0105-251 (SFD)LICENSED CONTRACTOR DECLARATION
"FJ 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
€ Fs"d:fl F3
Date ' I car Signature of Contractor- •�* '~"r�..,
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, arr 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 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
,6'ction 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:
Carver I • 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,fhat if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall'forthwith complywith those provisions:
Date: ` AD Plica
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees. �P
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set for —oR his
application.
1. Each person upon whose behalf this application is made & each[atwhose request and for whose benefit work is performed under or uanany permit issued as a result of this applicaton agrees to, & shall, i ernhold. harmless the City.of La Quinta, its officers, agents and a loyAny permit issued as a result of this application becomes null nd vo
work is not commenced within 180. days from date of issuanc of s
permit, or cessation of work for 180 days will subject permit to ca cellation.
I certify that I have read this application and state that the above infdRi�atioR-is
correct. I agree tocomply with all City, and State laws relating to the building
construction, and
..hereby,' authorize representatives of this City to, enter upon,
'the above-mentioned property forfinspection purposes.
Signature (Owner/Agent)7r'^` "�''i �� ` Date >'13, r
f
BUILDING PERMIT PERMIT#
DATE r� VALUATION LOT TRACT
JOB SITE
APN
ADDRESS
S2,6.!$VEMPA VAMWO
�
I 773-293-W9
OWNER
CONTRACTOR/DESIGNER/EN INEER
OXYRd?.A1 IL IMMSIMIT f'`•'71M
CORONM CORM RUC ON
,?A-156 5 mik4picomin
78-150 CALLETAMPICO RME10230
uk QUA CA 92253
]n,k QUINTA. CA 92253
(760)W-40155.(X'f.Ht 2261
USE OFPERMIT
3dmG EFANOY MYflDRI
.
SYD - MR101T VO "? �"-''A9C34' INCLUDEX12 C °i�': �� .�.,5, Pool, O1 DPJ'Vi'WAY
APPROACH
36.00 SIT
GARACE M0.00 3F
=1'Y1AMM) COST Ole CIONSTRUMOM
CC,+1°8k►T R.IJ :4' 0i 4 FEE $5941:50
PLAN CHECK F$rF, $590.12
%u4EMANI,GA,YZE 4dl`&,•000-421-000 $00.00
MACTIUCA1, ME 101-000.4320.000 $1.29.44
k'Lk.Rt+11E IN113 MY. 101-000-419-000 311017S
TfRO O M01`10N REM . R ESID 1011.000-241. -000 It&93
t. -
S:fak'4K)1)40 "1B 101 a01'nG-42 3-000 r40.00
Lill•LMti1PBR..V,h. ACTffl%,'
" �
PRECTSK PLAN 101-000-441-345 9100100
IMIL? D `IPOS.15' 301440-439-318 -$250,00
�' 'a AL CG N. 91—RUMOVI AND 1:' CEM
$3,430.74
A 1 5 2001 WS MR-I'AID KW
4W.00
' AL PERMrr FEES =7 NOW
S3,190,74
RECEIPT
DATE+'' %
By
DATE FINALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
j MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
4 Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
1 Compressor
Insulation
I 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
BLOCKWALL APPROVALS
POOLS - SPAS
I Steel
Set Backs
I 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 TopyOut
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) p_ _� /
"w�-�,..-:.:.....:.r.-w.-ti.:..-w..--'^^.,--+`-. '"i'""'ti;.;sr' "1-'�..rr-,•r•,a:..i�,.� -► �.. .-•- .....4-'...�",.Z-�.l",:...,�Z.:-.-'-..... ..- .., ..
e 4 \�
P.O. BOX 1504 APPLICATION ONLY
Building78-495 CALLE TAMPICO
AddresLA QUINTA, CALIFORNIA 92253
Omer \ 0
" ` —
Mailing
Address'
BUILDING: TYPE'CONST. OCC. GRP.
} e
A.P. Number.'`-.-.)�
Legal Description.. \
Project Description .'
City
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Zip
Tel.
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CityZip
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State Lica •T 1
8 Classif.l\�yCA q, I'
City
Lic. #""\ 4
c� 1
Sq. Ft. ,l�A \ 2) No. , No. Dw.
