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0209-102 (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 Exxp� Date .. Date 4, �t `t Signature of ContractorX ' OWNER -BUILDER DECLARATION I hereby affirm,. under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 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,_,Businessprofessionals Code). ( ) I, as• o'w`ner of theoproperty, am exclusively contracting with licensed contractors tot construettie project (Seca 7044, Business & Professionals Code). () I am exempt. under Secjon B&P.C. for this reason Date '/Sgr(atureof Owner WORKER'*COMPENSATION DECLARATION I .heFeby affirm under ,pb4d ty of perjury one of the following declarations: O I have�antl will maiAta`in a certificateof consent to self -insure for workers' compensation;, to provided'for by'Section 3700 .of the Labor Code, for the performance of=the work dXwhich this permit is issued. ( „) L 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'& poli%kno. are: Carrier STATE FUND � Policy No. 154%93`1-01 ' (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,;arid agree that if I should become subject to the workers' compensation provisions ofj'Section 3700 of the Labor Code, I shall forthwith comply with those provisions.;/ . Date: ;*• Applicant )i -_f A" 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 nulland 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 Wth all City, and State laws relating to the building coi;kructidn,J,gnd he.re6y Yauthorize representativese of this City to enter upon the above-mentioned property for Inspection purposes. Signature (Owner/Agent)-h-110 Date ; ? BUILDING PERMIT PERMIT# =2s•4 -1O DATE VALUATION LOT TRACT D oa -�; *8 7141K WAX 06 UJOB SITE! ADDRESS �%a`�i i�°ati�bla� r APN OWNER CONTRACTOR / DESIGNER / EN INEER , ix'(Ah�33t'•�VV�7.-389 t��1aa�'AA 'T9.15t7D����.'x`M�'A�7� �.�;te�J'1CO Sir.tr"nEgW2• �1 t�yyH�uS5 1A Ly�l�.ialtl TA CA. 92 53 L.A. <! dLE�11iC'�. � CA 922 3 t� (760)564=4604 m -A. 2.2rji USE OF PERMIT MN au ?A4Vm•y DWMDI TO yr 1461 S.V SFU PERMIT 0623 'NOT 1NC'1,bC3G.noCK ww, .'poo o DRi'VIt"WAY' A.ffiftOACH } C4AC`F CO?i"3Z'PUCT1014 44U00 SF POI1.CWPATIO, 36.fl.f'i S'tt' 4' t`ARA01MARIPORT r PERNIT.1901' SUMMARY com rauC'I`ol Fn 101.000.418yi0 5585,30 PLAN w.HK 'YEE '£ T DEPO3!' 1 Cil rtS�JiJa�}' 3 z $ $2rit, MWHAXICAI, FU 101 -0004v �Goq 959.00 91 -000410-000 $108.44 MIUMBINC;< PF f STROM MOTiiON FRE - RUID ' 101-00044 -1-000 Syys3,fltlR,.cf�i1Yy:��1�1�rlCc�9 Mr, 101 PPOr{•2"s'-000 94 'SIF. PLAN 101 1-345 t ij4t : - SUP,^�IYYI'AT.. � 3Ai�"1t'1� C1Ct ��f.)2� _Wks 1�rLAX 0'k3kaCK *3{M. 13 D OCT 2 2001 .000FLAQUINTA L FINANCEDEPT. RECEIPT :• DATE � O� BY �.. i DAIVIN� LED � INSPECTO� INSPECTION RECORD OPERATION j 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 O F.A.U. Framing _ _.03 ��/ 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 15,-Zc) d3 ,��_ 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 I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines L Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection 1 Z_ 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) ' G COMMENTS: �L�C Ll1 ( P73 1.2-- Cf- o `Z Ife 15 ..BOX 1504 APPLICATION ONLY 6il1 ) 78-495 CAL'LE TAMP.ICO ".Address �) _ \�/ _ �\\\ LA QUINTA, CALIFORNIA `92253 ' pry Owner BUILDING: TYPE,'CONST.' OCC. GRP. Mailing �i Address ; ,.. . `� A.P. Number 1�� ti ''a Cit Zi Tel. - ' Y� ;P� : ~I ` LegalDescriptionf� �1r , '-•. t �»: C is `. -Contractor.. �- �, .i •v _ :' � Project Description