9811-140 (SFD);. LICENSED CONTRACTOR DECLARATION
-1 hereby affirm under penalty of perjury that I am licensed under provisions of
H' Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
W--Professionals Code, and my License is in full force and effect.
.License #. , Lic. Class Exp. Date
Q u7 <
•p
o -- r- V to �� ' / /Signature of Contractor
co S2-'.
WOWNER -BUILDER DECLARATION
r`
f— 0-
U)
Z
.c
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).
( ) .1, 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:
(') 1 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.
001,DEN RAt7sf.61NSo
(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`o.become subject -too the
workers' compensation laws of California, and agree that if I'should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Cod'e,,l,shall forthwith comply wiih those provisions.
VDate: 1 -') 7 �/ /.. Applican't'—
Warning:
PPlicani Warning: Failure to secure WorkersCompensation 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 represen `atives of this City to enter upon
thea ovve-mentioned property for inspection purpose "y
,Signature (Owner/Agent) Date? "
BUILDING PERMIT PERMIT#
DATE VALUATION LOT 9811-140 TRACT
3/22/" 5137.682.01) -;, .4 11211, U20
JOB SITE APN
ADDRESS 53-270 EISENHOWER DRIVE 774-691-001
OWNER CONTRACTOR / DESIGNER / ENGINEER
t St"QUIELCORONE31, COFt0NUIf;ONS''ltI1G 101,
31-540 t 1SENHOWER DR. � 514-10 EMENHOWEA DR.
LA. QUINTA CA 9`2253 LA QUJN-Ttk (2A 92253
(760.)-,64.4604 C13L4 21461
USE OF PERMIT
SI14C',L1: MAWLY 1)W:L1..tNCr
"x£'i) - i31:Y.Mi'f DkNt'; BLOCK WALLS OR 1000L
TRACT CONSTRUCT TON 2,333.00 sx
O.ARt* FYCAlt_PC0.kT 5fi�t.00 4.,;
Enld IjsZL•FED COST OF �..�>NS dl.U( fl ON
PERMIT FEE SUNINIARY
CONStRU>✓TI )N FJX
101-W04118-00
rr2.W
P1, AN C. Tt7('h F# H
(fli,fill?(i rl�E)-�1�e
�fzR(►,1c)
FUE DEVO G
11011-000-439-3118
_3250.M
NfEC,IDT NIC AL FU,
101-000-4121-000
3i�t!.if0
ELECTRICAL VIDE
It?.t- HAIL-4204iW
SIaS fti
141,11NIAIN ,V%R
I0I-4XW)..i1I4�0011
43Fit 010
t%IV01'd0 h r- TION f --ER - ;fit .S)-�
t0t ,000.24 1.000
Z11.77
u tAOINO 1.44,
11)i -+)G .12 +�itt:rti
s2k(p)
1NFXAtrfAV0r(IkLr. VVE
'22.5-000-44J-342
$3,097.85
PR I17C I; :t; 1)),A14
1014)00-441-345
V f!(I'm
Xt'1' 04 PIA LIC; 1°7 AC.,.1"S - 1;1;.T3' C 701400-453.000
$94.221
,wt_fri=_riYl'A►., C(:)NSI'R.i r(;q'u'N ANi).P1,AN (:;31}?C'K
LE&S PRE -PAID FEES
'1011 AL !'Ed21t'1 T Y 1~ KS IME NOW
RECEIPT ` /1j �^ �. I DATEI J� � `�� I BY/��,� DATE FINALED I INSPECTOR
137,682.00
$5,119 92
4240.00
INSPECTION RECORD
OPERATION
DATE .
I INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings 7
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K to Wrap
F.A.U.
Framing .. —
Compressor
Insulation S, Z
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans 8 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 —
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 y
Appliances
;
Final
Final
Utility Notice (Gas)
ELECTRICAL A PROVALS
Temp" Power Pole14 2Wt
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:
f
.n
S3 - 5-J77 6
Building Cj�j4
C&hf 0 4 "
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Owner
F SECJV)Ic
Mailing
Address tin��7Sc1
City Zip ITel.
ity - Zip Tel. 11
State Lic. City
8 Classif.w L4 r Lic. #
Arch., Engr.,
Designer
Address I Tel.
CityI Zip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Susiness and Professions Code: Any city or county which requires a
permit to construct, after, 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 thealleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than live hundred dollars ($500).
