0206-149 (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
�It
Date a Signature of Contractor
Y 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, 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.
('t) 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 STATE 1?irND Policy No. `154 ?-04
(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 that if,l should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
/ Date: ~s'`� r,.�'= Applicant y.
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 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 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/Agent) �. _ � •�� �� J• Date -i-- ,, . >"
BUILDING. PERMIT PERMITk
DATE `f VALUATIONLOT, 1 1 TRACT
REX5
41
' ✓Z Y
JOB SITE
ADDRESS '^�i�hS Ea��?.Tr
APN
OWNER
CONTRACTOR/DESIGNER/EN (NEER
`1`O BOX 389
T5-1 std CAT.TS TAWIC 0 MM'. ,4230
LA 0,1111M CA 502253
1AQT„I'Lk3'hk CA 92253 s
(760)W-4601. cmo 22.61
USE OF PERMIT r
04GLE
V.D • 1,at' 11, LTANDA,,RD SANTA FN WMER. d'1128r AT F,lOPS NOT
INCLUDE BLOCK WAUS, P001,, SPA OR DRIVE+i�d'.t��.'YAPPROACH
TRACT CC31+ISTRUC:TION f.,421,0)1 Z I'
POPCHarAA130 26.00 SP
OA RA.OrUCA,R1aORT $10,00 OF
517'i'. WOW) n,�_ 'CE 200.00 11F
JITWATED COST M CO?i+SIMUC7:10M
f'ONSTPLUCIVON FEE 101=00m, 18.000
IRIS CHRICK FU 101-000.439-318
M90HANIOALF&E 1011-1000.11211.000 �6f9,00
w' L1.r; TRICAL YEID 1€)9 -000.420-000
ILC 1 i1tA0C1 V99 $110.75
5'd"R.ON0 MOTION r, 3T - RFS] D 101-000-24 -000 0.93
GRADMOFEY 101-000 -411-000 Vorri.o
UMBIX)PIM, IMPACT M. $, ;405.00
PRECbSE PLMI 101-000-441-345 $100.00.
101-000.43$-318 4250.00
l;�."N M -FAM YI
42.10.00
KRAWFE,F,S, D Ur. XIV
JOL 2
C'TYOFQUINTA
FINANCEnFPT �--?
RECEIPT BY; /
DATE FINAJED
INSP C Oi�
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
. Q
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
447
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
22_L ,ir
w_" lrG �"`"
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
_3p, 0 i
Encapsulation
Gas Piping
Gas Test
Appliances
_
�_/� _ G
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) �� 2
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
Date 7/24/02 La Quinta, CA 92253
No. 23406 (760) 771-8515
>.>� o
Q BERMUDA DUNES r
RANCHO MIRAGE b
INDIAN WELLS ti
PALM DESERTQUIN
,y
�Z%a NDD10Ty��'�
Owner
Coronel Enterprises
APN #
Address
PO Box 389
Jurisdiction La Quinta
City
La Quinta Zip 92253
Permit # 0206-149
Tract #
BLK5
Study Area
Type
Single Family Residence
No. of Units 6
Lot # No. Street
S.F.
Lot # No. Street S.F.
Unit 1
11
#51465 Calle Hueneme
1421
Unit 6
12 -9 51485 Calle Hueneme 1397
Unit 2
14
•51470 Calle Guatemala
1421
Unit 7
Unit 3
15
*51450 Calle Guatemala
1421
Unit 8
Unit 4
10
•51445 Calle Hueneme
1492
Unit 9
Unit 5
13
78270 Avenida Nuestra
1435
Unit 10
Comments Five Cashiers Checks from VIB
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiosANalkways, residential additions under 500
square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile homes. It
has been determined that 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
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.14 X 8,587 S.F. or $18,376.18 have been paid for 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 CC VIB - Ish COronel Check No. see above
Name on the check Telephone 760/564-4604
Funding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Crystal Scott $18,376:18 0.00
Payment Recd Over/Under
Signature
NOTICE: Pursuant to Government Code Section 66020(d)(1), this will serve to notify you that the 9D -day 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 issued, or from the date on which those
amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original - Building Department/Applicant Copy - Applicant/Receipt Copy - Accounting
377
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P.03
INSTALLATION CERTIFICATE CF -6R
S/ -''W, 4 yen e r,, t I—(X
.• to Address Permit umber
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
,DUCT LEAKAGE REDUCTION
Pressurization Test Results (CFM L 25 PA)
- - Test.Leakage (CFM)
Fan Flow
If Fan Flow is Calculated as 400 efmhon x number of tons, or as 21.7 x }seating Capacity
in Thousands of Btu/hr, enter calculated value here
If fan flow is measured, enter measured value here
Leakage Fraction n Test Leakage/(Measured or Calculated Fan Flow) = 3, f
Pass if leakage fraction <- 0.06 ❑
Pass bail
❑ For AEROSOL TYPE SEALANTS ONLY - The following diagnostic testing was completed:
Duct Fan Pressurization at rough -in measured leakage (CFM)
CHECK AFTER FINISHING WALL:
❑ Yes ❑ No ❑ Pressure pan test or House pressurization test
❑ Yes ❑ No ❑ Visual Inspection of Duct Connections ❑
Pass Fail
THERMOSTATIC EXPANSION VALVE (TXV)
ryes ❑ No Thermostatic Expansion Valve (or Commission approved
equivalent) is installed and Access is provided for inspection ❑
Yes is a pass Pass Fail
❑ DUCT DESIGN _
i ❑ Yes ❑ No ACCA Manual D Design calculations have been completed,
Duct Design is on the plans and duct installation matches
plans.
