0206-136 (SFD)LICENSED CONTRACTOR DECLARATION
I he?eby 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
t
o0 a `; 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). -0
( ) 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.) 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 FUND Policy No. 114.2937.01
(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/I should become
subject to the workers' compensation prto��visions'of Section P700 of the Labor
Code, I shall forthwith comply with !thoseiprovisions.
Date:' Applicant
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 af,
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 j
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/a representatives 9 this City to enter upon
the above-mentioned property for inspect7iion purpose
j { P
Signature (Owner/Agent) `�••-iJi`� % '� ' "-" _ �� Date "`ate -'> 4r • �'
4
4
BUILDING PERMIT PERMIT#
DATE % % VALUATION 6a449 LOT' TRACTJOB
SITE
ADDRESS 148.15 C"UC X,J6J�t.a AWK
APN 7703-^10-EY414
OWNER
CONTRACTOR/DESIGNER/EN INEER
V0 BOAC $89
7.3.150 CATIZT. M- PICC SUK 72022 3
L&AUDITA CA 922 ss
L,A,QUINTA Cil 922.,3
2261
USE OF PERMIT .
4`24ir7I'?:FJ' I4 y 3i � Iafi1t7
51111. LOT 14, 3A Q:t1lN` A'd`C3fR ER MAS EP— P&t'.MIT 001US :N,OT
INC I.t1DI U LOOK WALL,% P00L "I'A OR D[ifiMA Y APPKOACH �
i
TRACT CONSTRUCTION
I� Jf%Cttlt r "iIt 96.00 Si
0AIALikJGAAPO T 316." SF
N.f3FSWI f -11O :.`(+SRS '4+•4ddCS.Itd64. CA4aJP
146,449o50
CON6TRUC-TION FER 101.000-418.000 S3?I1110
1yL&N CHECK AUK 101_4000-439-318.
PER DEPOSIT 101.00-439-318 4290.00
MECHANICAL tf IM 101-000-421-000 $60.80
XLECTIAI ALFYZ 101-000.420.000
PLSiM1 INO FEE 101-000-419-000
�'1'13:c 140 I4 OTION F,RA, - R ' SID 101.000-241-_000 .",64
ORADINQ YAC' 101-0004213-000 WL00
DEVELOPER IMPACT FEE �2,403,4i�
Pumnsr.P! 10+;-00G-441-345 $1f�Ei,O'J
,40TALC ommi.1' ow Pam+ k w t"HEax
3.I 9.7 e
LU5 PIM -PAM RES
4.�;�C+,00
COUL FERN Irk. FECS1 DIM NOW
'810;V29a71
JUL 2 411du1
CITY OF LAQUINTA
FINANCEDEPT. _
RECEIPT DATE
/] -6YF, DATE/fFINALLEED / INS/PjF
1
j
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set BacksUnderground
Ducts
Forms & Footings . o
Ducts
Slab Grade It IReturn
Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap 2 p
F.A.U.
Framing _ -p
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 —
BLOCKWALL APPROVALS
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 Q
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection -7i -O z_
Pool Cover
Encapsulation
Gas Piping
Gas Test
Appliances
Final
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) -'
COMMENTS:
4-
4
P.O. BOX 1504 APPLICATION ONLY
Building S` � X� \\ 78-495 CALLE CALIFORNIAO
Address iS G. , .� � tr.p vti t LA QUINTA, ORNIA 92253
uwne
Mailing
Address ���
City Zip Tel.
Address
P.QC�
city zip
State Ljc. r G , . City
& ClasilC, b)� t , ty Lic. #
Arch., Engr.,
Designer 1
Address I Tel.
City — (Zip (State I
Lic. #
LICENSED CONT CTOR'S DECLARATION
that 1 am I se un provisions of apter ommenc
3 of the a sines pn rofessiRns Code, antl my ansa is
J.,
WNER•Brom the
DECLARATION
I hereby aflir, thatxempt from the Contractor's License Law for the following
reason: /Sec. 70 1.5.Band Professions Code: Any city or county which requires a
permit to constru alterve, demolish, or repair any structure, prior (o *its issuance also
requires the applica, r 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
lot the alleged exemption. Any violation o/ Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty o/ not more than five hundred dollars (8500).
t ' 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, 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 /or sale. 1!, 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 !or the purpose o/ sale.)
