0105-253 (SFD)LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty ofperjurythat I am licensed under provisions of
Chaptdr 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
644991
Dated' Signature of Contractor \f '
OWNER=BUILDER DECLARATION I .
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 foi
sale (Sec. 704.4, Business & Professionals Code).
( ) I, 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 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.
STAT ? FUND 194293'x•00
(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 thatIf (,•'should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those°provisions.
Date: / Applicant , f
"Wariing. 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 Buildr(g;a d Safety
for a permit subject to the conditions and restrictions set firth on his Lr
application. �J
1. Each person upon whose behalf this application is made & pf
at
whose request and for whose benefit work is performed under urto� N
any permit issued as a result of this applicaton agrees to, & s inify
& hold harmless the City of La Quinta, its officers, agents ar d empl yees.
2. Any permit issued as a result of this application becomes r ull and id -if
work is not commenced within 180 days from date of issuance of sucF�
permit, or cessation of work for 180 days will subject permit t an ettatictrL
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 hereby7'authorize representatives of this City to enter upon
the above-mentioned property for inspection purposes.
Signature (Owner/AgentN J., ,4 Dated e �j
/ BUILDING PERMIT
DATE / / VALUATION LOT
r
JOB SITE '
ADDRESS
OWNER .
PERMIT #
!D1 �3 aY,10C� TRACT
APN
CONTRACTOR/DESIGNER/ENGINEER
.. e.
Col20?znm Co1°fnaaC:'"l oN C(1IiOMEL CIONSIT UTC'UMT
7 8-1 50 CAUZ,, TAWITC0.IDT7. 230 78•-150'AT„ X TAMPICO ti'?171'MM 0
IA,,QUJNTA, CA 92253 LA QU:UM CA 92253
('� at9� f 4-46{�4 C°1"DL4 x261
USE OF PERMIT
M1011,17, ?+:#t►iMMY" DWEI2010
SW6 ap1f�' �yt{hyy�z^�' fl'C�%LdSjt �0(e t�jdCjT.dJ}�.:.ili.t?C:lti,;bU.dtLLS; 3� Jw f,3l2 f14'itf lft 1`
AL"n3'P�t�rb�AA1H.M.t11r�TER 1.. RA
TRACT faO1<EMUC Y10H OF
PO1.C.&VI)AT90 112.00 Sig
5 F T. WOODMICR 200.00 U?
Mu"'ACYE 480.00SP
E ,"17.0 C°ORT O:F CON e IRUC711 N
Y"1
'{��p9p..g/j•�u�+.�1y.�'ap��0
Fp?A7LlJ.O.Kf,i. Ai .♦;tilfy iiLi�.[�H1S•I•.13. l�
A .a •
.
CONRST RUI 771:014 FEE „
101-000-418-000
$531,00
PLAN CHECK FEE
101.000-4N9418
$488.c6
W13ANICAL FR
101.0001.421-000
T60.00
FEE
101 -OW -420-00
� 120.03
�% .
101.000-419.000
$110.7$
STRONG MOTION N FE .:PE511)
101-000-241-000
ClA.NNO RAF,
101.000.4.23-000
DlX1110P1;:Tt lIV1D ACT ME
slpl oo
P.FiECISF,PLAN
101-000-4441.345
$100,00
�
1.,. _
1,01 -OW -439-319
4250.00 `
1 5 2001
1'110F LA OU141,A
FIiIAIVCE DEPT.:
C>:D1aTMCiteTC' TOW AM RCAF C E:C.TC.
i aS 14t"f -PAID 1iY 1
.v .y
DATE BY DATE FINALED INSPECTOR
K X5r
4150,00
b
INSPECTION RECORD T
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
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
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
I I
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
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G. F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
Buildin
Address :_) �G �o N. r,
Owner
(-- C ,� {
Mailing (�•
Address
City
ILC_ *_1\
Contractor Ac \
P.O. BOX 1504 APPLICA N ON
L
78-495 CALLE TAMPICO
LA OUINTA, CALIFORNIA 92253 S
1
BUILDING: TYPE'C-7ONST. OCC.
,GRP.
A.P. Number ! - "� -5'- Uo d
Tel. j h
50,A _qJQL! Legal Description �� �. t ,; �� • S� , J .
