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9807-110 (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). ( ) 1, 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 penaltyyof 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., (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 hat`ifi I should becomes,,,, subject to the workers' compensati? °-rovisions,,of Section 3700 of the Labor Code, I shall forthwith comply with �e provisions. th / g F Date: 3 ll .� r APPlican / /• ; FFF /l Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or -pursuant to any permit issued as a result of this applicator agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property°for inspection purposes. Signature Owner/A' ent >`, .0 •e A ` Date g ( g ) �' ry> BUILDING PERMIT PERMIT# DATE VALUATION LOT��{I TRACT SIX -132 Ult-10 JOB SITE AM y 'ADDRESS J1 -R% A.'6��L1�WA Vt��U.eEi0 APN rb < ,OWNER CONTRACTOR/DESIGNER/ENGINEER 0,O11ONCL CONS'i'RUC310N CORON131, CON517R iC."I" ON 51 -340V%SCURUWM. B_ 31-5413.L.rSEINHf)W8RDR, LA. QLr.W"TA (-''A 92253 1.A QU% '. A CA 922.53 (760)5A( 604 t C,BU , 2261 USE OF PERMIT -• . rD •- C,'O tONIX [VI S fllk i. 1WUL 1PLC, :al1'-lNM( FAL. 100% PLAN i°.t(l=Ci: i� !' AT'lri:X1'sl ► "PF.i[$'E�fift}13.1'i't fl'.F'"I.1`i' .P.)t; IRS MY.t ihFXUDEF 531' OCC WAL1, 3' Y (;sit, POCIL. t� ' RAcr CONS. TikUC` ION 1,421;i13J 531 ?� 1�81. WOOD FfsNC,iv 200.00'1.1 'If ST 11%1ATE 1) COST Ole C70NS7°tiIX 1'1VIN f'fT 101-4)(110-41P-00 $5694:50 Pi ANC.99,K Fii1, 1 A10!1},4;3'9-316{ $%;1170 t'-,1,taCI-t.A.t4ICA1. VV8 10.1-000-42.1.000 $51,50 d r-, LRC;. VikfCA1,i f�a $1.23.52 Pl,lJtt:1i3f1Vt ,1 ! 101-000419-0XitT $1.33.St1 sw(i't°(()'Y;r� - RV, 110 10140)0-22-4!-01NJ �.�. GKiVAt-4431"0.; 10 t -00 0-423.Oftf1 ildF l't.sat+�3.GZI�::'i'tri>t�:F='�s➢', 2;23 -E) 60 -=l43-342 �1,�►r�1.`r3t t �tC1iC:1 yk; F'l 6123 1014Y)0-441-345 345 5250) T' Vf+:V�;t'I.P t 1'P 1.01 -000 -.139 -*1.9 425ost9 �. . ai 1h `1t Yl'gfs 4. ONS"'1'RI15',"iIONAND PLAIN (,JIF-.CK $3,,424 44. -.� G# WS PRE-PA€D HES 250.tt0 r RECEIPTi -1 t DATE C/ c E 64'1 " BY ( I 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 OX to Wrap $ F.A.U. Framing, j Compressor Insulation Vents Fireplace P.L. j Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final POOLS - SPAS BLOCKWALL APPROV is 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 4 Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test / Appliances Final COMMENTS: 1 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) . rr•r.• L 4 P.O. BOX 1504 Building /l a /� 78-495 CALLE TAMPICO APPLICATION ONLY Address L�f�C 1 G Ile l C� LA OUINTA, CALIFORNIA 92253 Owner Mailing Y„R Addressp J(JX l City al_ F Z2� ITel ;Jbl�`�%D�� Address P Cite f / _ Zip-�Z17 Tel. �/. [/�vcy State Lic. -F,C `-�/ City & Classif.�31�lJ / Lic. n ''Z G, Arch., Engr., Designer Address Tel. City Zip State Lic. k // 9 LICENSED CONTRA WFPSlOkCLARATION I herebyy affirm that I am lic nsed under� r visions of Chapter 9 (commencing with Sectli 7fXW) of�Diviston 3 o�ttje Bu inass; and ffS_q sions_Code, and my licensels in fyl _ repai t 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 thathe 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”] 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 orimprovement 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 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.) 1-1 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. ❑ 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. Dale 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 sof this city to enter the above- mentioned property for inspection purposes. Signature of applicant —Date— Mailing ateMailing Address City, State, Zip ILDING: TYPE"CONST. OCC. GRP. t. Number -7 !.*-3 " 2 ~ 002— . ? jai Description U•�' if .,..M 17%--...in•inn (I Sq. Ft. L 2 No. No. Dw. 7 Size Stories Units ....