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9700-009 (SFD)LICENSED CONTRACTOR DECLARATION U) 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 N W Professionals Code, and my License is in full,force and effect. O Z) M License # Lic. Class Exp. Date W Z r, /Date r✓' ` + Signature of Contractor0�s CD U rn OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's ~ 41 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). ce) () I am exempt under Section , B&P.C. for this reason LO nl Date Signature of Owner ON 0) LD Q WORKER'S COMPENSATION DECLARATION o 2 Z I hereby affirm under penalty of perjury one of the following declarations: 1,2 0 () 1 have and will maintain a certificate of consent to self -insure for workers' X W �= compensation, as provided for by Section 3700 of the Labor Code, for the O J Q performance of the work for which this permit is issued. E0 Q U ('j) I have and will maintain workers' compensation insurance, as required by O U Q Section 3700 of the Labor Code, for the performance of the work for which this rn H permit is issued. My workers' compensation insurance carrier & policy no. are: ? z Carrier FT 1 t� Policy No. ob iia °L3�I`7of l,fi� i,la i�� i, cv +`4'19*tr)1) `VtJ (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 3 subject to the workers' compensation provisions.`of Section 3700 of the tabor Code, I shall forthwith comply`with those provisions. 1/6ate: = r % Applicant 4 4y Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each personat , whose request and for whose benefit work is performed under or pursuan66 any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is • correct. I agree to comply with all City, and6State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for insp� ion purposes. t: rSignature (Owner/Agent) �� �� /d Date/` BUILDING PERMIT PERMIeI�aW� CONTROL# 1 3 8 DATE n� VALUATION ea LOT TRACT (/d 7 h �. �. , , , ADDRESS v �' t�� i 1�I��LC Pi .il� �i�1r1 .� JOB APN 777, Y'}1. 6101N OWNER CONTRACTOR / DESIGNER / ENGINEER IS ISI.' EL B t:°>" )%,01 Sh;1, 3i ►aii livl, h°° dlSa'►Y�'I°i� .DR LA Q1116V`V N. (.'A O.IYV1 I mA 01 II�rCIN, CA 4 253 11,49),W-4404 MAI 1117161 USE OF PERMIT SF0 - P11 -kA ll Lr'K1RS tN04 INCrA0011 t3LK;fi k WA1:I.v t* P� j,. rpt_,L01)Ls*i 1411)1"K, 6' WOOD F1'ih't'E (JAR A(ItY 'ARYL &V' +.t .( 1 83 rNTIAIA`F ,D CONTOr CONS RUCHO+'d OR;6 01< SONIMAai' C0'N8TX11(7rI0NFIF F to$ 1.J1_A1q CIO -4'K FRI 10 14100-1311 if 8 ter.°t,tfAt�Ie�Ahl I �; Iui<Oilth�i�I-440 �ti3 tia 14,Vf 7RICA11, 1 EFF 101 (M-40)0 SSi Ifkli I" 14,1 I,NIIIATKfi 04- 1101 Pplt1h 1114-(11}1) gl I� 75 `a I' %%�vtiC�G�.SII Citi1'r'I "tt?`�IIJ 101 (Wi�")'74IVO �3 f'r tFil)l�i I•t I.CIltdt Ib1PRAN11V1f�'i' ;XA'-'F'hi' ?211* lft _4-13-34u " ttil,s" 117 PtiJ, (T4F M N � i AI �(Jt!(? �I,�1 _,�h ��R tit) NOJ�i-I'l'►'�!(dt'C> J "I}iC3L"�`iC`a t Ai>I1_) At,A t"�li�t� 0�111009w IX,%., ld?-I'AI1 1, 1," 0 51997 SUN 'I'M At. P�,, Wff IF FM Darr, N()VIf Cf RECEIPT DATE ABV; DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE ZSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVA 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 BLOCKWAI.X APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final z 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 Piping Gas Test Appliances Final COMMENTS: Final ev Utility Notice (Gas) ELECTRICA PPROVALS 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) T4 4 4 Q ulk& T704 -- 001. P.O. BOX 1504 APPLICATION ONLY Building ' /�U /J_ _ _ / / /G S�v 78-105 CALLS CALIFORNIAESTAD9 Address J` /N�' (-/P ( LA QUINTA, ORNIA 92253. Owner Mailing / BUILDING: TYPE CONST.______ ^ 0l — 60NST. OCC.GGRPP.. Address S� --75,S�'V� V �G S(C� A.P. Number / 7 City / Zip` Tel. L J (�%• E+ J (�/ r / 7 !c !', C Ukd� qZ � 3 S6LI 41662 Legal Description Co tractor Project Description �_f• ��• 2 v t20r7_e 1 co I � ���'� •� Address P_ 4) - �k 3 City/ Zip.? 2 Tel ,Li�t1UL� ,,a- PL, Lr f�'a- 5 State Lic. c City & Classif. j y / � j } Lic. # ZZ 6 / Sq. Ft. C No. No. Dw. Size , Z /�� Stories Units Arch., Engr., Designer New i]/ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic: # LICENSII�D CONTRAC R'S DECLARATION 7,�I ereby affirm that I am ficensed under provisions of Chapter 9 (commencing with Section 0 of Divisio of the Business and Professions Code, and my license is in full forceand Aetfe t. A // 7 / !1 AC �/ r SIGNATURE \ ty' v DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated. Valuation 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 for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 1 1, 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. 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, Mech. 