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0105-333 (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. UJ O =) M License # Lic. Class Exp. Date �CU.) ///. u 1 . 634181 '13 f jt 1/31/2(. oZ r1_ Dat,-( t-� - . t Signature of Contractor CO 0- 11� r`""""� OWNER -BUILDER DECLARATION JU(D o HaLU I hereby affirm under penalty of perjury that I am exempt from the Contractor's U) License Law for the following reason: Z ( ) 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). C0 O I arh.exempt under Section B&P.C. for this reason N Date Signature of Owner O.S: rn U Q WORKER'S -COMPENSATION DECLARATION Q I hereby. affirm under penalty of perjury one of the following declarations: Lin r F- O (;) I have and will maintain a certificate of consent to self -insure for workers' X U compensation,'as provided for by Section 3700 of the Labor Code, for the O � Q performance of the work for which this permit is issued. m Q U(r�) 1 have and will maintain workers' compensation insurance, as required by O U Q Section 3700`.of -the Labor Code, for the performance of the work for which this d rn I— permit is issued,; My workers' compensation insurance carrier & policy no. are: It Z Carrier: -, Policy No. J (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, 1 should become subject to the workers' compensation provisions of Sect on,3700 of the Labor 3 Code, I shall forthwith comply with those provisions. 1, Date: K • z Applicant t_ Warning:"FailUre'to,•secuFe 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 1 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 cr 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 cf 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 tit-, correct. I agree to comply with all City, and State laws relating to the building construction, and herebyauthorize representatives of this City to enter uponthe above-mentioned property for inspection purposes. cSignature (Owner/Agent)'_, r _ - df Date/ I '� ! .� A; BUILDING PERMIT PERMIT# DATE t VALUATION LOT (<}lh,�i TRACT ; 1f� ! i• f W.4.69230 12 JOB SITE APN ADDRESS 5 1-995 DW 773- 1 OWNER CONTRACTOR /DESIGNER/ EN INEER ao.R,,O ��.?+1i��i.�'FCTi -w CORcim, CON- '.i�',katiftC°i1014 �Ao' "i8-isp-CA .al..«}'' 9AMPICO NV&li ?.30 l� LA 4Z,UNITA CA 92253 1'.,A Q1_blNTA CA 92253 (76r0)W5 -4604 E',.�U) 2261 USE OF PERMIT sn) - nzhtmi 1' vom PitY7' 114CLUDE BAD= WAW L JUP-s 01A. PA: OR 1e i).MOACH D1@,YVF''MAY • M.P6.STRR ZE K1.4&5 . Ttd AC`''i' C:O1Qw`1 IUC TIMI J,435,00 d'iI' PORCHIPA'PIO 16.00 SF 0APA0FJCARi'0RT rtyU'C, 9^ 40 5 YT. WOOD IMIM1CF, 200.W LF, F�r'EMWAI 043NU Oka' C0107'RUCTIVON RZ 101 n000.41 S-41aO %603100 AIAX C KECX Yu 101-000-439-118 $5(Y;. ) 7 MlCK—ANICAL 101-000-421-000 03.50 EILECE44!AL nZ ;© ;tO5'.:75fTi S$Ht tbLUNDO FEE 101-000419-000 11'R13N0- MO','f ION 'FEE - R231D 101 -OW -241.00 $9.7i ikRAW110 Mit :OI -000 423. 00 920,00 )AVSIDPER )A'Ff?&S.+r! IfUl P,9fY?.w PREC1 IC, MAN 101.000.441.341 3109100 101-000-439-518 .,$754.6 D m.mmov, COR , C'11010 A14��ayy��P��tt ,yyK :ppC�� �K� f�esy,;.��ryy���� S:3�h,, 41.m, 250100 J U N 1 2 2001 "To �DITE NOW CITY OF LA QUINTA FINANCE DEPT RECEIPT DATE.. BY DATE FINALED INSPECTOR INSPECTION RECORD I • OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air 1 Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents i Fireplace P.L. Grills 1 Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines ' Party Wall Firewall Exterior Lath i Drywall - Int. Lath l Final Final POOLS - SPAS BLOCKWALL APPROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover, Equipment Location Underground Electric Underground Pibg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final i Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover I 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) 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 5/31/01 No. 22067 Owner Name Coronel Construction"`-;` �l No. 51-995 Street Avenida Diaz city La Quinta Tract# B 3 2 Lot# 12 Type of Development Single Family Residence Comments APN# 773-155-024 Jurisdiction La Quinta Permit # 0105-333 Log # Zip 92253 Study Area Square Footage 1,485 No. of Units 1 At the present time, the Desert Sarids;:U*fied 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 L ale= This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 2.05 X 1,485 or $ 3,044.25 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 r Fees Paid By CASH - Ish CoronelTelephone Name on the check By Dr. Doris Wilson Superintendent A.