Loading...
9709-085 (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 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 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 pert rmance 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: + �s -�,� Policy No. ANt1 - � .P , Carver ;,;�%1.i7%� L's,�.L�. AI�eU. 14 K't+'�bicrc�,v.Ofj1 (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 worcompensation laws of California, and agree that if I should'become s bect to the workers' compensation provisions of Section 3700 -of the Labor ode, Ishall forthwith comply with those`provisio s. Date: �"�� ?/ Applicant— Warning: pplicant Warning: Failure to secure Workers' Com pen salioplcoverage is.unlawful and shall subject an employer to criminal penalties/nd 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.... f� 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'withjn 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 correcVola' gree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of,, -this City tole -ter upon g Xth above-mentioned property -for inspectioi -purposes. ignature (Owner/Agent)�" '� ' Date`'�� x BUILDING PERMIT PERMIT# CONTROL# 6011 DATE 1W )/97 VALUATION >�"�'LOT TRACT i 13 Cod , VL.Q I AV4►>tii JOB SITE 5AV1KNIDitl VVL AI,1M'O 1 APN 7 13-W15_044 ADDRESS `OWNER CONTRACTOR /DESIGNER / ENGINEER ►w:�c { ' :' 'r?1'�*Fc�i; 1.•412. ♦e• � \..r.. 4\. 1 v {. Cerap . rT, !.J {.L.1, .r , 5.... — �.! i..i •r 1 i?.G1 BOX 399 / 40K 39-9 1 LA QL11N'1'r1, c,k q,?n. t.1A.QUINTA' A 9129 (760).V1,1-4604 104 (:11111; 7?61 USE OF PERMIT , ti1:lJ 01f13 -.l XIAUWA I 11A_Pk•.ZI1 114!31 1VtQ %jL,fU 1:1..R."_T- , lt.Ac S'vL,tl.. tx'1c,o.LLF13ts;,S :'+Je11.•4�„ 6' 4yiuf�tla��1`si1€�::E. inti,11* 4C'0114STRUI' ,;'014 i,.� a5.� ;1.1, 50-00 y.� 61!7WCODD 1,17,NCH Zfafl.f►t► LF ES"TINTA"1 13) COOSTRVV(71,141M f. P5711a 1313-4031'r 1vi[Gt74ANICAL FEE,: 00 547,40 ►:1XO"12ICAL YM 1014)00-4-20-000 �$12S.'26 01k.A11tril"NO. F .H. 101.11 1-&i 94,1{I{A e t fi,'!.5 :1I`42UtL' it1c:IZ.'ItJTQ1' �'•i2twS21 101-000-N41.0©0 Z!.<.: ORANN0F0- 101-ON1423••G00 SInf),W 01 ON A.5'1`RC.ft_'11f138F"kF 225.000-443-342 + 8t - tY 4 :fit t;1"i , �l � J R N :; a' �'t f �i, $3,t;:4�5 43 ; ,"1'4��+ , �iy� �.✓jr' 1�. LESS ice..-. ", fi .y D 1'1!+:RMIT 1+'VIU41atf1'.NOW 0 3 1967 $3,)96.43 OCT i i_�S3i %—D +• , RECEIPT DATE t � BY >F DATE FINALED INSPECTOR ts;. 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 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 BLOCKWALL APPROVAL -S 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 APPROV LS 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 Appliances Final Final Utility Notice (Gas) ELECTRICAL APP OV LS 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) COMMENTS: P.O. BOX 1504Fcif uildin78-495 CALLE TAMPICO LICATION ONLY Addrress vka geloSCO LA QUINTA, CALIFORNIA 92253 Owner r . In _ Mailing Address CitylL,Zip Tel. 2,�2'S'3' 167:64-- Contractor Address 4 If c State Lic./ a City 8 Classif. (n 3 � q / Lic. q Designer , `�` Address -"—"-- Tel. City (Zip (State Lic. k 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 II ense is in full force and effect. ') J --, f._ J �.Qi_ 1(/ L A7 41 SIGNATURE k / DATE If 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, 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 five hundred dollars (E500). I.: 1, 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.) FI 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.) i ] 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. O 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 (E100) 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 rhe 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 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 -of this city to enter the above• mentioned property for inspection purposes. Signature of aQplicant Date Mailing Address City, State, Zip DING: TYPE"CONST. OCC. GRP. Number ,I Description Ict Description �• /, REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line VaVk from Property Line FINAL DATE INSPECTOR Issued t.- C WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION 4 Sq. Ft.--'- No. / Size y f -a Stories NoDw. Units New p-- Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. . �a Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line VaVk from Property Line FINAL DATE INSPECTOR Issued t.