Address • City Zip _ Tel.. State Lica City & Classif. it t,` Lia # 4 Arch., Engr., 4. Designer Address Tel. City Zip State Lic: # n LICENSED CONTRACTOR'S DECLARATIOI I)hereby affirm that I am licensed"underjprovisions of Chapter 9 (commencing with Section 7000):of-Division-3 o'ff the Business i6d�Professions Code, a,{nd my -license is inlfuyll I ce.'anCr SIGNATURE - 1 -/' DATE r' OWNEWBUILDER DECLARATION .I hereby 'affirm that;f em exempt from the Contractor's License Law for the following reason: (Sec. 7031,.5,,88uusiness and Professions Code:. Any city ; or county, ,Pubch'� requires a permit to construct, after.'improve,�demo6sh,-o, repair,any stmcture; prior to'its issuance also requires the. applicant for such permit. to, its a'. signed sfatemenbthat he is licensed pursuant to . the provisions ;of the' Contractor's -License 'Law, ;Chapter: 9'Icommencing,wltA Sectkn„7000) of Division 3•of the Business.and Professions Code; dor that. he. is' exempt therefrom,• and the basis 7 �lorthe 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 dollais (5500).' ' CJ I, as owner of the property, or,my employees with wagei as their sole compensation, will . do the work, and the structure is not intended or offered for sale. (Sec. 704, Buisness and ' Professions Code: The Contractor's. License Law does not apply to an owner of property who k builds or'improves thereon ,and who does such wOrk'himself or through his own employees, P rovided 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.) 1'1 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 thereon, and who contracts for such projects with a confractor(s) licensed pursuant to the Contractor's License Law.) 17 I am exempt under Sec. - B. 8 P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION - rI hereby affirm that 1 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 C.7 Copy is filed with the city. 0 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 ($700) valuation or less.) 1' I certify that in the performance of thg work -for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. _x Date Owner r NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject, to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. ` r CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) _ Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information Is correct. I agree Id comply with all city and, county ordinances and state laws relating to building construction, and hereby authorize representatives 'of this city to enter the above- §- mentioned property for inspection purposes. Signature of applicant - Date Mailing Address A ' City, State, Zip tr WHITE = FINANCE YELLOW f . �'=h.. ::':1.*ur.+. ,. �.���: .,. •r.$:i�.l �:-.... :'�:,:.t.xi',r ah ... a7.. 1f�r': /.,7 �.; REMARKS Sq. Ft.iii Size 1 O . No. 1 No. Dw. Stories ` Units ' New O Add ❑ Alter G Repair ❑ Demolition ❑ y ZONE: BY: Minimum Setback Distances: • Front Setbac c from Center Line .i Rear Setback from Rear Prop. Lina Side Street Setback from Center Line i Estimated Valuation ;) PERMIT`„` AMOUNTr -t PIan,Chk. Dep. J> Issued by: Plan Chk. Bal. Validated by: Const. Mech. r 5 i Electrical ;;•, t3 Plumbing y Grading 7! fA 1 Driveway Enc. PINK = BUILDING DIVISION Infrastructure .,.vz ii.r ;�,;•..., .-6c iP,r:..'�: _. 3,.ai�:�x=�..a .—+a,_;`�-4 M.,.;.. ... l.c_ a.:i- '�'.ie. _. t.w �.. ._�.r".". _ 'I � {r .. _.. ,r�"',Yf TOTAL REMARKS ZONE: BY: Minimum Setback Distances: • Front Setbac c from Center Line .i Rear Setback from Rear Prop. Lina Side Street Setback from Center Line i Side Setback -from Property Line FINAL DATE INSPECTOR J> Issued by: Da_e Permit Validated by: Validation: y APPLICANT' PINK = BUILDING DIVISION .,.vz ii.r ;�,;•..., .