0006-206 (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 # Lia Class Exp. Date
634981 B01/31/2(
Date,'' I - Si nature of Contractors"
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 contractingwith licensed
contractors to construct the project (Sec. 7044, -Business & Professionals
Code). I., ' .
( ) 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 STATE FUND • Policy No. 15007-09
(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 th"ose provisions.
Date: Applicant t ,
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 propertthor inspection purposes
Signature (Owner/Agent) t1 r f 'f Date
BUILDING PERMIT PERMIT#
- 4100•-'t,OY'b
DATE VALUATION LOT TRACT
fir`
JOB SITE
ADDRESS 77-30 C r . a`JONO
APN
7"M 2-012
OWNER
CONTRACTOR/DESIGNER/EN (NEER
CORONEL CONSTRUCTION
COR0147EL CON37RUMON
P,4J. D(YX 3€39
51.540':1- SE ROS M DR,
L QUINTA Cly. 92253
LA QUINT'A CA 92253
(760)564.4604" CEI,# 2261
USE OF PERMIT
SINGLE F.Pl"..Y DW.0 IM40
SFD - PR.P,.MIT INCI.i.11ZS 50.1.E 5' & 25LF 4' '' .M BLOCK *WAJ.,1.
PERMIT DOES NOT INCLUDE POOL
TRACT CONSTRUCTION 1,397.00 5F
PORCH/PATIO . - 36.00 SF
OARAOEIC:ARPOR.T (31) 11,015.20
e
6 FT. WA1.1.. ' 50.00 LF
6 FT. IXALI`-- 2.300 LF
5 FT, WOOD FACE* 130.00 111?
FISI' I" COST OF CC➢NSIMx,7fIMON
19,938.60
PMZMT M frowm"Ry
CONSTRUCTION FEE 101.000.418-000 $394,550
PIAN CHECK FEE 101-000-439-318 $407.04
CIMICAL IEEE 10'1.000.421.000 $33.30
ZLkz^TRJCA1, ME 101-000-420-000 $123:64
PLUMBING WE 101@000-419-000 $110.7:1
STRONG MOTION FEE - RZSID 101-100-241-000 $8.99
GRAlaINO FEE 101-000.423.000 $'120,00
DEVELADPER IMPACT FEE $1,907.00
/
PRECISE PILAW 1011V00.441-345
}?EE DAPOSIT 10 3000-439-318 •$ 50.00
Y 11
.. '
P UC -1.10 5 AND PLA14 CHECa
$1,415,42
H IMS PRE -PAM FM
-$250.00
OF �MAT
.�%#ITY
RECEIPT $
DATE
BY
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDIhIG
APPROVALS
MECHANICAL APPROVALS
Set BacksUnderground
Ducts
Forms & Footings
Ducts
Slab Grade '
_
Return Air
Steel
_
Combustion Air
Roof Deck
_
L�—y _�
S
Exhaust Fans
O.K to Wrap
_
F.A.U.
Framing(–
(��
Compressor
Insulation
•djp
�j
Vents
Fireplace P.L.
Grills
Fireplace T.Q.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
�J
Final
Final
_�— o
S
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
���'4�
Plumbing Final
Plumbing Top Out
1
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
�p . �j _oma
��J
Encapsulation
Gas Piping
�
Gas Test
I . ZG • O
Appliances
Final
COMMENTS:
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)
�"s%'--�`��4�P,"—vx^rir.}m'��*._....--�`!�1's?�,.•....-.`.•..y.�.v«o.�,...r„�.�,r-� ��,�'c�r--� •,�-��s�r-�;�^,.F—ars! as,"`�.'s'�4�^'i �57'a' :"'�,�"'
1040
T -,&t 4
P.O. BOX 1504
78-495 CALLE TAMPICO
Address APPLICATION NLY
Building _Ll \1 LA gUINTA, CALIFORNIA 92253
l c, \� p,nc�C G�
Mailing i
Address O ` ✓, _
City Zip Tel.
Address
�3-() -Y_�.0v, 3gr1
\. ;., U. ", r-\`, Zi I U D S-4, <, _ k
State Lic. City
& Classif�. Lic. # ^1
Arch., Engr., r'X
Designer
Address Tel.
City Zip State
Lic. #
//. �� LICENSED CONTRACTOR'S DEC-I,ARAT4 NN
�t_nereby affirm that I am jlcensed under provisions df Chapter 9 (cdmmencing kvitl
000) of Division 3 of (`Business aJPr fessions Code, and my lick se is�Cn full'!
61
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, atter, 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).
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.)
I'I 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'] I am exempt under Sec. B. & P.C. for this reason
Date IOwner
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.
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 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 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 applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE'CONST. rOCC. GRP.
—T
A.P. Number 1 -I 3— as:) — (.n -a
Legal Description ,Q �+�F�
Project Description-----------------.
f� f
Sq. Ft. ,� [:1
Size [ /
SNo.tories
Stories
No.