- C WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION 4 Building Address P.O. BOX 1504 ,/ 78-495 CALLE TAMPICO - G e l 4 Sid LA QUINTA, CALIFORNIA 92253 Owner Mailing ? �� Address Po City Zip Tel. L. W. 1 722 5.3 el Contractor Address _1 City Zip Tel. 2- Cfj • %? �, $ ..SJ L s� SIG State Lic. City 8 Classif. j Lic. # 2 Arch., Engr., Designer Address Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION p1reb (firm that I -ffaensedb[lder vis ns of Chapter 9 (commencing with Section 7 i ne Business a " essii)ns Code, a -m nse is in full force.and e" ' �. .,- ;IGNATURE 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 five hundred dollars (8500). C-1 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.) t l 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.) i? 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. a 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 employany 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 it work thereunder is suspended for 180 days. I certify that I have read this application and slate 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 a(iplicant Date Mailing Address City, State, Zip -00 15'6c p6p-mIT *Ci -7 0 -080 rare APPe —55 citcttAa APPLICATION ONLY BUILDING: TYPE'CONST. OCC. GRP. A.P. Number Legal Description Project Description r Sq. Ft. IH No. No. Dw. Size Stories Units New R-__ Add ❑ Alter ❑ Repair ❑ Demolition ❑ mated on PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL " HEMARKS WHITE = FINANCE YELLOW = A AMOUNT ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FIT INSPECTOR 19 Iss e b Date Permit (VQlr_alpalatl d y: 1,99 7 Validation: PPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District Notice: 82-879 Highway 111 • Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 i CERTIFICATE OF COMPLIANCE. Date 10%2/97 APN # 4,.773-065-004 No. 16142, Jurisdiction La Quinta Owner NameEsequiel Coronel Permit # No. 51-100 Street Avenida Velasco Log # City La Quinta Zip 92253 Study Area Tract # Lot # Square Footage 1556 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: ' x EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.84 X 1,556 or $ 2,863.04 the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issUedy, ►; ; Fees Paid By Esequiel Coronel Telephone i5b4=460 Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Ellen Patino Payment Received $2,863:09:, Check No. CASH Signature OTICE: 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 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 public entity authorized to oltecl 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 Ll SALE ESCROW INSTRUCTIONS THIS DOCUMENT WILL AFFECT YOUR LEGAL RIGHTS - READ IT CAREFULLY! TO: COMMONWEALTH LAND TITLE COMPANY 72855 Fred Waring Dr. • Suite A5 Palm Desert, CA 92260 (760) 836-3726 Escrow Officer: Kelly Collier Escrow No.: 97.6880KC Date: 09/08/97 Page: 1 THE ESCROW HOLDER IS COMMONWEALTH LAND TITLE COMPANY WHICH IS LICENSED BY THE CALIFORNIA DEPARTMENT OF INSURANCE. Buyer will hand you additional funds prior to closing in the amount of .......... $ TOTAL CONSIDERATION and any additional funds and instruments, required from me to enable you to comply with these instructions, which you are to use on or before October 8, 1997, and when OLD REPUBLIC TITLE COMPANY can issue a Standard Policy of Title Insurance Owners form, with liability of $12,500.00, on real property in City of LA QUINTA, County of Riverside, State of CALIFORNIA viz: Commonly known as: �APN773`-0.65 004-4.;; LA QUINTA, CAL"TFORNIAj LOT 4, BLOCK 69 OF SANTA CARMELITA AT VALE LA QUINTA, UQNITNO-7%-,TAS SHOWN BY.MAP=ON FTEE IN.BOOK 18 PAGE 69 OF MAPS, RECORDS OR RIVERSTDE COUNTY, CALIFORNIA - Except any reservations of record of minerals, oil,' gas, water, carbons and hydrocarbons.`,:. Showing title vested in: ` ESEQUIEL M. CORONEL, A SINGLE MAN Free from encumbrance except: A. Current general and special taxes for the fiscal year in which this escrow closes, and taxes for the ensuing year, if any, a lien not yet due or payable. B. The lien of supplemental taxes, if any, assessed pursuant to the provisions of Chapter. 3.5 (commencing with Section 75) of the Revenue and Taxation Code of the State of .California. C. Special improvement assessments, if any. D. Easements, rights,_rights'of way, covenants, conditions, restrictions and reservations of record.