-6c iP,r:..'�: _. 3,.ai�:�x=�..a .—+a,_;`�-4 M.,.;.. ... l.c_ a.:i- '�'.ie. _. t.w �.. ._�.r".". _ 'I � {r .. _.. ,r�"',Yf Date . 10/28/02 No. 23785 Owner Coronel Enterprises Address City La Quinta Zip 92253 Tract # Type Single Family Residence CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # Jurisdiction Permit # Study Area No. of Units N�1FLEbsC us. CO) Q BERMUDA DUNES l -A rn RANCHO MIRAGE INDIAN WELLS di PALM DESERTLA 4 INDIO Ti�~�7 0 774-063-021 La Quinta 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 9 53175 Avenida Villa' 1421 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered paltios/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 1,421 S.F. or $3,040.94 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed proect may now be issued. Fees Paid By CCNIB - Ish Coronel Check No. 27f877 Name on the check Telephone 760/564-4604 Funding Residential By Dr. Doris Wilson Superintendent Fee collected /exempted by Monica Guillen $3,040.94 0.00 Payment Recd Over/Under c - Signature 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 projBct 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 t/17/2002 14:25 7607777011 LA QUINTA PAGE 02 Oui•il- Zuut"II:IVAM No•4317 P, 1111111RECORDING REQUESTED BY: THE ESCROW SOURCE, INC. AND MEN RECORDED MAIL TO: AND MAIL TAX STATRMENT T0: CORNELL ENnRI'RISES, LVC. Order No. R-2124834 Escrow No. 02 -3215 -SA ��) Parcel No, 774063-021 774063-022 LV I Ob ` 17 Y /L- L A SPACE ABOVE THIS LINE, FOR RECORDER'S USE GRANT DEED THE UNDERSIGNED GRANTOR(S) DECLARE(S) THAT DOCUMENTARY TRANSFER TAXIS 673.7D aad CITY S X computed On full value of property conveyed, or - oomputed on full value lose liens or encumbrances remaining at the time of sale. unincorporated area: X LA QLANTA and FOR A VALUABLE CONSIDERATION, receipt of which Ig hereby acknowledged, JOSEPH E, RAWLAVSON, A Married Man hereby GRANTS to CORNELL ENTERPRISES, INC. the following described real property in the County of RIVERSIDE, Stat® of California: PARCEL NUMBER 774-063-021, 774063-022 LOT 9 INBLOCK 206, OF SANTA CARATELITA AT VALE LA QUINTA, UNIT 20 AS PER MAP MCORDED IN BOOK i. 19 PAGE 38 OF MAPS, RECORM. RIVERSIDE COUNTY. Date rut 16 20112 JOSEPH E. RAWLINSON STATE OF CALIFORNIA ) COUNTY OF } On before. me, the undsrslgned, a Notary Public in and for said County and State, personally appeared JOSEPH E. RAWLINSON personally known to me (or proved to me on the basis Of satisfactory evidence) to be the person(s) whose name(S) Is/are subscribed. to the within instrument and acknowledged to me that he/she/they executed the same In his/her/their authorized Cep2Clty(le3), and "that by his/her/their slgnature(a) on the Instrument the person(s), yr the entity upon behalf of, which the person(s) acted, executed the Instrument. WITNESS my hand and official 9921, Signature 0117'061 ri�unun „inn MRK-1'L—'L10106 kdb_:623 HM - P. 04 INSTALLATION CERTIFICATE (Page 2 of 8 CF -6R -7 Lcj er t .. um er , @ Address FENE$TR6T1QN/GLAZ&9: Total Quantity of Like exterior Shading U FProduct odu t(S S lOduc(S M of Product Square Device or Commcrttc/Location/ acto: r pl, net A (GROUP LIKE PROD) .. - , ^ Ifr ✓l"t . L Z✓ 4. 6, — 8. — 9. • J 14, -- 12. 13. —. 