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 Electrical of proving that he did not build or improve for the purpose of sale.) II I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing strucI the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law doesnot 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 1 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. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (8100) 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 C nter 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 from Prope Line Lender's Name R Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE 4 INSPECTOR 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 Pef 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- Mailing 2 139 'Q /1 Mailing Address Validation: APR 0 97 City, S4ate, Zip BUILDING DIVISION I CITY OF LA Ql. INTA 7 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING F� IST FL. SO. FT. @ $ UNITS SLAB GRADE 2ND FL, SQ. FT. BONDING YARD SPKLR SYSTEM POR. SO, FT. @ MOBILEHOME SVC. BAR SINK GAR. SO, FT. 4r, POWER OUTLET ROOF DRAINS CAR P. SQ. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. @ OTHER APPJEQUIP. DRINKING FOUNTAIN SO. FT. @ TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN BOND BEAM MECHANICAL FEES WATER SOFTENER =$ VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) FRAMING 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,TEMIPERM LAVATORY SPARK ARRESTOR HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB LATHING SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 11A c SEWAGE DISPOSAL INSULATION/SOUND SQ.FT.GAR @ 3/ac HOUSE SEWER GAS PIPING PERMIT FEE CERT. OCC. PERMIT FEE PERMIT FEE FENCE FINAL DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE GARDEN WALL FINAL 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 APPJEQUIP. 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 SIGNATURESIINITIALS GARDEN WALL FINAL Desert Sands Unified School District Not ice• 82-879 Highway 111 y - Document Cannot Be Duplicated Indio, CA 92201 619-775-3500 CERTIFICATE OF COMPLIANCE Date 6/4/97 APN # 773-091-005 No. 15598 Jurisdiction La Quinta Owner Name Ismael Coronel r Permit # , No. 51340 Street Avenida Velasco Log # City ,La Quinta zip 92253 Study Area 113 Tract # Lot # Square Footage 1290 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 mobilehotnes. 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 1,290 or $ 2,373.60 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 cc/Valley Independent Barik/Coronel Enterprises, Inc Teleplone - 564-4604 �F Name on the check By Dr. Doris' Wilson L Superintendent � `' r � �l,l wf ��, • Fee collected /exempted by Pauline Pearson Payment Received $2;373.60 Check No.' 141454 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 'Ilett 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 RECORDING REQUESTED BY: ORANGE COAST TITLE COMPACOMPANY 96.5787KC R-151224-1. WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BELOW, MAIL TAR STATEMENTS TO: ISMAEL B. CORONEL and MARIA M. CORONEL 51-755 Avenida Velasco La Quinta, CA 92253 P AID Doc. Transfer Tax FRANK K ,JOHNSON Riv. Co. Recorder 196834 RECEIVED FOR RECORD AT 8:00 O'CLOCK MAY 2 91996 Recaoeo in unsaw necorc . of Riverside counly,calitorrva. 111YYY Recorder !" Fees S l �r SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED APN: 773-091-005 77L1�- ; O ZO 0) V The undersigned grantor(s) de�lare(s) Documentary transfer tax isi'$9.90 (XXX Ccr"put,?d r,.n ftzl1. valt.tb of nr.onerty conveved, or Computed on full vale less liens -and -encumbrances remaining at time of sale. Unincorporated areay ( ) Pity of and FOR -A VALUABLE CONSIDERATIbIT,,Zeceipt of ::Anich, is hereby acknowledged, STANLEY I. COHEN and ADRIENNE D. COHEN, as Trustees of The 1992 Cohen Revocable Living Trust, u/d/t July 21, 1992 hereby,GRANT(S) to •ISMAEL,B. CORONEL and MARIA M. CORONEL, husband and wife as joint tenants the real property in the City of LA QUINTA, County of Riverside, State of California, described as: LOT 5 IN BLOCK 63 OF UNIT 6, SANTA CARMELITA AT VALE LA QUINTA, AS SHOWN BY MAP ON FILE IN BOOK 18, PAGE 67 OF -MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA Dated May 16, 1996 State of California County of Lo S ',. ^ _ t S ..S • ca " u'_.�f a,4, I,, ct before m personally appeared stcj_�.,(e.� Aek rip- yl v f) I C,keh (or,proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) i&/are subscribed to the within instrument and acknowledged to me that he{-j:he/they executed the same in /their authorized capacity(ies), and that by h4-r�/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted., executed the instrument. WITNESS my hano and official eal. Signature MAIL TAR STATEMENTS TO: STANLEY COHEN, Trustee ,. ..AE . COHEN, Trustee (This area for official notarial seal) / • ^� ni �p �u nen-� '-`.: � �ir i bic. C;_:.;,: is \\ fAy ccr mis ,nn f-:xriies `,✓ c SAY 10.1c (This area for official notarial seal)