I 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 (hereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
i l 1 am exempt under Sec. B. 8 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
fl Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is /or one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thp. 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, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you ,must fortluvith
comply with such provisions o/ this permit shall be deemed revoked. QQ
CONSTRUCTION LENDING AGENCY
Ihereby 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
BUILDING: TYPE•CONST. OCC. GRP.
A.P. Number _70 —1 ��—Oa�A
Legal Description\--\ • d �.3
Project Description _ , SP. -
Sq. Ft.
Size
New 9
�l No.1 No. Dw.
I Stories Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
I PERMIT I I AMOUNT
Plan Chk. Deg
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
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
Issued by: Date Permit
Validated by:
Validation:
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
w
Date 7/24/02
No. 23406
Owner
Coronel Enterprises
Address
PO Box 389
City
La Quinta Zip 92253
Tract #
BLK5
Type
Single Family Residence
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road
La Quinta, CA 92253
(760) 771-8515
Comments Five Cashiers Checks from VIB
APN #'
Jurisdiction
Permit #
Study Area
No. of Units
La Quinta
0206-149
6
AI Xµ o
Q 13ERMUDA DUNES
V) RANCHO MIRAGE
INDIAN WELLS b
PALM DESERT
�INDIO
��n T��`�
Lot # No. Street S.F.
Unit 6 12 -v 51485 Calle Hueneme 1397
Unit 7
Unit 8
Unit 9
Unit 10
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 (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
I
Fee collected /exempted by Crystal Scott $18,376.18 $0.00
Payment Recd Over/Under
Signature �L—
NOTICE: Pursuant to Government Code Section 66020(d)(1), 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 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
Lot #
No.
Street
S.F.
Unit 1
11
•51465
Calle Hueneme
1421
Unit 2
14
@51470
Calle Guatemala
1421
Unit 3
15
s51450
Calle Guatemala
1421
Unit 4
10
•51445
Calle Hueneme
1492
Unit 5
13
78270
Avenida Nuestra
1435
Comments Five Cashiers Checks from VIB
APN #'
Jurisdiction
Permit #
Study Area
No. of Units
La Quinta
0206-149
6
AI Xµ o
Q 13ERMUDA DUNES
V) RANCHO MIRAGE
INDIAN WELLS b
PALM DESERT
�INDIO
��n T��`�
Lot # No. Street S.F.
Unit 6 12 -v 51485 Calle Hueneme 1397
Unit 7
Unit 8
Unit 9
Unit 10
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 (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
I
Fee collected /exempted by Crystal Scott $18,376.18 $0.00
Payment Recd Over/Under
Signature �L—
NOTICE: Pursuant to Government Code Section 66020(d)(1), 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 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
05/16/2002 08:2.9 7607777011 LA QUINTA PAGE )03
142),!5. 2002 x:3241 No -2678 P- 3
/ yW5_....��-E
.......... urn ��. .
L ot. l 51 X 65 4!?P L -.L L
Tf-
RECORDING REQUESTED BY:
AND WHEN REOORAED MAIL THIS oneD AND,
UNLESS OTHERWISE SHOWN OELOW,
MAIL TAX STATEMENTS TO!
CORONEL ENTERPRISES INC.
WAGE ABOVE THIS LIME FOR RpoORDER's :6 USP-
rant
SE
rant Deed.
} A.P,N, 770-169-4444 .4/024
b
Th■ unoeraigned Brantor(o) declers ( )
Documentary Iransfar lax la S —
computed an full value of property conveyed, or
( ) oompulad on lull valva leas value of liens end enoumbrarlces remsining at time of agile, end
( ) Unlncorp6r2(6d ore3; ( . ) Gh,Y of
FOR A VALUABLE C01981DERAT(ON, receipt of which IS hereby ackncwledped,
PETER W}JINTRAUB
hereby GRANT(S) to CORONEIL ENTERPRISES INC.
the real proptrty In the Cily Of L:I QuittCa
Sta(e of Califomle, desulbed as.