Project Description 4::_1-�
- I
City%jy� Zip Tel.
G o v ,rte\ ip c� 1N -1i C�
State Lic.\� ,r City
& Classif.� l , Lic. # L,
Arcn., tngr.,
Designer
Address Tel.
City IZip I State I
,.�.� Lic. #
LICENSED CONTRACTOR'S DECLARATION
n licensed under p!rOvisions of Chapter 9 (commencing It Section
i Buslriess and Professions Code, and my license is in full force and
OWNER -BUILDER DECLARATION
I hereby affir Ih,,Ul)am exempt from the Contractor's License Law for the following
reason: (Sec. 7031. ,Business and Professions Code: Any, cityyor 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).
I7 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 II'
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.)
17 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
r7 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed it 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
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.
1 certify that I have read this application and state that the above information is correct.
J 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 aOplicant Date
Mailing Address
City, State, Zip
C. V-\ LA PAZ-
Sq.
AZ
Sq. Ft.`tJ�,L No. , No. Dw.
Size i(�J Stories Units
New El-- Add ❑ Alter ❑ Repair ❑ Demolition ❑
Imateo valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const. .�
Mech.
Electrical
Plumbing
S.M.I. JIL
Grading
Driveway Enc. I IJ
Infrastructure
TOTAL '1e
■ AMOUNT
■
■
_=Halt
ii'WN
■�o_-■
110
■
■
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:
L` . .
\ WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
Desert Sands Unified School District
47-950 Dune Palms -Road
Notice: La Quinta, ,CA 92253 f�
Document Cannot Be Duplicated 760-771-8515
CERTIFICATE OF COMPLIANCE
Date ,6/15/01 APN # 773-293-008 .
No. 22130 Jurisdiction La,Quinta `
OwnerNameCoronel Construction . Permit#0105-253
No. 52-680 Street .' Avenida Vallejo ],og # 4
city La Quinta <; Zip 92253. Study Area '
Tract # Lot # Square Footage .135.8
Type of Development .Single Family ResidenceNo. 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 1,358 or $ 2,783.90 the property listed above and that building•. '�
permits and/or Certificates of Occupancy for this square footage in this proposed project may now,b`elissued�: t
Fees Paid Valle B CC / dent Bank - Ismael Coronel i
Y y Independent p Teleph m'e X760 -X5644604
Name on the check
By . Dr. Doris Wilson ;;ps
fCZ
w
Superintendent
Fee collected /exempted by .. Annette Barlow Payment Received $2,783.90 `
U�Z11� Check No. 246507
Signature ,
F
TICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1998) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other.payment identified
ove w 11 begin t, 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
lect them on the District('s)(s') behalf, whichever is earlier.
I
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 4
AMERICAN TITLE
SAN BERNARDINQ
RECORDING IEQUESTED BY:
AMERICAN TITLE COMPANY COMPANY
10735.DT 5244371-42
WHEN RECORDED MAIL THIS DEED AND,
UNLESS -OTHERWISE SHOWN BELOW,
MAIL TAX STATEMENTS TO:
CORONEL ENTERPRISES,. INC.
P. 0. BOX 389
i
DOC q x001—=.3824'4
04/16/2001 ea: Ta
FeP0,
Paid '
Page 1 of.1 Doe T Taxx Paid
Recorded inoffRicialversRecords
county
Gary L. orso
Assessor, County Clerk d Recorder
III
I
I
II
I
I
I
I
I
I
M S I U PAGE SIZE DA PGCR' NOCOR SMF MISC.
� In
II r ,yl.;
LA QUINTA, CA 92253 I
COPY LONG REFUND NCHG EXAM
7 GRANT DEED �
The undersigned grantor(s) declare(s): �.
Documentary•transfer taxis $36.30
(XXX) Computed bn'full value of property Conveyed, or
( ),Computed on full'value less liens and encumbrances remaining at time, ofsale.
and
( ) Unincorporated area:.( ) City of
FOR A VALUABLE CONSIDERATION', receipt of which is.hereby acknowledged,.