----- New Add ❑ Alter ❑ Repair ❑, Demolition ❑ 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 7 Issued by: Date Permit Validated by: J �J Validation: JUL 1 1003 WHITE = FINANCE YELLOW = APPLICANT a PINK = BUILDING DIVISION d iTY`r"_ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep., U(] Plan Chk. Bal. Const. _. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL 25/). o 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 7 Issued by: Date Permit Validated by: J �J Validation: JUL 1 1003 WHITE = FINANCE YELLOW = APPLICANT a PINK = BUILDING DIVISION d iTY`r"_ 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 8/4/98 APN # , 773-132=002 No. 17453a Jurisdiction La Quints Owner NameCoronel Construction Permit No. 51-550. street Avenida Vallejo Log # City La Quinta r` Zip 92253 Study Area Tract'# Lot # Square Footage`,.1,421 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/caiports, 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 F This certifies that school facility fees imposed pursuant to Government Code 53080 :,in the amount of 1.93 X 1,421 or $ 2,742.53 the property listed abo�veo th build g'` permits and/or Certificates of Occupancy'for this square footage in this proposed pr ject rhay flow be issue H Fees Paid By Cash/Coronel Construction J T-lephonfd56' 4604; Name on the checks By- Dr. Doris Wilson Superintendent W* - Fee collected /exempted by Juanita Green Payment Received $2,742.53 Check No. N/A t Signature (aa4U7,k;. NOTICE: Pursuant of Asse y 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 above will begin to run frontffie 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! ity plan check application form to district copy for all. waivers.' Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting x'o k , SALE ESCROW INSTRUCTIONS '4. IVF THIS DOCUMENT WILL AFFECT YOUR LEGAL RIGHTS - READ IT CAREFULLY! TO: COMMONWEALTH LAND TITLE COMPANY Escrow No.: 98.7783KCr� 12.855 Fred 'Waring Dr. Date: 07/15/98 Suite A5 Page: 1" rF Palm Desert, CA 92260 (760)'836-3726 / ;t`}�.�';; Escrow Officer: -Kelly -Collier . 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........: $,T., 1x2500": TOTAL :CONSIDERATION $ r •,12500 and any additional funds and instruments re uired from me to enable you to comply with t ese-,4;V k.. instructions, which you are.to-use on or be ore August 14, 1998, and when -CHICAGO TITLE COMPAN"' can issue a Standard Policy of Title Insurance Owners form, with liability of $12,500.: 00,40n real property in City. of LA QUINTA, County of Riverside, State of CALIFORNIA viz �tiw ' ;- � � �+ ;i•'�i kx�' .fir • l� - Commonly known as:.APN.773=132-002-9, LA-QUINTA, CALIFORNIA 92253 • OT 23 ,.� BLOCK 53 !N IT NO. 5 , : SANTA CARMEL ITa �� VPLE LA QU,I NTA , AS, e, A, . 2,s,1 . .,..e ,. ' PER_MAP RECORDED; :N BOOK v18' PAGE 63, OF MAPS RORDS OF COUNTY , CALIFORNIA' Except any reservations of record of minerals, - gas."water, carbons and hydrocarbonsrr Showing title vested in: r' ��,�>; .` ESEQUIEL- M. CORONEL, A SINGLE;MAN Free 'from encumbrance -except:,,' A. Current general•and special'taxes for the fiscal year in which this escrow choses;; :Mand taxes for the ensuing year, if any, a lien not yet due or payable.,: �"fk, i' 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:.'JL D. Easements,' rights, rights of way, covenants,,conditions, restrictions and res'ervatw�ons .record. s •µ<<f rrq i' Al Sel 1 er f� Buyer �, r ■ I Certificate of Occupancy C - �FLa Quintalit �= �StVDepartmen--�t _- n�nand.afe� MOF,eui�dg_._ . E 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 City regulating building construction or use.. For the following: BUILDING ADDRESS: 51-550 AVENIDA VALLEJO - Bldg. Permit No.: 9807-110 Use Classification: SINGLE FAMILY DWELLING 9 Occupancy Group: R-3 Type of Construction: VN Land Use Zone: RC O.wner,of Building: CORONEL'CONSTRUCTION •Address: 51-540 EISENHOWER,-DR.. City: LA O.UINTA, CA., 92253 By: DANIEL P. CRAWFORD JR:` . Date: 12/19/98 Building- Official - POST IN A CONSPICUOUS PLACE