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9912-005 (SFD),n 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 amend-'"' Professionals Code, and my License is in full force and effect. License # Lic. Class Exp, Dater �►3�a` 1 Fi 0i/i1r'e01 Dat e% ✓� L��?Signature.of Contractor i OWNER -BUILDER DECLARATION I hereby affirm underpenalty 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,.td construct the' project'(Sec. 7044," Business '& Professionals Code). O 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 Policy No. GCaL1 :, QAC=L:tltir.'�L'C.1N2�;5tD-ERZ.. ' (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 subjecteto the,: workers' compensation laws of California, and agree that if -I shoul necome subject to the workers''comperisaiiop provisions'pf"Section 3700 of.the.Labor Code!? sh I .orthwith comply with thos provisions( Date:r'' - VApplicant Warning: Failure to secure Wo46fs''1Compensation coverage, is unlawful and shall subject an employerto.criminal.penalties and'civil fines-up.to $100,000, in addition to the cost of compensation; damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the :conditions: and' restrictions set forth .on his application. j 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton'agrees to, & shall; indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a resultof this application becomes null and void if Work, is not commenced' within 180 days from date of is of such permit, or cessation of work for 180 days Will subject permit to'cancellation. I certify that I have read this application and state.that.the above information is correct. I agree to comply.wjth all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned' proerrty for inspectio/n�purpos s Signature (Owner/Ageri!�� �/ ``wDat1�^ L+ " e BUILDINpPEpRMIT (• PERMIT # G- DATEI /ey VALUATION �1aS?��b+y�l�,7 ,. LOTTRACT�rS.t'.eyf�`CITZJ JOB SITE ' 41�-390 ���.,.�.ch�t �L ANI iIJJ�l.ifa APN ADDRESS c { OWNER CONTRACTOR/DESIGNER/ENGINEER �?RTINC. EL CON CORON,��CO 5.1-540Ei$E,N�'1i01tVHK DIL.' 31:540 ISEN1iOWE l:}`R_ I.TA C UINTA C:1}, 9225:3 � €xiq*Ay i; �U�AAAI'Ael��'[/(4�� ���5 . BB y� fy p USE OF PERMIT' Lt'�+1s iLk FfiOEdt:�; .9FQ - PEPNiff DOES NOT N'G'.1'WC.RX-ALOe^%.WALL oi;-.Pool.. - 771C.. 'Csi5iRUC,3.0. 5 76.i$ S 0, ffOCC�i)X 77O 4.18.00 (iA4Z.r:�311C�f142:�(;Jk`I' 74t't.tlti 5#% . ES uINIA'i`L4 3'Clogr OF C;C;'.'N�$��d�;IC ��C3N '�;rfi��'$b.�i� sulkiMARV t;t1N�S'l`lCUt49'b� )l d "r;F E. l0i-it3-�10 $53.0(6 �3fp�'Yt�+!'CHECK F?i, 0l-fC�i?{f(y}-A(y�q-33.€\3 $Q71/7�.(6,1 LV1A-o."--.Cv'@.1�6�t..1.41 i�. .�V�'•4/l➢LI``�dG..P• I<f ,Ci�C.I Yf. P.LUfY1iJ.NQ'fF'Fi7 101 -0$419 -WO ST1tON(J 10YA10N ET, - R.GUSID 10t-000-29:1- } $36,05. i OR "U. 1 F'kx l�.l.•{)Q�-4i�3-ttC�13 $ t�.QlY TiEVk'f 01)0 VN1P/qG 9 -VE, I;f,S'U7.fs0 'Pti.ECJn PT;At_u 11.()1-1it10-4141-345 Ja�ttl+Crc) �GiT ips�1�fA.tT1C: r'L,A�'L'.+ ,laS-S� 7f,j•.(1(�(}-2`:'��Q S!�1..?4 FE -B, DIL"FT M., 1€1.000--439-318. SUD-'MTW, CONST? UC7TTOINAND MAN Ci•tUX, V$ ,11:95.77 .LESS PPE TAID I;l;ES -roAAL PERMIT FEE..81.Dl?.K`1' NOW RECEIPT DATE�BYi-DATE FINALED . INSPECTOR - t > ... .... �. _ .. .MLP.:. r.. s ...,. _. INSPECTION RECORD M OPERATION DATE INSPECTOR OPERATION' ` '. DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Slab Grade AE Ducts Return Air Steel Combustion Air Roof Deck S!. It - O'0 S? Exhaust Fans O.K. to Wrap - Z ,&a 57- F.A.U. Framing p-`-ooSf y L,od 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 _ �` 5 Final u _s/O 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 -11 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 Utility Notice (Gas) �l 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) 1 ' P.O. BOX 1504 Building!! /1 78-495 CALLE TAMPICO Addresf ✓R^_{ L G�(Ic�1:,7jCf% it LA QUINTA, CALIFORNIA 92253 Ownern Mailing Address,F ���(� f.-! Wit'/1� >j,�J!