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0003-052 (SFD)3 x 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. O License # Lic. Class Exp. Date - 63yZi 33 N3Il20t o Z r— Date Lr'_ Signature of ContractorJ, , Or U coo OWNER -BUILDER DECLARATION HLU 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 I. 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 O N Date Signature of Owner rn d Q WORKER'S COMPENSATION DECLARATION oZ I hereby affirm under penalty of perjury one of the following declarations: LO �!r O () 1 have and will maintain a certificate of consent to self -insure for workers' X W 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 ( ) I 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 li v Z permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. ob O STAT itC.IND 1342937.00 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 I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code shall forthw'th comply with those, provisions Dater Applicant ��: ' lA� t\` d'I, /`-A Warning: Failure to secure Workers' Cornpensation 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 Ca 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/Ag"ent) , _ < `W " t%'t "�•---D>ate BUILDING PERMIT . PERMI 003-05z 4 _ • . DATE VALUATION S91.294.IQ LOT 22 TRACT .. , 13L3 AN U."R JOB S T 11 ADORESS 54-290 EXS J�THOVVEH URIW!, APN OWNER(^) CONTRACTOR /SDESIGNER /�ENGINEER (( I yy {9 ( CC!!ION 1,11, 4V1Y�9 a�Vr•i 101`Y j/may C: J,1t01.4t41, CONIST[�.U• "R3i 1l'/ S'1-501Si�f:E�i6VL`1t.�R. 31-5�'cGiSEc'v'FI!>>Bd'I Ti 1)t�. LA Q INTA C -JA 9`2253 LA"t'i)1.DF:it\ CA 92253 OQ (160)5014-:1604 2261USE ��C131�.# J J OF PERMIT iilfi ! !^Fi_,3ILY DWEELLING R 0 5 2000 SPID-D S !�01* .INCL UDfA, BI,O'::3{. WALLS OR P00L ✓ITY OF TRACT CONS`t•RUC-NON 1,475.00 SF PORi"'fldi'.ATIO 9x":00 S . G.AR.As'S*YC'Ai P0X1' 403.00 S4 5 FT. WOOD FENCE 100.00 LF � . ESTIY3.tE.TAB.'' D COST OF 'I,ONS11 I i 7110lit PE TUMIT FEE SUMMARY CION311RUI-710N :M 101-000--M-OW "60'3.50 PT.AN04-170K. RMr 1014M-43+9••24!8 $509.119 I;D010=1 401_4TO-4319. 13 -1250.00 {. 1ANTc A1. ►' 10t -OBJ -421-000 _'Eu '.'rRICAL FEE '101-0013-420-000 $124.39 P:AX149!Na iii; 101-0001 419 -(?X) $1.79.75 SIRONO NIO T ION I'1.X - ltMID 101 -000.241 -GW $9.13 ORAII UK) FEET i () i -0004221.0 i'0 $20.00 INFRASTRUCTURE F!E 225-000-443-342 $2 OttS;�6 PRP:CI SE PLAN 101-000-4411-345 MOW (-'l,)N1,Zf'RUC1'xO ? �INE.'� _�.py("WT"4?C` 63y5 (ii H'!° L 3 (v b.n,.Q a L.• .ai 4250.00 TOTAL 1v Ee RM ff FER B DUE NOW $3,311.82 RECEIPT DATE ------B �1 DATE FINALED INSPECTOR L/ G�- INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings — Underground Ducts Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K to Wrap a -c�0 F.A.U. Framing _ Compressor Insulation CPC2,9 j Vents Fireplace P.L. Grills Fireplace T.O. ' Party Wall Insulation Fans & Controls Condensate Lines Party Wall Firewall Exterior Lath Oo S Drywall - Int. Lath - - OD S Final Final BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings f c/- _ , 0,5 �� 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 57 ZZ 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 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: fi.ig .. 7rY.ao- ..3at14 . .44, V 1> Ar7 Oyi �0 3' u�l'ItrCv ,_5 R 0 P.O. BOX 1504 APPLICATION NL _- Building�- / �_ i 7^ 78-495 CALLE TAMPICO Address '� �! 7 (' _Ali- %�)( t��`� LA QUINTA, CALIFORNIA 92253 Owner Mailing Pr1 Address �r 1 PCI I Lt _`5� I CQJeC-)A)(-_-l_ Address State Lic. City & Classif. 3 e_191 Lic. # Arch., Engr., Designer Address Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 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,Business 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 or 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 !or 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). 1,21 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 -builder will have the burden of proving that he did not build or improve for the purpose of sale.) t 1 I, asowner 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.) 