14. — l s. — ' Manufacturcd'fenestration products use the values from the product label. Field fabricated fes s ration products usc,tht default values from Section 116 of the Encrgy Mciency Standards. ' Installed U -Factor must be less than or equal to values from CF -IR, Installed SHGC must be less than or equal to values from CF -1R, or a shading device (exterior or overhang) is installed as spaeificd on the CF -IR Altematively, installed weighted average U -Factors for the total fenestration area are less than or equal to values fron CF- I R. I, the undersigned, verify that the fenestration/glazing listed above my signature: 1) is the actual fenestration product installed; 2) is equivalent to or has a lower U -Factor and lower SHGC than that specified in tae certificate of compliance (Form CF. 1 R) submitted for-tiompliance with the'Energy Efficiency Standards for ratidcntial Wildings; and 3) the product meets or exceeds the appropriate requirements for manufactured devices (fl•om Part 8), where applicable, Item #s /i2nn"ature, Data Installing Subcontractor (Co. Name) OR (if applicable) Oeneral Contractor (Ca. Name) OR Owncr OR Window Distributor Item 98 Signature, Data Installing Subcontractor (Co. Name) OR (if applii:able) General Contractor (C). Namc) OR Owner' OR Window Distributor Item qs Signature, Date Installing Subcontraett:r (Co, Name) OR (if applicable)Ganeral Contractor (Co, Name) OR Owner OR Window Distributer ., COPY TO: Building Department HERS Provider (if applicable) Building Owner at Occupancy January 4, 2001 Nov .25 2002xa, 1 37PM FR TO 95544202 No•8310"0zp 3 REPORT QP rIF-LD :COMPACTION TES 7 S OVZ ;ZEPURr NO.: 0� 3 0 9 A- v CLIENT: c 0 oaTE \\ 1 2 rRe,ter: — r�.r^r► e.L�f�+11Jo, V1L1-�• ul)CIAAA CAUCE INFORMATION ANO OA+IY STANLARO CALIORATIQN Numbos '/LAIR TI50, PERCENT,•l- Ga06E aojusY fmT X VARIATION FRO _r•uiR,a TION COONTS FAOAt SHEETS UST VSE '�VOd TY��bTAOXIftV MreEu natSTustE: `00 '•OIIYVRft _ _ I,IOISTut Ir �tO;LTuNt, 11091 UO.• DENSm; I OENStTv: I O:r.SrtY; I )v,OR Ir• OIINIATION,. ;011 ID = VISUAL CLASSIPICATION OF SOIL ` Nna X. DRY,OE�:SITY, ?Z;F I OP7lN1U,M P+tO15TURE. O\\�N%. G R I.. nlrrllc� r.��ea I tnr� In�i. %l,\t-n\-,ir, ,V1 nnQUlfteMENTS. 90 `� Q i;EQUIRFMEIvTS, �' I 9 4 TEC.'WICIAN: EST �E;A I]ING DUO Tt ENT/ SOLI.---- TEST EL°4gTIQN I :AOt$Tt. Ad WET/qRY 7: ACCN7 COMh1QNTS .IQ PCS ID N0: OEPTM, IN J? TEST I ;,OvTE'tT, OEPIS,TY, Ot•,IpaCTlOrt q - D.C' 'F (6 }- :3 I ; I Z D- T—s : ( I�2� 7 ' ll .<p 9 4 TEC.'WICIAN: 7uj.MA A = r CAC101" - OASF COURSE C - . - SVagaSE 0 - f SOttcam q - T—s : ( I�2� 7 ' ll .<p 9 4 'F (6 }- :3 I ; I I I � f`f-�_•-___•__,_rte I i j 11 I ii it 170—M7 no -N-4 ME$ NOT COMPLY wry. SPECTFICAt 1014S ot:t.gw srocl�t;nnarts Zi Celrtifi ateofpan CCUc - ♦ - ... " - of 2 N., 0 Y a _ Cit of.La: in t' ., 3 .i 7 � • 1. _ � ' � ``� - AFM of �ti9 , Buldin and Safet De artmentr: " z� 1�� This Certificate issued,pursuant to the requirements of ,Section 109 of the Uniform Budding Code; u a .:certifying that; at the'time of issuance, this structure was in compliance ivitht�ihe, various ordinances of the City regulating bui/ding construction, -or use: :For the fo%%wing: p - , 1 _ - f.,BUILDING ADDRESS: 53-,175 AVENIDA_VILLA Use Classification. SINGLE FAMILY DWELLING ,Bldg. Permit No.. 0209-102 S' Occupancy Group: R-3 Type,of1C6nstruction:VNy Land Use Zone,' ° RC ti' - - , yr - a ' ♦1 .� • . ... t • y+. } Owner of Building:, CORONEL ENTERPRISES Address:- P.O. BOX "189 = :- R r:- t City:, LA,QUINTA,�CA92253 `• By:'- KIRK KIRKLAND+f Date: ..MARCH 20, 2003 Building Official ...;, POST IN A CONSPICUOUS PLACE