[; 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 fmprovement is sold within one year of completion, the owner -builder will have the burden
ofproving that he did not build or improve for the purpose of 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
doesnot 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 I 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
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., 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.
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 adplicant—.—Date—
Mailing
Date
Mailing Address
City, State, Zip
,,6
APPLICATION ONLY
UILDING: TYPE'CONST. OCC. GRP.
.P. Number—/ 74J_ //)P/ • /)/I J
egal Description,4n; -..23 /-21/ /' /,ir 4// /%it/,li -2%_)
roject Description 5 _F. 1 l
Sq. Ft. -p j � S .
Size 7
New Add ❑
No. Dw.
Units
Alter O Repair ❑ Demolition ❑
stlmateo valuation
PERMIT AMOUNT
Plan Chk. Dep. 2 C3 OCD
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 y INSPECTOR \�
Issued by: Date Permit ---.
r�
Validated by:
\r
Validation: T v
W 11
WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION
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 3/22/99 APN # 774-091-001/002
No. 18474 Jurisdiction La Quinta
Owner NameEsequiel Coronel
No. 53270 Street Eisenhower Drive
City La Quinta
Tract # Lot #
Type of Development Single Family Residence
Comments
Permit #
Log #
Zip 92253 Study Area
Square Footage 2332
No. of Units 1
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
1.93 X 2,332 or $ 4,500.76 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 ccNalley Indep. Bank/Zeke Coronel Telephone
Name on the check
By Dr. Doris Wilson
Superintendent
Fee collected /exempted by Adriana Gauto Payment Received $4,576.00
Check No. 188369
Signature
40TICE: Pursuant of Assembly Bill 3081 (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
allect 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
M
'MAR.19.1999 6:1813M
C— ..N
`"KEu` RING REQUESTED er
AND WHEN RECORDED MAIL TtfiS
UNI -r-95 OTHERWISE: SHOWN
NiAll, TAX STATEMENTS 1
Cara nal. zuterpris ea,
P.O. Bcm 389
La Quina, CA 92253
?"7 W r p elI t► a s
The emntor(e) di
Ducurrerrtary tranxfor tax Ic S
( } cetrput®d pn NII value
( ) computed ort Mil velya
! i L'ninwipamod area;
FOR A VALUA4 LF. CONSICI
CORMIR $t '$>ti RISBS,
hereby GRANTM to
COR mm INT73IM038,
COMMONWEALTH
AND,
"NO. e02 ' P. 1:'1
C0 P Y of Document Rovaard'ed
on
as IHdo. U=.L
&je not b9an comiwed w6,111 0711001211 -
SPAcI?ASOVSTHIS LINE FOR RO�CORPER's USP
Great used Q.P.N.
arty awveyed, or
Iwo of lions and en ur0rances remaining at time of sale,
) 04w of _.....,. end
N, receipt of which Is hereby ecKplvWledlged,
, a Wif arlsin C®rporation
„ a Caworai.a CoworatIon
the real prawy In the City of LII: Quinto.
Stats of callornle, d9scr1bod ae -
Coyntyof Uverside
Lots 23 and 24 ;Ila Rlocl- all of Santa Cs=eUta at: vale La Quiat"a, Unit No. 20, e►Q algin
b7 Nap on S' le iaa Book 119 Pale 38 of Ups, aecardo of R,vertaide Comty, Caliiorx►ia
TI(iS DUD RIFLUCTS FAR01 MUM NO. 42=34M AS APS BY TEIR CXTX 07 LA QUA.
state of 0
county of
pesrWrialty lassswn to me lar Fraved tp
evldence) to be the pp,-van(p) villose
with!n InWumant and uMowledaed I
the Game Its Nother.hhelr amoda
hleRleNlhatr SOON* an the Ing+
upoA behalf at v hlah eparse,*) bet
WITNEOlLMy 420lnd 04e1 $0,
iMAJL TAX
j SS.
Ma,Rells Co1I3sr
to PM the boNp of aetlorectory
I;se(a) is/are e4bocribod to the
Me that hglaliaAMey executed
at+peslty(lea), end Ihet by
5nt the pvMri(s), of tea engty
I, axsievted the inatruMant,
TO, ® g= AS AM
SIgnaturo of Granter
Qo t3.
Ji
7L. Coro 67.1
r
V.