\\N FRANK ELLSWORTH RAMIREZ, Successor Trustee of the George and Maxine Truman 1973 Trust
1J dated 9./17/73
hereby GRANT(S)'to
T
CORONEL ENTERPRISES, INC., a California Corporation
J the real property°in the City Of -LA QUINTA, County of RIVERSIDE, State of California,
described as:
LOTS 15 AND 16 IN BLOCK 152 OF SANTA CARMELITA UNIT NO. 16 AS PER MAP
RECORDED IN THE OFFICE OF THE COUNTY RECORDER IN BOOK 18 OF MAPS.
•'J
Dated February 22, 2001.
State of California
County of Zo S'' Awe s w. } S.S.
On J .41-C1Y e- z Dov /
before me, . Lc1cs A/25 1242' !641'
personally appeared
I-
��EL!6;W OA YH
personally .,known to me
�ltde ) . to be
the person M.whose name W is/ate subscribed
to the within instrument'and acknowledged to
me that he/sjx/tP4�y executed the. same in
his/1Wr/their authorized capacity(iA$) ,. and
that by his/4e�r/ti &r signature W on the
:instrument the person,. or the entity upon
behalf of.which the person(,�A acted., executed
the instrument.
WITNESS my hand a d official sea
Signaturel.
`-``''
MAIL TAX STATEMEN S TO:
Frank Ellsworth Ramirez, Successor Ttee
4
T
,
LUIS IZURIETA
COMM. #1201126 CO
M-'- .. Notary. Public -California v
* n LOS ANGELES COUNTY
My Comm. Exp. Nov. 28,.2002
(This area for official notarial seal)
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 Coronel Ent
SITE ADDRESS 52-680 Avemida Vallejo
APN 773 - 293 -008
LEGAL: LOT 16
CASE NO.: 2001-482
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 tr94 applications and assign. case numbers.
A—
RE QUIRED ITEM
Y
N
COMMENT/COF ti TION
Verify legal and APN information
&000
L .
Consistent with MDG on -file (as
/
applicable
MDG filing required (5 filings since
9/3/98)
Architectural variety within 200 fee PXI
the surrounding area:
ColorP
se
rib`
. Go<
d
Materials
ures
A to a d07feat'
/ ' -70
Other Requirements
4/--•
G9•v 2
:/6A
'CITY Of LA •QU:'NTA
o o 66I1 -DING & SAFETY DEPARTMENT
777 -70 12
INS,IPECTION REQUEST LINE
a 777-7153
Owner CORONEL:CQI�JST U: x N
Contractor C''OlRDNE .'(' )NSTJ31ICTi(;N
Permit Number,:` 01K�,:253
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES '
JOB ADDRESS '52-680 AVENIDA VALLEJ•O
SFD - PERMIT DOES NOT INCLUDE BLOCK
WALLS, POOL, OR DRIVEWAY APPRO5,CH
TYPE OF INSPECTION DATE INSR. .
FOUNDATION & SETBACK 31
FOOTING STEE
MAIN GROUND.:SYSTEM
GROUND PLUMBING
PRE-GUNITE•
DO NOT POUR CONCRETE UNTIL ALL ABOg HAS BEEN SIGNED
CONCRETE SLAB 97
,JOISTS & GIRDERS '
ELECTRICAL GROUNDWORK >
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS,& GAS TEST
HEATING & V ENT- AJC i
FIREPLACE
ROOF
BOND BEAM r
O.K.'70 WRAP GY
GROUT 0 4'. O 8',
FRAMING
INSULATION -�tf
ARE-RQOF
COVL R'NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR ij
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK O /
FINALS 1
ELECTRICAL
PLUMBING ?
FINAL GAS TEST
HEATING - A/C
HOUSE'NUMBERS ?;
JOB COMPLETED
TEMP POWER,
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO'-,.�,
I 'd E V 00N UTILITIES OR OCCUPY, BUILDING Wt: 1 OR ' 9 ' 08Q
rofoccupa'ncyCe t�ficeto
Cit of La Ouinta
Building and Safety Department �oFti°
This Certificate issued pursuant to the requirements of Section 109 of the Uniform Building Code,'
�Certifying,that, •a 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: 52-680 AVENIDA VALLEJO
Use Classification: SFD Bldg. Permit No.: 0105-253
Occupancy Group: R3 Type of Construction: VN Land Use Zone: RC
Owner of Building: CORONEL CONSTRUCTION Address: 78-150 CALLE TAMPICO #230
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 10-26-01
Building Official
POST IN A CONSPICUOUS PLACE