notice (Perm) COMMENTS: _ TA hf 0 • .:./..., .....:-•.:-.. ..., BOX 1504 APPLICATION ONLY �� Building L� 3 /3 l 78-495 CALLE TAMPICO- Address ✓✓✓ , QIQ( PV LAQUINTA, CALIFORNIA 92253 OwnerCOR Mailing AddresstL�, AllINTA,, CA .92353._,. City Zip Tel. Contracts , Address era- BOX 389 LA QUINTA, CA 92253 NI - ;lav 111' / y 8 Classif. Z Z� Arch., Engr., Designer Address Tel. City ZipIState Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divisiorf3 of -the Business and Professions�o . d my license is in full/(orccejand effect ,�� / 7 ai DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors 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, pdor.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 fhat. 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 (8500). 1: I, as owner of the property, or my employees with wages as their sole compensatlon;: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 'hat 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.) I1 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 contractor(s) licensed pursuant to the Contractor's License Law.) 1*1 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 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 1 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 ame Lender's Address / This is a building permit when properly filled out, signed and validated, and is subjectt'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. 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 "Y�_ BUILDING: TYPE'COO7N—Sy7. OCC. GRP. A.P. Number / / .q[._— 0? -9/—,0/f0 / Legal Description L U / /, K� I� f2 J 41, Project Description •"V• IV Sq. Ft. / No. No. Dw. Size �y ( Stories Units / New 9—'—_ Add O Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. .. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: d Front Setback from,.Center Line f Rear Setback from Rear Prop. Line rs Side Street Setback from Center Line If ! Side SetFiack from Froperty Line WHITE = FINANCE .1YELLOW= A INS?ECTOR Issued by:_�r1��Date Permit Validated by: qq Validation: lk Oi1.D��gppgg F�Y i A PPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District Notice: 82-879 Highway 111 Document Cannot Be Duplicated ,Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Date 4/1/98 APN # '773-184-002 No.: 168318 Jurisdiction La Quinta owner NameCoronel Construction Permit # No. 53-385 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 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 flee amount of 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 nocw,be issued X Fees Paid By Cashier Check/Coronel Construction Telephon'c. 564-4604 Name on the check 7 By Dr. Doris Wilson Superintendent Fee,collect6d /eiemp ted by Juanita Green Payment Received 42 5, Check No. 158279 Signature [.N kp 549, STATS.'1996) this will serve to not you that the 90 -day approval period in which you may protest the fees or other payment identified NOTICE: bcive will begin to run from the date an 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 t copy for all waivers Embossed Original- Building Dept./Applicant Copy'-' Applicant/Receipt Copy - Accounting AFN: //4-UV4-Uld, EGRANT DEED V -undersigned grantor.(s) declare(s):. IffiN O�l.".I;i�',,D'6'c'um-e.nt'a-ry--transfer tax is 0 Jk (,XX -X) Computed on full value of property conveyed, or - MR -4. Ckn� Computed on full value less lens and encumbrances remaining a-- In7 1 time o .,-.,.P,Unincorporated 'area:* City of and Wr - -'A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, �,` ESEQUIEL,M.' CORONEL, A SINGLE MAN 02 5 �.,��'6R�NT (S) to. JMQ,,2 01 1 .181 PeW K -, ,sMARINand ALMX`L.�, MARIN, & VT. . • 'Ab 4-i r' California they real,, the City of QUINTA, County Riverside, State of g4W, gesc d rib.ed as: , �LOT,0, IN BLOCK 214 OF'SANTA CARMELITA AT VALE LA QUINTA, UNIT NO.20, AS PER MAP' VVREC' ORDED IN BOOK 19, PAGE 38 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA pv Dat6d,,. Mwch 22, -1998 I!r,,t,"State; of -'California County',of, S.S. ESEQUIEL M. CORONER, re me, personally appeared "Lj,fii-66nal,ly known to me (or -proved to me on 'of, 6atisfactory,evidence) to be - - p n s %whose name�(s)., -is/are' subscribedIn .., to,;, Eh .'w thiih; iristrumeht. and acknowledged'to me-_,thdt�*,]�'e/sh�/the' ex6c'uited'the- same -dn', _j "V y ;o, their - authorized capa . city (i6s.) and s '-/her/their signature (s)'6nthe instrument the person(s)., or the entity -upon of ;which the,person(s) acted, -"executed the 'instrument . my hand and official seal. ISignature =z,.MAI LJAX STATEMENTS TO: A-7 (This area for official noia'�, ,RECORDING REQUESTED BY: ',REPUBLIC TITLE COMPACOMPANY --7370KC 103935-17 M05%R L. N IJAdK,MARIN 'dnd ))LMA L. 1%f1AR I N AFN: //4-UV4-Uld, EGRANT DEED V -undersigned grantor.(s) declare(s):. IffiN O�l.".I;i�',,D'6'c'um-e.nt'a-ry--transfer tax is 0 Jk (,XX -X) Computed on full value of property conveyed, or - MR -4. Ckn� Computed on full value less lens and encumbrances remaining a-- In7 1 time o .,-.,.P,Unincorporated 'area:* City of and Wr - -'A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, �,` ESEQUIEL,M.' CORONEL, A SINGLE MAN 02 5 �.,��'6R�NT (S) to. JMQ,,2 01 1 .181 PeW K -, ,sMARINand ALMX`L.�, MARIN, & VT. . • 'Ab 4-i r' California they real,, the City of QUINTA, County Riverside, State of g4W, gesc d rib.ed as: , �LOT,0, IN BLOCK 214 OF'SANTA CARMELITA AT VALE LA QUINTA, UNIT NO.20, AS PER MAP' VVREC' ORDED IN BOOK 19, PAGE 38 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA pv Dat6d,,. Mwch 22, -1998 I!r,,t,"State; of -'California County',of, S.S. ESEQUIEL M. CORONER, re me, personally appeared "Lj,fii-66nal,ly known to me (or -proved to me on 'of, 6atisfactory,evidence) to be - - p n s %whose name�(s)., -is/are' subscribedIn .., to,;, Eh .'w thiih; iristrumeht. and acknowledged'to me-_,thdt�*,]�'e/sh�/the' ex6c'uited'the- same -dn', _j "V y ;o, their - authorized capa . city (i6s.) and s '-/her/their signature (s)'6nthe instrument the person(s)., or the entity -upon of ;which the,person(s) acted, -"executed the 'instrument . my hand and official seal. ISignature =z,.MAI LJAX STATEMENTS TO: A-7 (This area for official noia'�, 1 Y IfCertifidate'of OY City'of La* Quints f Buildin'g.'alnd Safety. -Department cF` 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: 53-385 AVENIDA NAVARRO- Use Classification: SINGLE FAMILY DWELLING ' Bldg. Permit No.:- 9803-149 Occupancy Group: R-3 Type of. Construction: VN Land Use Zone: RC Owner of Building: -ESEQUIEL M CORONEL Address: PO BOX 389 ? City: LA QUINTA, CA., 92253 By: DANIEL P. CRAWFORD JR. Date: 7/11/98 Building Official POST- IN A CONSPICUOUS PLACE