Unitss
New ❑O Add ❑
Alter ❑
Repair ❑ Demolition :3
Estimated Valuation
PERMIT
0
flU AMOUNT
n�a
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
kla Ul
TOTAL
REMARKS
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
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Desert Sands Unified School District `
47-950 Dune Palms Road '
-Notice: La Quinta, CA 92253'
Document Cannot Be Duplicated 760-77178515
CERTIFICATE OF COMPLIANCE
Date 7/13/00 APN # 773,252-012
No. 20720 Jurisdiction La Quinta
r +,
Owner NameCoronel Const. Y Permit #
No. 77-345 Street Calle Sonora �, Log # a
City La Quinta Zip 92253 ,' Study Area
4 Tract # Lot # 1 Square Footage 1397
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 amo$n of5
2.05 X 1,397 or $ 2,863.85 the property listed above and that building
permits and/or Certificatesof Occupancy for this square footage in this proposed project may now be issued -,�(, Ui: ,r__ '
Fees Paid By cc Valley:Indenpendent Bank, / Coronel Telephone 564-4604 i
Name on the check y
+ By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Sheryl Simmons Payment keceived ' -$2,863.85
Check No. 222868
Signature
�I' '
777/
e-11.,el
TICE: 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 paymeni identified
ovwill begin to run from the date on which the building or installationpermit for this project is sssued or on which they are paid to the Districts) or to another public entity authorized to
them nn Iha niefrirtr'clrc'l haheH whi haver ie anriier
_ Collector: Attach a copy of countyor chPlan check application form to district copy for all waivers. ,
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
'Recording Requested '16y ®®C a 2000-033524
CHICAGO TITLE COMPANI- 01/28/2000 08:00A Fee:6.00
Page 1 of 1 DocT Tax Paid
RECORDINGS REQUESTED BY: i Recorded. in Official Records
CHICAGO TITLE. COMPANY COMPANY I County of Riverside
I Gary L. Orso
99.9473 KC 97057908 i Assessor, County Clerk & Recorder
WHEN RECORDED MAIL THIS DEED AND, —
I
UNLESS OT
HERWISE SHOWN BELOW,
MAIL STATEMENTS T0. I
II1111 I
1111111, 11111111111111111111111
M I S I U PAGE SIZE DA PCOR NOCOR SMF MISC.
CORONEL ENTERPRISES, INC.
51-540 EISENHOWER DRIVE I
LAQUINTA, CA 92253
-7
1 7 3` IS 2--01 Z A I R L COPY LONG REFUND NCHG EXAM
o ► -] GRANT DEED ---
The undersigned grantor(s) declare(s): ��3 &
1 Documentary transfer tax is $15.40
(XXX) Computed on full value of property conveyed, or
• C r „
l
� ..) omputed on �u�� value ess liens and encumbrances remaining at time of sale.
Unincorporated area: ( ) City of and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
CORNELIO MEZA AGOOT and DORA P. AGOOT, husband and wife as joint tenants
ti
P hereby GRANT(S) to
CORONEL ENTERPRISES, INC., a California Corporation
the real property in the City of LA QUINTA, County of Riverside, State of California,
described as:
LOT 1 IN BLOCK 9 OF SANTA CARMELITA AT VALE LA QUINTA, UNIT NO. 1, AS PER MAP
RECORDED IN BOOK 18, PAGE 46 OF MAPS, RECORDS OF RIVERSIDE COUNTY, CALIFORNIA
Dated January 26, 2000
State of California
County of RIVERSIDE } S.S.
On JANUARY 26, 2000
before me, CHRISTINA BOIVIN,NOTARY PUBLIC
personally appeared
CORNELIO MEZA AGOOT AND DORA P. AGOOT
P (or proved to me on
the basis of satisfactory evidence) to be
the person(s) whose name(s) is/ subscribed
to the within instrument and acknowledged to
me that he/she/CSO-)-p executed the same in
his/hemi authorized capacity(ies), and
that by his/her signature(s) on the
instrument the person(s), or the entity upon
behalf of which the person(s) acted, executed
the instrument.
CORNELIO MEZA AG T
DORA P. AGOOT
'�_ CHRISTINA BOIVIN .
f Commission # 1146795
Notary Public - California
Rive -side County y
My Comm. Expires Jul 14, 2001
WITNESS my h�ofseal.`
Signature (This area for official notarial seal. -
MAIL TAX STATEMENTS TO: CORONEL ENTERPRISES, INC.
51-540 EISENHOWER DRIVE LA
V
RC DISTRICT - PLANNING REVIEW FORM
This form is to be used by CDD staff for review of single family dwellings in the RC (Cove Residential)
District, in order to determine the applicability of compatibility issues or need to require the filing of Master
Design Guidelines by the applicant. It shall be transmitted to the Building and Safety Department as your
correction list. Please attach additional explanations as necessary.
APPLICANT CORONEL CONSTRUCTION
SITE ADDRESS' 77-345 Calle Sonora . '
APN 77'3- 252 - 0.12 BIN NO.: CASENO.: 2000-234 -
LEGAL: LOT 1 BLOCK 9 UNIT 1 S.C.@V.L.Q.
CHECKED BY: Leslie Mouriquand DATE:
Inform the assigned Building plan checker upon your assignment to this case. The CDD Executive
Secretary maintains,a log book to track applications and assign case numbers. ,
REQUIRED ITEM
Y
N
COMMENT/CORRECTION
Compatibility Review
Case logged and number assigned.
Verify legal and APN information
Consistent with MDG on file (as applicable
r
MDG filing required (5 filings since 9/3/98)
-
Consistency with street/surrounding area:
Colorscla'"
Materials
Architecture
Other Requirements:
APPICED
BY
EXHIBIT
CASI
COMMUNITY DEVELOPMENT GAP i
BY COMMUNITY DEVELOPMENT DEPT
DATE
NO.
r
kA
CIL
Certificate of Occupancy
Cit of La Quinta
y
..a
Building.- and, Safety- Department
This -Certificate' issued pursuant to the requirements of Section 109 of the* Uniform Bui/ding :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: 77-345 CALLS .SONORA
;Use Classification: SFD Bldg: Permit.No.: 0006-206 .
Occupancy Group: R 3 Type of Construction: VN Land Use Zone: RC
Owner of Building: CORONEL CONSTRUCTION Address: P.O. BOX 389
City:' LA QUINTA, CA 92253
` By: STEVE TRAXEL ,
Date: .02-13-01
Building O icial