Size Stories Units
Arch., Engr.,
New 17 Add ❑ Alter ❑ Repair ❑ Demolition ❑
Designer
Address
Tel.
I
' City
Zip
State
/111)
f-
Lic. # ,
LICENSED CONTRACTOR'S DECLARATION �
l hereby affirm that I am II e�d undei,provisions of Chapter 9 (commencing\with Section
loo df Divisio_n.3 of thw§usiness and 1P{lofession/s Coade, andlmy license is in full force and
effect. � `�„+.Ss/ �l _ 1, 1! 11
OWNER -BUILDER DECLARATION
I hereby affirm that I a�exempt from the Contractor's License Law for the`,following
reason: (Sec. 703/NS,Business and Professions Code: Any city or county which requires a
permit to construct, after;'�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 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.)
7 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. ❑ Certffied copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 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: It, 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. +Ie. . `
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. 1k
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 a0plicant —Date—
Mailing
ateMailing Address
City, State, Zip
,timated Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing - -
S.M.I.
Driveway
Infrastrul
TOTAL
CITY OF L
AMOUNT
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
Jo
a
Notice:
Document Cannot Be Duplicated
Desert Sands Unified School District
47-950 Dune Palms Road
La Quinta, CA 92253
- 760-771-8515
CERTIFICATE OF COMPLIANCE
Date 6/15/01
No. 22131,
Owner NameCOronel Construction
APN # 773-293-009
Jurisdiction La Quinta
Permit # 0105-251
No. 52-660 Street Avenida Vallejo Log #
City La Quinta Zip 92253 Study Area
Tract # Lot # Square Footage 1421
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
2.05 X 1,421 or $ 2,913.05 the property listed above and that building' E'
permits and/or Certificates of Occupancy for this square e is
footage in this proposed project may no
Fees Paid By CC / Valley Independent Bank Ismael Coronel TelephopR 760-5.64-4604
Name on the check
`L.
By Dr. Doris Wilson
Superintendent
Fee collect4/exefted by Annette Barlow Payment Received $2,913.05
Check No. 246511
Signature
IOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified
ibove will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to
ollect them on the District('s)(s) behalf, whichever is earlier.
Collector: Attach a copy of county or city plan check application form to district copy for all waivers.
Embossed Original- Building Dept./Applicant ' Copy - Applicant/Receipt Copy - Accounting
N
J—
TvIERICAN TITLE .
SAN BERNARDINO
RECORDING REQUESTED BY:
AMERI('AN TITLE COMPANY COMPANY
10735.DT 5244371-42
'WHEN RECORDED MAIL TRIS DEED AND,
UNLESS OTHERWISE SHOWN BELOW,'
MAIL TAX STATEMENTS TO:.
CORONEL ENTERPRISES, INC.
P. 0. BOX 389
LA QUINTA, CA 92253
a
r
2001-158244
DOC
O 04/16/2001 08:00A Fee:26.00
Page 1 of 1 Doc T Tax Paid
Recorded in;Official Records
County of Riverside
Gary L. Orso
Assessor, County Clerk d Recorder
I I
I IIIIII IIIIII VIII IIII IIIIIII II
I
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I
M
S
� 1■■111 ■.u__
U PAGE
...._
SIZE
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NOCOR
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COPY
LONG
REFUND
NCHG
EXAM
;193 ooy
o�o o% 7 GRANT DEED
D
The undersigned grantor (.$) declare(s): - �Z-'p�� Uc
Documentary transfer tax. is $36.30.
(XXX) Computedoft full value of property conveyed,, or
( ) Computed on full value less liens and encumbrances remaining at time of sale.
( ) Unincorporated area: (,. ) City of and'.
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
FRANK ELLSWORTH RAMIREZ, Successor Trustee of -the George and Maxine Truman 1973 Trust
dated 9/17/73
hereby GRANT(S) to
CORONEL ENTERPRISES, INC.i,
r ,
a California Corporation
the real property in the City of LA QUINTA, County. of RIVERSIDE, State of 'California,
described as:
LOTS 15 AND 16 IN BLOCK 152 OF SANTA CARMELITA UNIT'NO. 16 AS PER MAPF"
RECORDED IN THE OFFICE OF THE COUNTY RECORDER IN BOOK 18 OF:MAPS.