17 1 am exempt under Sec. B. d 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 r7 Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (5100) 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 Exemptionyou 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 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 adplicant Date Mailing Address City, State, Zip BUILDING: TYPE'CONST. OCC. GRP A.P. Number Legal Description �C�?' --29 0" Project Description Sq. Ft.No. _Size 1` I � No. Dw. Stories Units New �/ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. S Od Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure t i 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 Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 Date 4/4/00 No. 20248 CERTIFICATE OF COMPLIANCE APN # 774-253-002 Jurisdiction La Quinta Owner NameCoronel Construction No. 54-290 Street Eisenhower Dr City La Quinta zip 92253 Permit # Log # Study Area Tract # BLK300 U28 Lot # 22 Square Footage 1475 Type of Development Single Family Residence No. of Units 1 Comments SFD-Does not includes block walls or pool. 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: .Jl'l:j I"S EXEMPTION NOT APPLICABLE;, This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 2.05 X 1,475 or $ 3,023.75 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 Independent Bank/Zeke Coronel Telephone Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Olivia Aguirre Payment Received $3,023.75 1` Signature Check No. 217749 NOTICE: 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 collect them on the District('sXs') 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 PC RECORDING REQUESTED BY: COMMONWEALTH LAND TITLE COMPANY 99.9174KC 6007054 OcCORDED WHUNL LOT H�R�T��EME4INTSDT LOW, CORONEL ENTERPRISES, INC. 51-540 EISENHOWER DRIVE LA QUINTA, CA 92253 TP M OW -0/5 M I S I U A I R I L GRANT DEED DOC N 1999-458058 10/15/1999 08:00A Fee:6.00 Page 1 of 1 Doc T Tax Paid Recorded in Official Records County of Riverside Gary L. Orso Assessor, County Clerk 8 Recorder 4 IIIIII IIIIIIIIIIIIIII II� IIIII� �IIII VIII ILII III VIII �I II PAGE I SIZE I DA I PCOR I NOCOR I SMF I MISC. f COPY I LONG I REFUND I NCHG I EXAM APN: 774-253-002 0037 00� The undersigned grantor(s) declare(s): Documentary transfer.tax is $42.90 (XXX) Computed on full value of property conveyed, or t ) Computed on full value less liens and encumbrances remaining at t.:i.m? of sale. ( ) Unincorporated area: ( )( ) City of L - /j Qu uTH and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, FOUNTAIN VIEW DEVELOPMENT CORPORATION, a California Corporation hereby GRANT(S) to CORONEL ENTERPRISES, INC%, A CALIFORNIA CORPORATION the real property in the City of LA QUINTA, County of Riverside, described as: r Lot (s) 20, 21 anC22, ck 300, Unit 27, Tract Santa Carmelita per map recorded 19, Page(s) 82 inclusive of maps, in th, Recorder of said County. Dated September 10, 1999 State of California County of Riverside } S.S. On October 14: 1999 before me, _ Kelly Collier personally appeared Thomas D. Mirasola 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 capacity(ies), and that by his/her/their.signature(s) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. f\ e WITNESS my han and.. f ici.'1 seal. ..................- Signatur_.__ ' t J MAIL TAX St to of CjtheC ia, at V , as offices,tfunty FOUNTAIN VIEW DEVELOPMENT, INC. BY / `Giles✓ //��/� 'h 1C1.�-�i Name/Title BY Name/Title T . ' KELLY COLLIER COMM. # 1223426 o-< NOTARY PUBLIC•CALIFORNIA�� RIVERSIDE COUNTY :) COMM..EXP. JUNE 6, 2003 (This area for official notarial seal) 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, 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 the Building and Safety Department as your correction list. Please attach additional explanations as necessary. APPLICANT CORONEL CONSTRUCTION SITE ADDRESS 54-290 Eisenhower Drive APN 774- 253 - 002 BIN NO.: CASE NO.: 2000-195 LEGAL: LOT 22 BLOCK . 300 UNIT 27 S.C.@V.L.Q. CHECKED BY: Leslie Mouriquand 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 Compatibility Review Case logged and number assigned Verify legal and APN information Consistent with MDG on file (as -applicable ✓ �� u'�'� �' MDG filing required (5 filings since 9/3/98) Consistency with street/surrounding area: Colors Materials Architecture Other Requirements: - O 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 ollowing: BUILDING ADDRESS: Use Classification: SFD Occupancy Group: R 3 54-290 EISENHOWER DRIVE Bldg. Permit No.: 0003-052 Type of Construction: VN Land Use Zone: RC . Owner of Building: CORONEL CONSTRUCTION Address: Building Official City: By: 51-540 EISENHOWER DRIVE LA O.UINTA, . CA 92253 STEVE TRAXEL Date: 08-30-00 POST IN A CONSPICUOUS PLACE