06-1455 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T4t(t-4.40"
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/27/06
Application Number: .06-00001455 Owner:
Property Address: 52600 AVENIDA OBREGON DOUG BELKNAP
APN: 773-285-005-4 -000000- P.O. BOX 297
Application description: DWELLING - SINGLE FAMILY DETACHED ALM DESERT, CA 92261
Property Zoning: COVE RESIDENTIAL o ®.
Application valuation: 102047 q
YQ Lo�� ontractor:
Applicant: Architect or Engineer: �� LENAP, DOUGLAS W
fit - . O . BOX 297
PALM DESERT, CA 92261
(760)902-7444
Lic. No.: OOR SQUARE FOOT Lic. No.: 205031
LICENSED CONTRACTOR'S DECLARATION
I hereby affirmunder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing' with
Section 7000) of Division 3 of the Busi s•a Profession Is Co ,and my License is in full force and effect.
License Class: B C36_Q442 Lice No.: 205 1
� 2/Dai� �� �Con�actor: '
0 ER -BUILDER DECLA ION
I hereby affirm under penalty of perjury that I am rempt from the Contra 's State License Law for the
following reason (Sec. 7031.5, Business and Pro essions Code: Any city or countythat requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State -
License Law (Chapter 9 (c6mmencing with Section 70001 of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis -for the 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 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, Business and Professions Code: The
Contractors'. State License Law does not apply to an owner of property who builds or improves thereon,
and who does -the work himself. or herself through his of her own employees, provided that the
improveme6ts 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 or she did not build or .
improve for the purpose of sale.).
(_ I I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 1 I am exempt under Sec. , B.&P.C. for this reason
Date
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERAIIT
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I 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.
10 I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor,
t— Code, for the performance'of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:.
Carrier STATE FUND Policy Number 1576785
I certify that, in the performance of the work for which this permit is issued, 1 shall not employ any
person in any. manner so as to become subject to qUPONE
is
pensation laws of California,
and agree that; if I shout come subject to then anon provisions of Section`±
3700 of
the Labor Cod s II forthw,' h comp) ions.
� �yAppltcant:
WARNING: FAILURE TO SECURE WORKERS' C PENSATION UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENA IES AND CIVIL E HUNDRED THOUSAND
DOLLARS ($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.
APPLICANT *ACKNOWLEDGE MENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this 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 application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
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 Ao
ove information is c rrect.. I agree to comply with all
city and county ordinances and state laws relating construction, d rebs authorize representatives
of his -county to enter upo the above-mentioned r inspection rpo
ignature (Applicant or Agent
V
El
Application Number . . . . . 06-00001455
Permit
BUILDING PERMIT
Additional
desc . .
Permit Fee
. . . .
650.00
Plan Check Fee
105.63
Issue Date
. . . .
Valuation . . . .
102047
Expiration
Date
10/24/06
Qty
Unit Charge
Per
Extension
BASE
FEE
639.50
3.00
----------------------------------------------------------------------------
3.5000
THOU BLDG
100,001-500,000
10.50
Permit
MECHANICAL
Additional
desc .
Permit Fee
. . . .
65.50
Plan Check Fee
4.10
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
10/24/06
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
1.00
9.0000
EA MECH
FURNACE <=100K
9.00
1.00
9.0000
EA MECH
B/C <=3HP/100K BTU
9.00
4.00
6.5000
EA MECH
VENT FAN
26.00
1.00
----------------------------------------------------------------------------
6.5000
EA MECH
EXHAUST HOOD
6.50
Permit
ELEC-NEW RESIDENTIAL
Additional
desc . .
Permit Fee
. . . .
95.06
Plan Check Fee
5.94
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date . .
10/24/06
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
1604.00
.0350
ELEC
NEW RES - 1 OR 2 FAMILY
56.14
446.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
8.92
1.00
----------------------------------------------------------------------------
15.0000
EA ELEC
TEMPORARY POWER POLE
15.00
Permit PLUMBING
Additional desc . .
Permit Fee . . . . 129.00
Issue Date
Expiration Date . . 10/24/06
Qty Unit Charge Per
BASE FEE
10.00 6.0000 EA PLB FIXTURE
LQPERA11T
Plan Check Fee 8.06
Valuation 0
Extension
15.00
60.00
Application Number .
. . . . 06-00001455
Permit . . . . . .
PLUMBING
Qty Unit Charge
Per
Extension
1.00 15.0000
EA PLB BUILDING SEWER
15.00
1.00 7.5000
EA PLB WATER HEATER/VENT
7.50
1.00 3.0000
EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
6.00 .7500
EA PLB GAS PIPE >=5
4.50
1.00 15.0000
----------------------------------------------------------------------------
EA PLB GAS METER
15.00
Permit . . .
GRADING PERMIT
Additional desc .
Permit Fee . . . .
15.00 Plan Check Fee
.00
Issue Date . . . .
Valuation . . .
