9806-175 (SFD)•. I LICENSED CONTRACTOR DECLARATION
'I hereby affirm under penalty of perjury that I am licensed under provisions of
F 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 License # - Lic. Class :_ Exp. Date
r– Q Lf). p' µ r,�
Gi:- / bs�iUkl B 1/S1%G4}
Y-Al
~`Z r— ate. � v)Signature of'Contrad'or - _
H OWNER -BUILDER DECLARATION .
W w I hereby affirm under penalty of perjury that I am exempt from the Contractor's
~'a • License Law for the foll'o`wing reason:
U)
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).
�F ( ) I am exempt under Section, Bul
&P.C. for this reason
-N Date Signature of Owner
.O�
U _Q WORKER'S COMPENSATION DECLARATION
CL
' C) �. Z I hereby affirm under penalty off' perjury one . of the following declarations:
Lo- <°.O ( ) .l have and will,maintain a certificate of consent to self -insure for workers'
X, LI u- compensation; .as provided for by Section 3700 of the -Labor Code, for the
< 0 _ Q performance of the work -for which this permit is issued.
Q U (.) I have and will maintain workers` compensation insurance, as required by,
;-,;.o.,U Section 3700 of the Labor Code,.for the performance of the work for which this
F_; permit is issued. My_workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
�3RdE._
.t1.oia7:..� 11 �i�W�.'�.Y���'-r'.i•�.
Y. J (This section neednot 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' compensationJprovlsionrf Section 3700 of the Labor
Code, I shall forthwith comply with"those provisions/
VDate' I �.J) . �a�J Applicant
Warning: Failure to secure Workers' Gbmpensation coverage is unlawful and
shall subject an employer to crimin4l 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. L
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'[ have read this application and state that the above information is
correct. I agree to comply'Aith all City, and�State laws relating to the building
construction, and hereby authorize, representatives of this City to enter upon
the •above-mentioned property for inspection purposes.
� t Owner/A e •fit) <� - � Date...
„Signa ure ( g
;: i _ `
BUILDING PERMIT'S PERMIT# '
` '1%:
')306
DATE VALUATION &9d 9� LOT 1�7
TRACT 87
6 T
uq
J(+ JI �}
JOB SIT -
APN
ADDRESS 511-220 AMNIDA VJ;iiai,EJO
773-0631-010
OWNER _ l _
CONTRACTOR / DESIGNER / ENGINEER,
1AS'EQUM—I.. Ct�RONEL
CO.f'LG EL C~ta�JSORLIC TION
5.t-3f+U T 15Ts�tH(��NFilt i�&t.
SI'-546'USEN:�.Ei�'i ER DR.
fa A QTJTN T.�C CA 9225.3
1.A. Q U 1'A. �`� CA 91153
(' ,60)564-�1f. 04 CBL# 7261
USE OF PERMIT
SIRD
sll) - PEx2:n�IT !JOSS NOT [NCLU"I E BLOCK. 3? i' LLS CJ.R P+30L.
'T`Tt.f�.t~",t' CO�d�;'l"E2Cii� ,1014 1„rj45.00 SF
PORCEMPAY10 65.0 Sr.
ciA(tf1l�NJt�i�F21%c<1.K'!' 463,01) S1%
'11) CC?'ST OF € ONIS�"�:.t1MO1S”
. ,.,�:, ",2�f2..80
CrA4t3't'W2t3r�".i30N D..�;`i.1 101 -00041R -OW $G:gI,�C►
n11 A_ d d;'it�";t,��tt !-Tr
1 1� t�f:VO ST'IT 101.-000-439-318-SF50.00
t 11~x. IR_ I�CA 'r'f~1J 1Et:l
RU r��r YN- 0x h FTR 01 -pf lf0-4 f .4-()C!T)
t 712Al�}.1V�# (tai: 1111-i�11 1423-i;E111.1 raw
.fNF AISTRUtc 110R�; FEBV 25-4MI-44 t-342
ty(pt?t'18B ?4.A_N b l_11.� k1.44. t-345
.9st}3-'t'%AT:,�'QN�►�t�Cf"fC11�.A:NDPLA.N r;Ft�;t;;ri
�3,771.rTn
LESS PRE-I�.t�.TT)FE� 'S
_$25{1. X)
ti 6 itTt�li,. PE�11ZMIT (TEES. �� � 4. NOW
$$3, 521.06
J U L 2 1998
t : •e'—•,'3 -1 � ;: \ .ail.: ow,
,
RECEIPT I I b �!t
DATE. :R i X I r' E 6
. BY y%
DATE FINALED
INSPECTOR
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 j/
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVA 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 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
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)
Building
P.O. BOX 1504
ZO r r 78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
vwne tt C00'Ca/ c - l
Mailing P�
Address L1 WiC SCI
City Zip 01
Tel.
Address
[ Its- Its% ZIP f 72-�_ j Tel.
State Lic. / City (cam b
& Classif. 6 ��� i� / Lic. #
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACq'TOR'S'DECLARATION
affirm that I am licensed under oovisiaps.of.Chapter.9 (commencing with Section
ivision 3 of the Buaines a tl P fessfons Code, and my'I� nse 's in full foc`iYre and
b-- l= -
OWNER -BUILDER DECLARATION
I hereby affi, 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 ($500).
l; 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, Bukness 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.)
