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9712-131 (SFD)LICENSED CONTRACTOR DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of H Chapter 9 (commencing.with Section 7000) of Division 3 of the Business and N W Professionals Code, and my License is in full force and effect. p 5 ch License # Lic. Class / �f xp. Date 1 w 1- 634981 B ,'/ � 1 �31ivt's Z D -' ' - „Signature of Contractor 0 r- U CD OWNER -BUILDER DECLARATION HLU ti I hereby affirm under penalty of perjury that I am exempt from the Contractor's U) License Law for the following reason: Z ( ) 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). C") () I am exempt under Section , B&P-.C. for this reason O N Date Signature of Owner CDd Q WORKER'S COMPENSATION DECLARATION p Q I hereby affirm under penalty of perjury one of the following declarations: r H O O 1 have and will maintain a certificate of consent to self -insure for workers' X W LL compensation, as provided for by Section 3700 of the Labor Code, for the O - Q performance of the work for which this permit is issued. CQ Q U () 1 have and will maintain workers' compensation insurance, as required by O U QSection 3700 of the Labor Code, for the performance of'the work for which this d to H permit is issued. My workers' compensation insurance carrier & policy no. are: Z Carrier Policy No. m CCY GOLDEN EAGI,,E INS, (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, shall not employ any person in any manner so as to,tiecome subject - workers' compensation laws of California, and agree that if I should become 3 subject to the workers' compensatiolfi provisions of Section 3700 of the Labor Code, I hall forth?th comply with 16ose prevision's. i 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 applicator agrees to, & shall, indemnity ICU &: 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 con tf8on, and hereby authorise representatives of this City to enter upon the above-mentioned property forinspection purposes.:--, 1 Signature (Owner/Agent) t R Date BUILDINGPERMIT PERMITiY ' CONTROL+ 9712-1 31 DATE., VALUATION $92,612.90 LOT TRACT . .6536 JOB SITE_ APN ADDRESS 5 -:%11 Ati !+'NIDA CURTEZ OWNER CONTRACTOR / DESIGNER / ENGINEER ESEQUIEL M CORONL CORONFL CONS"fRt.MION P0130X: ;tfi9 P.O. BOX 389 LA QUINTA CA 92.253 LA QUINTA. C'A 92253 (760)564-4404 - C8L# '26t USE OF PERMIT 811I - PMAOT OCIES NOT W(UT)BLOCK WAILS r.,lk P(J(1 L. PAILJ TRACT CO'NSTRuc OIN 1,485.00 tiF �.%'� �� LA OUNTA PORCHIPA:1.10 30 00 SF GARAGUCARPORT 501.00 $F I o FT. WOOD C'ENCE 200.0 LV �? ESTIMATED CONT OF CONyy'i RUC1 ON 92,614.�.II .. PERMIT T FEE SUMMARY CONSTRUCTION FEE 101-000-4111-0000 �i�f18.00 PLAN CWCK FEE 10.1-000439.3t8 " $511. YY 11riC t'idANICAL "-,F (01-U0", 21-t10() $5150 FLECTRWAL HE 101X000-420-000 $1125-56 PLUMBING FEE M -M-419-000 $127.50 STRONG MOTION FI~ - RESID 101--0004241-000 59.26 GRADING Fa 101-00042341010 3^zt1.i.'t► 1NFRASTRIJc;TUR.F FFF ?-►7-000443-342 YIiT:CISEPIAN 1011-Off0-X19]-�15 br . , FEE DEPOSIT 425k)JO) PLAN CHECK FEE 1101111-000�'i3y-31 t3" -$3$3.52 60,6401' CON STRUC11 N AND PLAN ME:Cti 1.X -SS PRE -PMD fFES 633. S2 TOTAL PERM IT FEES DUE NOW 58,�83.Z2 RECEIPT DATE BY DATE FINALED INSPECTOR vA INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APP OVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footing Ducts Slab Grade IJ Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap A 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 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 WrPlumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final COMMENTS: 10 Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fbdures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) Desert Sands Unified School District Notice: 82-879 Highway 111 Document Cannot Be Duplicated Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Date 1/14/98 No.. 1.6509 Owner Name Esequiel M. Coronel APN # 774-102-0(f(_* Jurisdiction La Quinta Permit # No. 53-560 street Avenida Cortez Log # City La Quinta Zip 92253 Study Area Tract # Lot # 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 1.84 X 1,485 or $ 2;732.40 theproperty 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/Coronel Enterprises Telephone Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Pauline Pearson :Signature PA _.LJZV10 I 1 6, Payment Received -$2;732.40 Check No. 158019 NOTICE: pursuant of Assembly Bill 3081 (CHAP 549„STATS. 