✓ ><�✓ - City { Zip Tel. Add/rreess City Zip�11a �,. Tel.,-- C1rt llLl✓��i� .1 66c/_4fb©. State Lic. City & Classif. �/� (� �' Lic. # 27 b Arch., Engr., Designer Address Tel. CityI Zip I State I Lic. If LICENSED that I am licensed 3 of the Business, my license is OWNER -BUILDER DECLARATION I hereby affirm that,l am exempt from the Contractor's License Law for the following reason: (Sec. 7wl!S5 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 ($500). (.: 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.) 1'1 1, 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 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, alter 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 1 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 a0plicant Date Mailing Address City, State, Zip BUILDING: TYPE'CONSgT. / A.P. Number �%� / �Zfillf Legal Description Project Description� Sq. Ft. 2 5 / Size New CE /— " Add ❑ stimated Valuation Plan Chk. Dep Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading No. Stories Alter ❑ No. Dw. Units Repair ❑ Demolition ❑ AMOUNT 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 Side Setback from Property Line FINAL DATE ,r < INSPECTOR Issued by: K Date Permit Validated by: Validatiofi: WHITE = FINANCE YELLOW = PIPPLICANT PINK = BUILDING DIVISION Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 5/18/00 No. 20454 Jurisdiction Owner NameCoronel Ent. Inc. No. 51-380 Street Calle Tamazula City La Quinta zip 92253 APN # 769-141-004 La Quinta Permit #9912-005 Log # Study Area Tract # Lot # Square Footage 2576 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: EXEMPTI®N NOT APPLICABLE This.certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 2.05 X 2,576 or $ 5,280.80 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 CCNalley Independent Bank/M. Coronel Telephone,,,- 760564-4604 Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Mary Ann L. Boda 'Payment Received t ire t �e� Check No. 2226321 ,. , , . Signature � NOTICE: Pursuant of AssemblyW 3081 (CHAP 549, STATS. 1988) this will serve to notify you that the 904sy approval period In which you may protest the fees or other payment Identified above 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 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 copy for all waivers. Embossed Original- Building DeptJApplicant Copy - Applicant/Receipt . Copy - Accounting 78-495 CALLE TAMPICO LA QUINTA, CA 92253 (760) 77777075 APPLICATION FLOOD PLAIN DEVELOPMENT PERMIT BUILDING SITE LOCATION FLOOD ZONE "AO" - DEPTH i y' �Z I 'Cc, G 1 !f''�%CI(/ COMMUNITY= PANEL NUMBER 060709 0005 B Map Revised: 8/19/1991 APPLICANT INFORMATION SECTION APPLICANT NAME. CJ ,� (-: �-, '%7e-• APPLICANT ` ADDRESS"C� (MAILING ADDRESS, NOT THE BUILDING SITE) r . DAYTIME TELEPHONE NO. (dj �, L160 INSTRUCTIONS . 1. A Flood Plain Development Permit is'required'by LOMC Section 8.11.040(A). The Applicant should complete the Applicant Information -portion of'this application and submit it to the Engineering•Department along with'the .noted required documentation hereon at the same time the Precise, Grading Plan.is submitted to the Building and Safety Department for plan checking.. Z. Documentation required for STEP 1 OF 2 APPROVAL prior to receiving clearance. for Building Permit issuance + Copy of the proposed Precise Grading Plan for review and approval containing all information required by- I-- the checklist shown on the back of this application. 