9612-070 (SFD)LICENSED CONTRACTOR DECLARAfION'
1• h'e'reby 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. Clas'sEx Date
6058's7 .8 - - it , - , I , � /-.) .19 tu/-,30/98.
Signature of
i DER
OWNER -BUIL DEJLARATI'Ok
I hereby affirm under penalty of perjury Tat 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'kle
compensation, will do thework, and the structure is not intended or offered -for
sale (Sec. 7044, Business & Professionals Code).
1, as_owne.r of the property, "am ,exclusively contract' ng with licensed
C' project (Sec. 7044,'
contractors 'to construct the proj Business• 9 Professionals
Code).
O l.am exempt under Section B&P.C. for,this reason
Date, _Sidnature7 of Owner l'_
WORKER'S COMPENSATION DECLARATION
I.,hereby affirm under penalty of perjury one,of •the followiIig-decl 'a
rations:
I ha4'and will maintain a certificate of consent to self -insure for workeis'
co `irnpensation,•as provided for.,by-Section 370Q,of the Labor Code, for.the
:Oerformance"of the work for which this permit is issued.
kers' compensatio
W I have and will maintain workers' compensation..insurance, as required by
Section 3700 of the Labor Code, for the 'Oerformance6f.,the� work ' for which this
permit is issued. My workers' Compensation insuranc . e . carrier & policy no. are.
Carrier Policy No..
JVIR40
(This section need not be completed if the permit valuation is for $100.00 or'.Iess)'.
I certify that in the performance of the Work for which tyis permit is issued,
shall not employ,any person in any manner so as to bedome'subject to th6
workers' compensation laws of California, and agir Ue,th, if I should become
subject to the .workers' compensaVon
provJsions of ectio�n 3700 of t e Labor'
CQde, I shall forthwith comply wi hthose p visions.
-,datellj, Qa Ap'plica A
Warning: Failure to.secure orrers" Compensation coVeragN uI-A Vularid
shall subject an employer todri final penalties anclCivil fines up.to $1.00,000Jn•
addition to the Cott 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 Bui,lding'and Wety
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 Oe'rsdh- I at
whose request and for whose,benefit work is performedi under or pursuant to
any permit issued as a result of this applicator 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 1180 days from date of -,issuande, of such
permit, or cessation,.of work f6r` 18.0 days will subject permit to cancellation.
I certify that I have read this application and state tot the abov I e information"is
correct. I agree to comply with-all.City, and/Stater
f I - Jaws relating to the* building
authorize r' S
construction, and hereby autho.' epresenta ive of. this City to enter Upon
the above- mentioned property foc, 19 �ectiolA` Doses- u y
Y i
Ib
ti �-
uSinnature
ses-
Sinnature (Owner/AnPn*fi Date
PERMIT # I I . . . CONTROL#
BUILDING PERMIT 4594
DATE VALUATION $99 '7,19. LOT TRACT
10
JOB
ADDRESS 54490 AVENTAA1
IDA ftJ
APN,9FZ 174-301406
�
OWNER
CONTRACTOR DESIGNER / ENGINEER
JOE; "At. trf.."Mmra m
4233,51 WASIAN(Ylvwirf, fdi-53
WASEHNG110i'4 $-r. #35.3
'PAL.N1 0f3.S)'l',AT CA. .97260
PALM CA 92260
ORY 2
USE OF PERMIT
RR
sn-xvE 'r 06ts -aciv tN,_umrs &LL9 OR POOL
-m."a calo,��,;ruvc-rfati ILG19'.00 SF
48,00 V
400.008F
fF
NITMAI ED CO'.Wr 01 CONS-TRUCT I . N"
C'()OSTRURO'ffiYN rll1111 1014-Y)O-41840)'
MAN C1.1 160.1 DCP0311111
-00(J -420-000 $129,2.`
$133,59
NIC0 t'O'. fR 13') 1��H--000-241 f $9.97
WFR.A-'� .1111W .225AVO-443-142' 00 i07.
T,
-7F0TAJ, UMrIONAND PLAN C
`0B, CONS- 'HECK
%3,7,% tR
PAID, 1'113SS Pla.-PAID FEIBS
4210.00
TOTALVi.-RNWIT JE, NOW
.'JAN 10 1997
A
CITY OFLA Q U I 14TAL
RECEIPT
DATE FINALED
INSPECTOR
7
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING
APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
o
Return Air
Steel
117
Combustion Air
Roof Deck
Exhaust Fans
OX to Wrap
F.A.U.
