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9911-201 (SFD)` LICENSED CONTRACTOR DECLARATION J' rl 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 # h Lic. Class Exp. Date d LO 605857 B % 0 11130;'20( �W� o ZO r-. tate/� f Signature ofContrPctor'� _t ' CD J UOWNER-BUILDER DECLARATION W W I hereby affirm under penalty of perjuthat Ila ry m'exempt from the Contractor's ~ License Law for the following reason: Z_ ( ) I, as owner of the property, or my employees with wages as theirsoler 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). ( ) I am exempt under Section B&P.C. for this reason LO N Date Signature of Owner ON 0) Q WORKER'S COMPENSATION DECLARATION IL C:) cc I hereby affirm under penalty of perjury one of the .following declarations: Lo FZ O () 1 have and will maintain a certificate of consent to self -insure for workers' X W �: compensation, as provided for by Section 3700 of the Labor Code, for the O � _;J performance of the work for, which this permit is issued. 00 Q U (y)' I have and will maintain workers' compensation insurance, as required by O C) Q Section 3700 of the Labor Code, for the performance of the work for which this li �H permit is issued. My workers' compensation insurance carrier & policy no. are: z Carrier Policy No. co Z) ST ATE FUM) 1.27 04012,-99 0 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 3 subject to the workers' compensation provisiotn`sjof Section 3700 of the Labor Code, I shall forthwith comply with_t 1 se provi o S.— ,Date: . „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 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, indemnity & 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,band hereby authorize representatives of this City to enter upon the above=;mentioned property for inspection -purposes. till I f S� ature (OWref/Agent) "� s Date BUILDING PERMIT PERMITN�y24�a DATE t VALUATION ' $92,987,40 LOT 9 TRACT 11,2341-J22 7� JOB SITE IDA .'����1 iW� 'DAC-4,R!L%NZA APN %%�-�. � ��� ADDRESS OWNER CONTRACTOR / DESIGNER / ENGINEER JOE W. SPINI1MERL 10hW. SIMryfMEII,JR. COTSIST. 423-35 �,`AS..HINCiT_f0, f ST. #355 42333 WASE- FNG, 1rDN ST. *353 PALM DESE110' CA 92211 PALF4 013SEWr CA 91211 (760)360416-5 CAL!` V1.9 USE OF PERMIT r ,"r"3l ->;g. INU f DOES, f14C.I: M, ,fiLt,:'l,'[.i+ WALLS OR 001. Tt'ZAr t CC), 7i U 1014 1,491.901 .S 1'1(.A CH PA.T!0 96aw :fir 0ARA..00C;Ak POINT 463.09 519' S .&"A . WCXA) rEIvCR 200.00 LSA r0l;'1 f:M. TIE C'O9 x 1113' CONSTRUCTION 'n,gtr"40 CONSTRUCrrte3N FEE 101-000-418-000 53 r`VA-0l.Au" 1"-ALl�Esu i�e,-�J��i","-Ld() $`33.511 0 diiECTWCAL FEE 101.000-X1i Pf',UMBINQ 91113 101-000-4.19-000 $1 ft).75 S`k"ROt4ii MOTION FFF - R1118 IT) 10,11410 -?41 -OM sq,,:Ao C+RtV'?TNC 1 L iQl U iO 4'.°3-f)00 a20,00 PRE `JSE,PLANT 101-000-441-341 $iCtO. J M -F, I-IFPOSJ.T 101-000-439-318 411%0.0 e r a'( �'.4 :A b ;ONS"PUJIG".RON AND 1'GAN CHECK $3,448.06 PAIM- AI I,F.S PlIE-PATD FEES -$250.00 DEC 14 1999 1'07FAL .fteRMIT ,LEN DOE NOW $3,.198.06 N'Te JITY OF LA QUIIM RECEIPT DATE t ± A BY / DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Forms & Footings Slab Grade —17 � � ( Underground Ducts Ducts Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap 7 F.A.U. Framing �a �� 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 I I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Water Piping _ y�© Heater Final 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 12 - ao- Q Y S 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: 6 This form is to be L Residential) Distric•_, 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. C/7 -Y 0� Ain.'- "rV7-A APPLICANT: JOE STEMMER, JR. - PROJECT ADDRESS: 53-925 Avenida Carranza APN: 774-15.5-018.. LEGAL: LOT 9 .BLOCK 232 , UNIT 22_..., S.C. @ V.L.Q. CK'D BY: Greg Trouddell BIN NO:. CASE NO. 99-157 CHECK -DATE: Inform -'the assigned Building plan checker upon your assignment to this case. The CDD Executive Secretary maintains a lo.g book to track applications and assign case numbers. ---------------- REQUIRED .ITEM Y-1 N COMMENT/CORRECTION ,.. \ ..w.•?:t:.;... a.tn?anv:.a:aav`.<.?'•?'C:•:Ji:•??:•:i::.?:i.?iatiS?\ v .... ,....v v.•. a.:... ,GM;PI��;li�.il'IT:�'::.:. \ v::n,, ar .,,`: •:(:} tj\.. i:<b� q .a Case logged and number assigned Verify legal and APN information Consistent with MDG_ on file las applicable) MDG filing -require d 15+ filings since 9/3/98) P 0� Consistency-with-street/sur-rounding area:. 8� Colors F"� Materials Ic. . r .Architecture . � t _ OTHER REOWREMENTS: The zoning code, architectural and landscaping manuals, and/or assigned inspector should be consulted where uncertainties arise. The completed checklist shall be maintained in the Building:& Safety address *file. /`� Notice: Document Cannot Be Duplicated Date 12/14/99 No. 19758 Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE APN # 774-155-018 Jurisdiction La Quinta Owner-NameJoe W. Stemmer No. 53-925 Street Avenida Carranza City La Quinta zip 92253 Tract # B234U22 Lot # 9 Square Footage Type of Development Single Family Residence Comments Permit # Log # Study Area 1492 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 mob'ilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: .j EXEMPTION NOT APPLICABLE f t: This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.93 X 1,492 or $ 2,879.56 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/Washington Mutual Bank Name on the check By Dr. Doris Wilson Superintendent Fee collected /exempted by Olivia Aguirre Signature Telephone Payment Received $2,879.56 Check No. 104629383 NOTICE: Pursuant of Assembly Bill 3089 (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 nun 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('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 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: Occupancy Group: SFD 53-925 AVENIDA CARRANZA R 3 Type of Construction: Owner of Building: JOE W. STEMMER Building Official VN Bldg. Permit No.: 9911-201 Land Use Zone: RC Address: 42-335 WASHINGTON ST. #355 City: PALM DESERT, CA 92211 By: STEVE TRAXEL Date: 07-17-00 POST IN A CONSPICUOUS PLACE a� � t1. � M m p N tid`. `�, Cl) O 0 0O V z o = w ry Q O W Q v Z N N w p C L W cc Q m J CL U 4V CO y Z Z Z �' U f° a > 0uj 3 0 > -ao LO U O ~ N a M U z0 y LO L V Cl) a z o Z G�j U CO J*+ C1 i o a ct y Q W C co V c6 y W N LU W `- ~ '� U U 43 ,C V m c CL ti `! V c ' fA L) v 0 0