❑ Yes ❑ No TXV is installed or Fan flow has been verified. If no TXV,
verified fan flow matches design from CF -I R.
Measured Fan Flow =
❑ ❑
Yes for both I and 2 is a Pass Pass Fail
❑ 1, the undersigned, verify that the above diagnostic test results and the work I performed associated with the test(s) is in
conformance with the requirements for compliance credit. [The builder shall provide the HERS provider a copy of the CF -6R
signed by the builder employees or sub -contractors certifying that diagnostic testing and installation meet the requirements for -
'rests Signature, Date Installing Subcontractor (Co. Name) OR
L
Performed General Contractor (Co. Name)
COPY TU; Building Department
HERS Provider (if applicable)
Building Owner at: Occupancy
05/16/2002 08:29 7607777011
LA QUINTA
, Santa
PAGE 03
May -!5. 2002 41 2PN
Quinta,
No•2678
P. 3
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_......
.........
County,
Lot.
RECORDING RSQUlr67ED gY;
I
Zo 1 2. J�� `�85
<._•Au
/t`IuC:�� %1'iE
Ah1D WHEN REOORAED MAIL THIS DO ED AND,
UNI -M OTHERWISE 6HOWN OELOW
MAIL TAX STATEMENTS T0!
CORONEL ENTERPRISES INC.
SPAGE ABOVE i HIS UrIS FOR ReoORDER'9 Use
Brant Deed. A.P,N, 770-169/023/
4041
Th■ uncleraigned gran(or(o) declere(s):
Documentary Irsns(ar tax le S
computed on full Value of property canvey�d, or
( ) oompuled on full value less \-alus of liens end ®noumbrances remeining at time of aele, end
( ) Unincorporat6d area; ( ) Glty of
FOR A VALUABLE CONMERATi ��TER (of whtch INTIRAU$tbY acnowtedp®d,
hereby GRANT(S) to CORONEL ENTERPRISES INC.
lha real property In the City of Lsl Quinca
6ta(e of CaliforTIS, descrlbad @5.
, County of p4vers:Ldc
Lot A /11/,I*of Bi0C):
_ Unit :Iqo,
, Santa
Carmelite
61= Vale Zg
Quinta,
a6 D%2: map revorded in BookPages
.9,
m Kap9
Pwcordg
of Riverside
County,
Gated A r it 26, 2002 Slgnaturs of Grgnlo(
Stale ofCciirornla --�-
County of ) PETER WEINTR 'US
On — baWs, me, ....--
—peraonally appeared
personally known to me (or proved to me on the bawl] of 5011112cto(Y
e,IdenCa) to be tho person(e) whosQ neme(S) ialcre dubtor(bad 1p IM
within InllNmonl Ana acknowledged lv me in -at holahohhoy /xmied —
tha some In hla/har/their au(horized capaGly(loa), And trial by
hia/herltheir slgnalur.(r) on No Inairvmant the per'on(a), or the onllly
upon bahsl( of which tha ptrron(s) octad, ex8CUI00the inavum#n(-
WITNESS my hand and oMolal seal.
signvure
MAIL_TNXSTATEMENTaTO, —Lli�G gSL �Z�s@
i .
N
i
Certificate of Occupancy
City of La Quinta
Building and 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 ordinance
of the City regulating building construction or use. For the following. s
BUILDING ADDRESS: 51-465 CALLE HUENEME
Use Classification: SFD Bldg. Permit No.: 0206-149
Occupancy Group: R3 Type of Construction: VN
Land Use Zone: RC
Owner of Building: CORONEL CONST
Building Official
Address: 78-150 CALLE TAMPICO SUITE#230
City: LA QUINTA CA 92253
By: KIRK KIRKLAND
Date: 12-05-02
POST IN A CONSPICUOUS PLACE
9