~'• ' ' •yl
Form 3196.4 lc -w 1 Trtls FORM MNIENH+D BY COMMONW"UTH LAND TITLE. COMPANY
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 ordinances
of the City regulating building construction or use. For the following:
BUILDING ADDRESS:
Use Classification: SFD
Occupancy Group: R 3
53-270 EISENHOWER DRIVE
Type of Construction: VN
Owner of Building: ESEQUIEL CORONEL
Building Official .•
Bldg. Permit No.: 9811-140
Land Use Zone: RC
Address: 51-540 EISENHOWER DRIVE
City: LA QUINTA, CA 92253
By: STEVE TRAXEL
Date: 10-21-99
POST IN A CONSPICUOUS PLACE
06/26/1994 17:28 6195644202 CORONEL CONSTRUCTION
REPORT OF FIELD COMPACTION TESTS
OUR REPORT NO-, '9,0"'7
GATE:
Z t vRDJECY;3 2.70
�1.
PAGE 06
NUCLEAR GAUGE INFORMATION AND
6118RATION
DAILY STAmOAAC
COUNY5
CALIBRATION NUMBERS
FROM SWEETS
VARIATION. PERCENT.. 1. GAUGE AOJUSTMENT
I
%VARIATION FROM
LAST USE
1110E YVFCXdC 41 tL
MOISTURE
MOISTURE;
MOISTURE: I MOISTURE:
IVO.
NOOEL NO: "M�
OEN511y.
DENSITY;
DENSITY:- DENSITY:
.
iROCT OR INPV MmAI{VN
SOIL ID 9 gun VISUAL CLASSIFICATION OF SOIL MAX: DRY DENSITY, PCF
-7
COMPACTION MOISTURE GENERAL LOCATION:
REQUIREMENTS, % 4 RFQUIREMFNTS, u� ► ue ��-
OPTIMUM MOISTURE, %
TEST
READING
QUOTIENT/
SOIL
TEST
ELEVATION
MOfSTUAE
WET;ORY ?EACENT
COMMENTS
IVO.
PCF
ID N0,
DEPTH, IN
OF TEST
CONTENT.
DENSITY, i COMPACTION
PGF
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em tie-,- 94.
M-
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TECHNICIAN:
MMM IFI NS
i w ;PILL COM►ACY10N PERCENTA09 DOE! NOT COMPLY WITH SPECIFICATIONS
CGUMA C . RVrWT OF PREVIOUS YES. /1✓1� '
�• . SussASE 0: MQ%T%!QC v1 CKVUS OF SPECT "71ONS
K
1 s - SOCEA Vfr !- MOYBTvrirl mow SPECtFICAT10Ns
B . OTHER
44
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TECHNICIAN:
MMM IFI NS
i w ;PILL COM►ACY10N PERCENTA09 DOE! NOT COMPLY WITH SPECIFICATIONS
CGUMA C . RVrWT OF PREVIOUS YES. /1✓1� '
�• . SussASE 0: MQ%T%!QC v1 CKVUS OF SPECT "71ONS
K
1 s - SOCEA Vfr !- MOYBTvrirl mow SPECtFICAT10Ns
B . OTHER
44
e�
This form is to be used by CDD staff for review of. single family dwellings in the RC (Cove
Residential) District, in order to determine the applicability of compatibility issues or need
to require the filing of Master Design Guidelines by the applicant. It shall be transmitted to
Building & Safety as your correction list. Please attach additional explanations as necessary.
APPLICANT: CORONEL CONSTRUCTION
PROJECT
ADDRESS:
APN: 774-091-002 &'774-091-001
LEGAL: LOT '-2-3& ?46LOCK' 211 , UNIT 20 , S.C. @ V.L.Q.
C K' D B Y : GREG TROUSDELL
BIN NO: 7B CASE NO.
98-25
CHECK DATE: 12-' 2 - 98
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 I
COMMENT/CORRECTION
i4l
::.{.+•vJ}.%4\��{
ti,mt�:}�•.p:.\h.;C}'••:}9r i:; \r{}:'l:r :v}ii::r4Y}virn..�
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F..:..
Case logged and number assigned
Verify legal and APN information
to
Consistent with MDG on file las applicable)
MDG filing required (5+ filings since 9/3/98)
Consistency with street/surrounding area:
Colors
Materials
Architecture��
'
ol
'�0 '1�
OTHER REQUIREMENTS: r1a
Vr�
The oning code, architectural and landscaping manuals, and/or assigned inspector should
be onsulted where uncertainties arise. The completed checklist shall be maintained in the .
Bui ding & Safety address file.