(,� fir/ Fee collected /exempted by Paula RuizPayment Received $3,o44.25",. . �;- 1A Check No. _ Signature f 40TICE: Pursuant of Assembly Bill 3061 (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 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 rolled 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 4 Cl/ P.O. BOX 1504 Building S t �� C1 < 78-495 CALLE TAMPICO Address 1 % •-, Z LA QUINTA, CALIFORNIA 92253 Owner Mailing , Address City Zip Te Contractor ,Address ' City Zip Tel. �- \ I i1,3 S( 4t State Lic. t t City & Classif. t -�� „; i Lic. # Arch., Engr., Designer Address Tel. d 0��� �v APPLICATION ONLY . BUILDING: TYPE -CONST. OCC. GRP. A.P. Number -7`1 :', - i �35- c. -1 ti (r f Legal Description L-"\��� Project Description (11 ` Sq. Ft. j 4 Size t New El' CityZip I State I �. Lic. # LICENSED CONTRACTOR'S DECLARATION—,,, I Hereby affirm that I am licensed undArr provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profession Code, and my license1s in full force and effect. lJ� L SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirgi, that,l sm 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, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to lila 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). 1 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-bdilder will have the burden of proving that he did not build or improve for the purpose of sale.) (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.) 11 I 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 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. It, 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. ...) No. t No. Dw. j 5 Stories 1 Units 1 Add ❑ Alter ❑ Repair ❑ Demolition ❑ PERMIT Plan Chk. Dep. 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 CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 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.) Side Setback from Property Line Lender's Name Lender's Address FINAL DATE INSPECTOR 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. Issued by: Date Permit 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. Validated by: Signature of applicant —Date— ateMailing MailingAddress Validation: City, State, Zip WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION 1 03/15/2001 10:03 760-773-2819 AMERICAN TITLE CO PAGE 02 RECORDING RS01=T2D 2Y, PIDSL L. LOPIB, TRUs'1'R! SYLVIA IIM1E08 TRUa'I'RR WAM RRCORDED MAII. Wi $IDSL I.. wras, TRusm SYLVIA HORNINO, TRUBTOI: Da4.4. C/o LAW OFPIM or RICHARD H. 21930 1OOTHIL11 BOUL,BVARD, OUSTS 3 2AYWARD, CA 94541-2111 000 N 12097,02M ea+1M ru:e.N ASM oitiau s...r� Qmmv of lu &a1d, ��wrr, aer�w/y yelp NAIL TAX BTATZMSM TO, /Io$ L. LOPEZ, TRUST= SYLVIA HORNING, TRUWr= 20626 JOYCE 2TRR4T ~ WAYWARD, CA 94555 �[�% IM" ORAHr SIM rw POR SAM AND AFFS�CTICN, receipt of which is hereby ackno�+ledgsd, IIDRL L. LOPS3 and SYLVIA LINO, Ttustses of THE LOPRR FAHILY TRUST DATED APRIL 26, 1929, hereby grant to FIDEL L. 1,0888 Mad anVIA HORNING, Taystees of THE WRVIVOA'B TRURT astablinhad in TRE LOPEZ FAMILY TRUST DATED APRIL 26, 1999, the meal property eituated inChe idCity of La Qniata, County of Riverside. Otsta of California, dssosibed as follovol Lot 12 of Block 32 Banta CaTmalita at Vale La Quints, as per snap recorded is Book 18. pages 55-56 of mpg is the office of the County Recorder of said aminty. APIA 773 -ISS -024. This conveyaaoe does not constitute a change of ownership pursuant to section 6442) of the Revenue and Taxation Code. NO 4ebt is being assumed. 4 8 8 2 6 DRDE" prop:oRiverside: Lot 24 o - RV -2000 00488276 3/15/0109:58 AM 1 of 2 Certificate of Occupancy City of La Quinta Building and Safety Department oTME°" 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: SINGLE FAMILY DWELLING Occupancy Group: R-3 Type of Construction: 51-995 AVENIDA DIAZ Owner of Building: CORONEL ENTERPRISES Building Official v ni Bldg. Permit No.: 0105-333 Land Use Zone: RC Address: 78-150 CALLE TAMPICO SUITE #230 City: LA QUINTA, CA 92253 By: STEVE TRAXEL Date: 11-07-2001 POST IN A CONSPICUOUS PLACE