1998) this will serve to notify you that the 90 -day approval period in whieh"you may protest the fees or other payment identified above will - begin to nm 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 colbct thorn on the Dishict('s)(s)°behalf; whichever ie 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 Building Address •A '4 9 P.O. BOX 1504 ^ 78-105 CALLE ESTADO L LA.QUINTA, CALIFORNIA 92253 vwner -1,-/sS 1,1 GJ C' / f 0 %G $11 Mailing / Address ��v 13 3 f y City Zip Tel. Contract?6'r orr1 //> //� r [Ji c)r.1.' J r ,, S Address ity Zip Tel. - & Classif: Lic. # Z C Arch., Engr.; Designer Address -,� Tel. City I Zip `I'Ste4e Lic. LICENSED CON�OR'S DECLARATION I herebTVJhat'i am licensed unbar.prpvrsions of.Chapter9 (commencing with Section 7000) oT'3 of the Business a 8 Professions Code, and my license'is II full fMend effect. ��-� Z ,? SIGNATLIR 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, e permit to, construct, after. Improve; demolish, or repair any structure, prlor to its issuance also requires the applicant for such permit to file a signed statement that .he Is /kensed pursuant to the provlsrons of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 offhe Business and Professions Code, or that -he is exempt therefrom, and the bass for the alleged exemption. Any violation of Section 7031.5. by 'any applicant for a permit sutrjects the applicant to a civil penalty of not more; than live hundred dollars ($500). El I, as owner of the property, or my, employees with wages as theirsole compensation, will do the work; and the structure, is not Intended or offered for sale: (Sec. 7044, Butsness 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 ernployees• provided that such: Improvements are riot Intended or offered for sale. It; however, the building or improvement it. sold within one year of completion, the owner -builder wig hive the burden of proving that he..did,not build or improve for Me purpose -of sale.)' 111, 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 tache Contractor's License Law.) 171 6 am exempt under Sec: B. & P:C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have.a oertificate�of consent to-self•insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sac. 3800, Labor Code]) Policy No. Company 17 Copy is filedwiththe city. ❑ Certified copy is hereby furnished. CERTIFICATE;OF EXEMPTION. FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if.fhe penin 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'Cali ornia: Date Owner NOTICE TO APPLICANT: If, after making this. Certificate of Exemption you should become subjecf 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:_ 3087, Cha? Code.) Lender's Name - Lender's Address This is.a building perrnftwhen 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. 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 APPLICATION ONLY�� /0 BUILDING: TYPE CCONST.. - OCC 774-/ A.P. Number — lo z — 66.3— Legal G.3 Legal Description G 1 11!� A/'11, l Project Description 3 fA ZONE: BY: n Midimum Setback Distances: Front Setback from Center Line Rear Setback fromsRear Prop. Line Side Street Setback from Center Line Sid&Setb Property Line FINAL DATE VJXINSPECTOR' Issued by: 21_Permit Validated by: Sq. Ft: No. Site f yS Stories No. Dw. Units. New Imo' Add.0 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: n Midimum Setback Distances: Front Setback from Center Line Rear Setback fromsRear Prop. Line Side Street Setback from Center Line Sid&Setb Property Line FINAL DATE VJXINSPECTOR' Issued by: 21_Permit Validated by: Val idation:ray� , p Q 1� tt ® LPA100 - CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO, PLUMBING FEES 1ST FL, SO. FT. @ $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SO. FT, @ FORMS SEWER OR SEPTIC TANK POR. SO. FT. 0 MOBILEHOME SVC. BARSINK GAR, SQ. FT. np POWER OUTLET ROOF DRAINS CARP. SO. FT. ® OTHER APPJEOUIP. DRAINAGE PIPING WALL SO. FT. 0 TEMP. POLE DRINKING FOUNTAIN SO. FT. ca, GROUT URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES =$ WATER SOFTENER VENT SYSTEM FAN EVA'P.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEWPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B,T.U• SO. FT, @ c BATH TUB SPARK ARRESTOR SQ. FT. Co c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 1'A c SEWAGE DISPOSAL LATHING SQ.FT.GAR a ?Ac HOUSE SEWER MESH GAS PIPING PERMIT FEE INSULATION/SOUND 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 GOND. 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 INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT, OCC. FENCE FINAL INSPECTOR'S SILiNATURESIINITIALS GARDEN 'WALL FINAL Certificate of Occupancy City ofLa 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 ollowing: BUILDING ADDRESS: . 53-560 AVENIDA CORTEZ Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9712-131 Occupancy Group: R-3 .Type of Construction: VN Land Use Zone: RC Owner of Building: ESEQUIEL M CORONEL Address: PO BOX 389 Building Official City: LA O.UINTA, CA., 92253 By: DANIEL P. CRAWFORD JR. Date: 5/26/98 POST IN A CONSPICUOUS PLACE