. 0
Expiration Date
10/24/06
Qty Unit Charge
Per
Extension
BASE FEE
15.00
----------------------------------------------------------------------------
Special Notes and Comments
1604 SF. SFD PERMIT DOES
NOT INCLUDE
BLOCK WALL, POOL/SPA
OR DRIVEWAY
APPROACH. 75% REDUCED
PLAN CHECK FEE
FOR MULTIPLY HOUSES OF
SAME PLAN.
--------------------------------
Other Fees . . . . .
-------------------------------------------
... . . ART IN PUBLIC PLACES -RES
20.00
DIF COMMUNITY CENTERS -RES
74.00
DIF CIVIC CENTER - RES
480.00
ENERGY REVIEW FEE
10.56
DIF FIRE PROTECTION -RES
140.00
DIF LIBRARIES - RES
355.00
DIF PARK MAINT FAC - RES
22.00
DIF PARKS/REC - RES
892.00.
STRONG MOTION (SMI) - RES
10.20
DIF STREET MAINT FAC -RES
67.00
DIF TRANSPORTATION - RES
1666.00
Fee summary Charged
---------------------------
Paid Credited
------------------------------
Due
Permit Fee Total
954.56 .00 .00
954.56
Plan Check Total
123.73 .00 .00
123.73
Other Fee Total
3736.76 .00 .00
3736.76
Grand Total
4815.05 .00 .00
4815.05
LQPERMIT
V Y—
CERTIFICATE OF COMPLIANCE
Desert Sands Unified School District
47950 Dune Palms Road BERMUDA DUNES O
U RANCHO MIRAGE
Date 5/1/06 La Quinta, CA 92253 INDIAN WELLS
DESERT
No. 28427 G'� PALM LA QUINTA y
(760) 771-8515 �
%INDIO N�
Owner Doug Belknap APN # 773-285-005
Address Jurisdiction La Quinta
City Zip Permit #
Tract # Study Area
Type New Residential Addition No. of Units 1
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 52600 Avenida Obregon 1604 Unit 6
Unit 2 Unit 7
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 "Unit 10
D'
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios✓walkways, residential additions under 5
00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho
mes. 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 $2.63 X 1,604 S.F. or $4,218.52 have been paid for 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 OC/Wells Fargo - Doug Belknap Check No. 0737705148
Name on the check Telephone 777-9572
]binding Residential
By Dr. Doris Wilson
Superintendent
Fee collected /exemptedby har Mc y Payment Recd
$4,218.52 ®ver/under.
Signature C ,
NOTICE: Pursuant to Government Code Section 66020(d)(1), this Wiil s rve to otify you that the 90 -day approval period in which you may protest the fees o
r other payment identified above will begin to run from the date on which a ilding or installation permit for this project 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 DistrictCs) behalf, whichever is earlier.
NOTICE: This Document NOT VALID if Duplicated
Embossed Original -Building Department/Applicant Copy -Applicant/Receipt -Copy -Accounting
+�`+e..n+s�tr+.c+r:.�7[ev. mew.sanaa` •ar=r.,r.rt--.we.^-'s.3r.w.r..wR.rrma..�,.:
aeea::e +��,_,�� ./ 1.4ar��ss ; v..+.n.a =-`sarsil:�.a�:- - ...� .t f
i
-,
(X)Sladd-n Engineering
Dry
Density
1
03.0414 i
6782 Stanton Ave., Suite A
39-725 Garand Ln., Suite G
114 9. California Ave.
15438 Cholane Road_
Buena Park, CA 90621 -
Palm Desert, CA 92211
Beaumont, CA 92223
Victorville, CA 92392
(714) 523-0952.
(760) 772-3893 -
(951) 845-7743
760-962-1868
Fax (714) 523-1369
Fax (760)772-3895
Fax (951) 845-8863'
Fax 760-962-1878
Date
6�'
FIELD MEMO Job No. 5-Z
. Project Name L.l ,,2j, , Client:
Site Address 2 lvof %?�2 G,B� at wGb Tei
Job. Phone
Work Done
Test Summary / Footings Inspected
Test
No.
Lbcatio _
7 Elev.
Dry
Density
Moist
%
% Relative
Compaction
Ref. Max
pcf
Moist
%
Z7 1—
5 L-1
C7Z�
2
%3.v
5
Comments
24- hour notice requested to schedule Field Technician. Thank you for
Certificate of Occupancy
Building & Safety Department
This Certificate is issued pursuant.to the requirerri:ents of Section 109 of the. California Building T.
Code, certifying that, at the time of issuance this structure was in compliance with the
Y g p f
provisions of the Building Code and the various ordinances of the 'City regulating building 3
construction: and/or use:
BUILDING ADDRESS: 52-600 AVENIDA OBREGON
Use classification: SFD
Occupancy Group: R3
Owner -of IBuilding: M/M DOUG BELKNAP
I Building Offici
Type of Construction: VN
Building Permit No.: 06-1455
Land Use Zone: RC
Address: PO BOX 297
City, ST, ZIP: PALM DESERT.CA 92253
By: K.KIRKLAND
Date: 9-26-06
POST IN A CONS PIC UOUS.PLACE