Dated February 22, 2001.
.State of California
County of Loy Aw6�aL_z�S- } S.S.
On aov /
before me,
personally appeared
personally known to me (Qr- proved t;Q we an
tie--hasis of satisfaetery evidenee) to be
the person * . whose. name X is/ar<L subscribed
to the within instrument and acknowledged to
me that he/sx/t.b�y executed the. same in
his/4,�/their authorized capacity(i ) ,., and
that by his/lyse/tt Cir signature (.s0 on the
_instrument the personpQ , or.the entity upon
behalf of .which the person(X acted; execu_—ed
the instrument.
WITNESS my hand and offi;c.i•al seal.
Signature''
MAIL TAX STATEMEN S TO': .
,Frank Ellsworth Ramirez, Successor Ttee
�M
+ a LUIS IZURIETA
CL
COMM. #1201126 00
M : Via; • Notary Public -California v
LOS ANGELES COUNTY
My Comm. Exp. Nov. 28,.2002
(This area for official notarial -seal)
L,4 ,
N
4
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 per Section 9.50.090 of the Zoning Code. Its purpose is to determine:
1) that the proposed house design does not duplicate the same architectural style of any
house within.200 feet of the. applicant, and/or 2) if there is a need for the applicant to file for
Master Design Guidelines. If the applicant does .need to file a Master Design Guideline, please
transmitted this information to the Building and Safety Department as part of your correction
list. Please attach additional explanations as necessary.
APPLICANT c'oronel Fnt
SITE ADDRESS 52-660 Avenida Vallejo
APN 773 _ 2931- 009 CASE NO.: 2001-483
LEGAL: LOT 15 BLOCK 152 UNIT 16 S.C.@V.L.Q.
CHECK AND APPROVED BY: Greg Trousdell 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
Verify legal and APN information
Consistent with MDG on file (as
applicable
MDG filing required (5 filings since
9/3/98)
d
sloe
Architectural variety within 200 fee p1
nn�n cil
y G o
, pep t,
the surrounds area: Q C
o
old4%No.
`
bu ,�,.II
Ca
EX
ibit and
tons.
Material
CQ
ith
Architectural design features
Other Requirements:
3
BUILD]:' & SAFETY DEPARTMEyT
777-7012
If�d-SPECTION REQUEST LINE
' 7y7-7.153•- � . ; � ,
Owner •
CORONEL C6nT)ktTd I,0„N.
•contractor. CORONEL. CONSTRTICTION
Permit Number 0105-251
POST ON JOB -IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 52-660 AVENIDA VALLEJO
SFD - PERMIT DOES NOT INCLUDE BLOCK.
WALLS, POOL, OR DRIVEWAY APPROACH
TYPE OF INSPECTION DATE IN5P.'
F UNDATION & SETBACK
FOOTING STEEL + .
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE ' A 1
'DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROOF
.BOND BEAM
O.K. TO WRAP
GROUT 0 a' 0 8'
FRAMING
INSULATION 4,<
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED .
DRYWALL INTERIOR
EXTERIOR LATH C.!
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK .�
FINALS
ELECTRICAL
'PLUMBING
FINAL GAS TEST
HEATING - NC
HOUSE NUMBERS
JOB COMPLETED r"
TEMP POWER
•AAnVE APPROVALS DO NOT INCLUDE' RE 0_11
Z ' d £ 8 £ 8 ' o NDN �a l &TI ITI'F'� OR �x ruPv BUILol
Wd£ti 8 1002 '9 '�aa
r
Certificate of'Occupanc
Y
City of LaQuinta,
Buildingand 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 Yarious ordinances ,
�of-the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification: SFD
Occupancy Group: R 3
52-660 AVENIDA VALLEJO
Bldg. Permit No.: 0105-251
Type of Construction: VN Land Use Zone: AC
Owner of .Building: CORONEL CONSTRUCTION
Building Official
Address: 78=150 CALLE TAMPICO #230 -_
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 10-26-01
POST IN A CONSPICUOUS PLACE