3. Documentation required for STEP 2 OF 2 APPROVAL prior to receiving Flood Plain Development Permit approval. , Note, this approval occurs after forms for the lowest habitable floor are set and before the Building & Safety . Department authorizes foundation construction. . " • Submit a completed FEMA "Elevation Certificate" form to the Engineering Department. t Submit 95% relative density soils compaction certification to the Engineering Department. STEP 1 OF 2 APPROVAL • 'STEP 2 OF 2 APPROVAL The Precise Grading Plan submitted for this application has been All requirements have been satisfied.This Flood, Plain reviewed'and found to contain all data required to satisfy the Development Permit is approved. requirements of LQMC 8.11 The proposed dwelling is eligible to "receive a building permit upon satisfying all other Building & Safety Department requirements.. A THORIZED S NATURE DATE AUTHORIZED SIGNATURE DATE La Quinta Engineering apartment La Quinta Engineering Department - Fo9b REV -1 11/99 CHECKLIST FOR PRECISE GRADING PLANS IN "AO" FLOOD ZONE 1. Prepare Precise Grading Plan in accordance with Checklist for Precise Plans and the following additional items. 2/3'. All elevations shall employ the NGVD-29 convention. w nd label elev i " ' n Grade" next to the 'building Sho a elevation of Highest Ad�ace t . footprint. This refers to the highest existing natural grade next to the proposed building prior to constructing the elevated the building pad. 4. Show and label the "Highest Existing Elevation on Lot' v5. Show and label the "Lowest Habitable Finished Floor Elevation". Note, this elevation shall beat least ONE FOOT higher than the "Highest Adjacent Grade" elevation. The following grading note shall appear on the plan: All fill material placed under the structure shall be compacted to ninety-five percent (95%) relative density. F080A 10/88 c� Sent -By: Desert Pacific Properties; 760 360' 7580; Nov'.5-.99' 12:C9PIJr, Page 2/3 y,6 ii/05/99 12:24 0 44-4SELE:VA PAC POP _ IZ002 , - r r CoMMOMrV�aUN SAND tME CO. Dail- . me, z sv>o— 3 i s es A6GORDLYC iltplfe5'11ta�y 671230lan ":eta Put* 1 of 2 tlmd 1 Tax PAld AMP WOW RXC011A7l MAIL T01 r Fpvrdad h orfleU) Nwmtds ca told+et alranle•� 4 4•ry L. Cram La Quint a•al, a- CA, A- 92259 Drive AO.OaOur, C0,401Y Cl•rb-4 Reeard•r • Y 11����If��(fuUlNlil�l��tl • M0G-, I l A. P. K,; 77(AN: 0 0'O/tr Order No.: do '7 0044 A I• i aa.^:aoa wuar ,�,, •,` GRANT DEEP T UHDLASIONPD UAAE(rOgp� pFt LAQF{N T1iA'C DOCu1d6Ni'AAY.TJt AK3P2R 7 ut iS: GDUNrySp C� �XJ eompuled'Aa ZI value of p eooYeystl, w - 1J1J =led on II uque less value-ot Ilene art',,, raaces cemeina,g ai tlmc of Rile, ` umnroR�omkd area; [ 7C City of I A.Q[LNTg, and FOA A wALUABLBCONSroBRA710m, RMIX Of+uYich is hereby ackaowlCdged, C MAMIEHUNT, awidow who srquired_title as C. Hunt hat GRANT(5)w EZFQUJZLCORONEL,. a married men no lata umt, an'3aeeydtet® >yroyl�rPy the fnllov.Ing described prvecriy in be My of LA QUINTA, County of Rl'YERS[DE 4)2te of CaGfomio; I SIBS USIBIT •A• ATTACHED HERETO HAD MADE A PART'196RE0PM AUNT t 1 DoeumutCDital l ne 3 1 5TATEOFCA rtAlA - ODUN Y 1° 9- 0 - Oo bermeed Penoravy hewn to we forpoeecd to.,o on eM buts o►,nitQrrorya°iJemce) In ae tLe pens p) Wllote nAaa,(y �lxm SWncrltad W dw wllhin ir,co0lnet• } and .cknOwkdrm m the ehet �drhudleY eseMod ft acme In hIlAIMAkir 61111Aariaed Crptdrypn) ant tf ttly Aufiw/d r r tlletsmn(,> On Ih0 tear n+nn the pmaon(i) Uy Of mti�, for rwMr.lt1 tele!, carcwtd dlt InAuvmere. , TWO 4m kraftal not. -I W. r J. iONTAINE ' • Q � f�mm. Jl6ir67 - O •'�Nm1ARY I onC• GtO WtA6 i �• • •e,.,aieaawry � Goan eaD On., i..Yel Moil Tax S(a(aments lo: SAME AS ABUYS or Address Noted Ealow , • o._ Citof�La. Quanta. Buildingan d 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 'fhe City regulating building *construction or use. For the following: BUILDING ADDRESS: 517380.CALLE :TAMAZULA Use Classification: SFD Bldg. Permit 'No.: ­ .9912-005 .Occupancy Group: R 3 Type of Construction: VN ..Land Use Zone: RL Owner of Building: CORONEL ENTERPRISES, INC. Address:. 51-540 EISENHOWER DRIVE City: LA QUINTA, CA 92253 By: STEVE TRAXEL Date: 02-05-01 Building Official POST ,INA CONSPICUOUS PLACE-,