Il 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 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
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 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.
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
APPLICATION ONLY
ILDING: TYPE'CONST. OCC. GRP.
t. Number II �" Cvs— DtC) - %
fat Description Kf) %��[7 -'9
Project Description
1b 1,b7l
�j
Sq. Ft. StoNo.ries
Size Stories 11,,,,�,r
No. s --�
Units
New b✓r Add ❑ Alter ❑
Repair ❑ Demolition ❑
7 ! 5 e%4 U
--I A 109 -
Estimated
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bat.
Const.
Mech.
Electrical
Plumbing
S. M. 1.
Grading
Driveway Enc.
Infrastructure
.. 1
TOTAL
i .-/ 15 0
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
INSPECTOR
Issued by: Date Permit
Validated by: nA
Validation: rm
JUN 1 1998
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
IL I
%A-11 Y Of- ► A QUIN i
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 7/21/98 APN # 773-063-010.
No. 17349 Jurisdiction La Quinta
Owner NameEsequiel Coronet Permit #
No. 51-220 Street Avenida Vallejo Log #
City La Quinta zip 92,253 Study Area,,
Tract # ~, Lot # Square Footage 1645,,
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
1.93 X 1,645 or $ 3,174.85 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 Cash - Esequiel Coronel Telephone 56:44604
Name on the check
By Dr. Doris Wilson f
Superintendent
Fee collected /exempted by Ellen Patino Payment Received
i
Check No. CASH
Signat b L
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
ollect 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
01/01/1994 21:39. 6195644202 CORONEL CONSTRUCTION PAGE 02
SALE ESCROW INSTRUCTIONS
Ti'iiS DOCUMENT WILY, AFTECT YOUR LEGAL AIGHTS"- REAi.) IT CARE FULLY!
TO: COMMONWEALTH LAND TITLE COMPANY Escrow No.: 98.7632KC
72855 Fred Waring'Dr: Date: 06/03/98
Suite A5 Page;`1
Palm Desert.•CA 92260
(760) 836-3726 +.A" ;� r
Escrow Officer. Kelly Collier
THE ESCROW HOLDER IS COMMONWEALTH LAND TITLE, COMPANY WHICH IS LICENSED
RY THE CALIFORNIA DEPAR'T'MENT OF INSURANCE.
Buyer, or- his agent, will hand you or cause to be handed you upon signing of
these instructions a deposit in the amount,of...................................S. 500.01
Buyer will hand you additional funds prior to closing in the antount.Of.......... $MINIMUM
Proceeds -from loan to be procured by Buyer (First Trust Deed) ................... SFHA MAX
TOTAL CONSIDERATION S 141:04. 01
and any additional funds and instrumentsreqquired from me to enable you to comply with. -these
instructions, which you are to use on or before September 2'5. 1998. and when,01.0 REPUBLIC TITLE
COMPANY can issue a Standard Policy of Title ,Insurance Omrer; form, with `liability of
$147.000.00, on real. property iri City of LA QUINTA, County of Riverside. State of CALIFORNIA
viz•
Commonly known as: AVENIDA VALLEJO. LA•QUINTA, CALIFORNIA 9?2.53
LUT 13 IN BLOCK 71 OF SANTA CARMELITA AT VALE LA QUINTA. UNIT N0: 9: AS PER MAP "173-003 —010
-REQ IN BAR "PAGE 69 OF MAPS. RECORDS OF,RIVERSI L , r ALIFORNIA
5,!- 226 AYS . �i1U..EJo `
Except any reservations of record of minerals, oil, gas, water, carbons and hydrocarbons.
Showing title vested in:
ISAAC M. JUAREZ and BELIA L. GRIJALVA JUAREZ, husband and wife and MARTHA ARELLANO.
Free from encumbrance except:
A. Current general and special taxes for the fiscal year which this escrow closes. and
taxes for the ensuing.year, if any, a lien not yet clue or payable.
The Tien of supplemental-t,axes, if any, assessed pw-su,)nt to the provisions of Chapter
3.5.(Comnencing with Section •75) of the Revenue an(1 i,rxation Code,of the Slate of
California.
C. Special improvement assessments.'if any.
0. Easements, rights, rights:of way, covenants, con(litionc;, restrictions and reservations.,
record.
E. Deed.of,Trust to record'in the amount of .FHA MAX. in favor' of a len6cr.to be determined
a
Seller Buyer
Cer if
t Hca te ofoc' cupanc
y
Citof L -a uinta .V rY
Building
and Salf6ty-b
e art- ent
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 Cityregulating building construction or uses For the following:
`
_ g: .
BUILDING ADDRESS: - 51-220 AVENIDA VALLEJO
Use Classification: SINGLE FAMILY DWELLING Bldg. Permit No.: 9806-175
Occupancy Group: R-3 = Type of Construction: VN Land Use Zone: RC
Owner of Building: ESEQUIEL CORONEL Address: 51-540 EISENHOWER DR
o
V" City: LA QUINTA, CA., 92253 t
By: DANIEL P. CRAWFORD JR.
5 Date: 10/26/98
Building Official
4
Y riY
POST IN A"CONSPICUOUS PLACE