County of p,versIde
Lot 10/11/12 'of' Block 5
oni� Ko,
Santa
Carmslt, a
at Vale L;a
Quinta.)
&s par map reoocded in Book
Pages
tn� piap9,
Racordg
of Riverside
County,
California
Dated April 2 6, 2 0 0 2 Signature of Crxntor
Slate of OClifornla
county PETER WEINTRYUB
On batre me,
,personally appeared
PETER WEINTRAU>�
personally known to me (or proved to me on (he baali of e�sllsfaciOrY "�
�
e,IdAnco) to bo tha person(s) who" neme(5) islare lubroribad to the
within Instlurrrenl Ana acknowledged tv me in -at holaho/they /zeculed
the vuma in hie/han'thelr eulhofized cepagty(loe), And thal by
htarherhheir signalurr(r) on the Inalrvmont.th4 peraon(s), or the onllly
upon behalf of which tho psrcon(s) aclod, executed the InsirvMOM.
WITNESS my Kana and MOW scat.
5ignoar• -
MAILTA'( STATEMENTS TO,
t
a
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 51-485 Calle Hueneme
APN 770 -163 - 024 CASE NO.: 2002-668
LEGAL:. LOT 12 BLOCK 5 UNIT S.C.@V.L.Q.
CHECK AND APPROVED BY: ',!ally Nesbit 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)
Architectural variety within 200 feet of
the surrounding area:
Colors
Materials
Architectural design features
Other Requirements:
DEC -06-2002 09:57 PM
P. 07
INSTALLATION CERTIFICATE CF -6R
vehGrn-tZ L -
Site Address Permit Number
DUCT LEAKAGE AND DESIGN DIAGNOSTICS
DUCT LEAKAGE REDUCTION
Pressurization Test Results (CFM en 25 PA) .
Test Leakage (CFM) �-
Fan Flow
If Fan Flow is Calculated as 400 cfm/ton x number of tons, or as 21.7 x Heating Capacity
in Thousands of Btu/hr, enter calculated value hereAt)
If fan flow is measured, enter measured value here
Leakage Fraction Test Leakage/(Measured or Calculated Fan Flow) = =
Pass if leakage fraction 5 0.06 ❑
Pass Fail
❑ 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 pressuriiation test
❑ Yes ❑ 1\o ❑ Visual Inspection of Duct Connections / ' /� ❑ ❑
Pass Fail
THERMOSTATIC EXPANSION VALVE (TXV
01"Yes ❑ No Thermostatic Expansion Valve (or Commission approved
equivalent) is installed and Access is provided for inspection 0
Yes is a pass Pass Fail
❑ DUCT DESIGN _
1. ❑ Yes (] No RCCA Manual D Design calculations have been completed,
Duct Design is on the plans and duct installation matches
plans. I,
2. Q Yes ❑ No TXV is installed or Fan flow has been verified, If no TXV,
verified fan flow matches desigr. from CF -1R.
Measured Fan Flow =
❑ ❑
Yes for both 1 and 2 is a Pass Pass Fail
9 1, the undersigned, verify that the above diagnostic test results and the work I performed associated with the tests) is in
conformance with the requirements for compliance credit, [The builder shall provide the HFRS 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
compliance credit,)
Testsignanue, Date - Installing Subcontractor (Co. '.dame) OR
Performed General Contractor (Co. Name)
COPY TO: Building Department
HERS.Provider (if applicable)
Building Owner at; Occupancy
Certificate of Occupancy
City of La Quintal
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 ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification:
Occupancy Group:
SINGLE FAMILY DWELLING
51-485 CALLE HUENEME
R3 Type of Construction: VN
Owner of Building: CORONEL ENTERPRISES
Building Official
Bldg. Permit No.:
Land Use Zone:
0206-136
RM - 17/1
Address: P.O. BOX 389
City: LA QUINTA, CA 92253
By: KIRK KIRKLAND
Date: DECEMBER 6, 2002
POST IN A CONSPICUOUS PLACE