Framing
Compressor
Insulation
97
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
al 40r—
Final
Final
POOLS - SPAS
BLOCKWALL
PP OVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground P[bg. Test
Final
Gas Piping
PLUMBING APP OVALS
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
63 P
Encapsulation
Gas Piping
Gas Test
Appliances
Final ,
COMMENTS:
Final -
Utility Notice (Gas)
ELECTRICA PPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fbdures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final em
Utility Notice (Perm)
K�r ,
Notice:
Document Cannot Be Duplicated
Desert Sands .Unified School District
82-879.Highway 111
Indio, CA 92201
619-775-3500
CERTIFICATE OF COMPLIANCE
Date 12/30/96 APN # 774-301-005
No. 15146 Jurisdiction La Quinta
Owner Name Joe Stemmer Permit #.
N6.54820 Street Avenida Ramirez- :Log #
City La Quinta Zip 92253 Study Area 110
Tract # Lot # Square Footage 1649
Type of Development, Single.Family Residence No. of Units 1
Comments
At the present time, the Desert Sands Unified, School District does not collect fees on gaages/carports, covered
patios/walkways, residential additions under 500 square feet, detached accessory structures or rep_acement 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
1.84 X 1,649 or $ 3,034.16 the property listed above and thatfbuilding
r, YriPermits and/or Certificates of Occupancy for this square footage in this proposed project ma Vobe issued
Fees Paid By American Savings BankNickY Stemmer
'v� Telepi:one�-360-9'365
R
Name on the check � �` � `a' � • � � ,
By Dr. Carol McGrew
` t_
Administrator in Charge
Fee collected /exempted by Pauline Pearson Payment Received ` $3.,034.16
Check No. ?
' Signature Ak_A4�
NOTICE: Effective January 1, 1997, Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval perod in which you may protest the fees or
other payment identified above will begin to run from the dale 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 waovers..
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting
RECORDINEt
It
VANY
AND WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE
SHOWN BELOW, MAIL TAX STATEMENT TO-
N'am a 'Joe -W. Stemmer, . Jr, .
Street
54 425 Ave. Alvarado
Address La Qui nta, Ca 92253
City &
State
Zip
Title Orae, No. 612477 Escrow No. 947448RW
Z
C5
. ..
�m=8
Q v o °C eo
.Yv �Ir d
SPACE ABOVE THIS LINE FOR RECORDER'S USE
T 355 Legal (2-94)
Grant Deed
THE UNDERSIGNED GRANTOR(s) DECLARE(s) 36. 30
DOCUMENTARY TRANSFER TAX IS $ '
El unincorporated area P City of _La Qui n td
Parcel No. 774-301-005 & 006 -rp_A: 0at)6)15
X computed on full value of interest or property conveyed, or
❑ computed on full value less value of liens or encumbrances remaining at time. of sale, -and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
JOHN: C. VAN BRUNT, a Single Man -
hereby GRANT(S) to'
..JOE W. STEMMER, JR. and VICKY STEMMER, Husband and Wife as Joint Tenants
the following described real property in the City of La Qui nta
county of. Ri VerSi de state of California:
Lots 19 -and 20 in Block 311, SANTA CARMELITA AT VALE LA QUINTA, as per, map recorded
in Book 19 of Maps, pages 59 and 60, in the Office of the Recor,dEr, of said County..
SITUS: '.Vacant Land, Avenida Ramirez, La. Quinta, Ca
Dated August 30, 1994
Jgfin C. Van Brunt
STATE OF CALIFORNIA
COUNTY OF / } S.S.
On _ �� �� before me,
a Notary
and
personal"nown 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(es), and that by his/her/their
signature(s) on the instrument the person(s), or the entity upon behalf
of which the person(s) acted, executed thinstrument.
WITNESS my Land eadi-officia seal
Signature
r: RdEBA WEST T
am COMM. # 985585 <<
NOTARY RMUC • CALIFORNIA G
rL r Rir•.rside County
`oA•
"I 0017M Ix*es Feb. 24,1997 -+
(This area for official notorial seal)
.....a, a� ucnacnm"11a av rAx1I OnVWIN UN rULLUWLNG LJNE; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE
Name Street Address
City &State