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12814 (SFD)P.O. BOX 1504 Building 53-585 Ave. Ramirez 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 .,.. James C. Belknap Jr. Mailing I.O. Box 297 Address ciy'alm Desert, ilik 92260 ITel. 554-2783 Contractor Belknap Construction Ad.e . Bax 297 Palm Desert, :A 92250 554-2782 State Lic. City & Classif. B 652815 Lic. # 2845 Arch., Engr., Designer Address I Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I herebyy att ifm that I arr licens' under provisions of Chapter 9 (commencing with Section . 7000) otrDi` on o1 the Business and Professions Cbde-<and my license is in full force and OWN ER -BU ILDERDECLA RATION I hereby affi that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Cbde:_Any cf>for county which requires a permit to construct, alter, improve, demolish, or repair a"yn ,-stnicture, 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 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). ❑ 1, 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.) O 1, 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 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.) ❑ 1 am exempt under Sec. B. & 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 ❑ 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 ($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 youshould 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 '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. Iagree 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 applicant Date Mailing Address City, State;,Zip ti No. 12814 BUILDING: TYPE CONST. OCC. GRP.; A.P. Number 774-121--017 Legal Description Lot 5 Block 232 Project Description SFtd Sq. Ft. 1583 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ OF aL cic- WAW.. - A, v Estimated Valuation 11INAzil PERMIT Issued by: Plan Chk. Dep. 250.00- 50.0Q Plan Plan Chk. Bal. 280.1`2- Const. PW k; '0 Mech. 55.5.0 Electrical 127.61 Plumbing 147.00 S.M.I. ,+ Grading 20.00 Driveway Enc. 00 Infrastructure 2, 044.84 Precise Plan 25.00 TOTAL REMARKS �1q �� A. ?jj}C/ r t ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback froIT.t.Proverty Line FINAL DATE 11INAzil Issued by: I Date Validated by: Validation: \r - V -ii. 1 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. I SO. FT. WALL SO. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET — v YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation ROUGH PLUMB. BONDING FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH)- METER LOOP LAUNDRY TRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB BOND BEAM SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11A c SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR ® 3/ac HOUSE SEWER FINAL INSP. S ^!/ —41/ 32/_974L/ Zz—yROOFING /wl FrGZ� J C fy C 44 J gC,t �„� Lh „$ u�j-��(cb f/ GAS PIPING PERMIT FEE VENTILATION PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING3—"V 6 UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE rA ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER RFI 8 ROUGH WIRING DUCTWORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH)- METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE Z 22,9J� 7l GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ _$ LUMBER GR. FINAL INSP. J r.2c^O1 FRAMINGL.�% FINAL INSP. S ^!/ —41/ 32/_974L/ Zz—yROOFING /wl FrGZ� J C fy C 44 J gC,t �„� Lh „$ u�j-��(cb f/ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE 0L1/S , r (J 4.,5445rem on FAJ i S S%4✓1 SPARK ARRESTOR Slef GAR. FIREWALL LATHING99 GStjj 1 sai Q CK� IOtJui fids Oil 11 bcJ • I Wei 5q l ` ( Z MESH INSULATION/SOUND L lGr/'%7 ?"o �I v FINISH GRADING Corl INSPECTION — 11 FINAL — ✓ LM 67, lI Shor~�� CERT. OCC. FENCE FINAL 8 w INSPECTOR'S SIGNATURESIINITIALS GARDEN WA FINAL __ i� `�� -moi � %�� �\�—•S_-•'iiE i"�/j � ::� � � �I 2 TIN d. Ila Oututa ut to � P tb�tr This Certificate issued pursuant to the requirements of Section 306 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 .53-585 •Avenida Ramirez 4 use Classification -Single Family Dwelling Bldg. Permit No. 12814 Group R3 • Type Construction VN Fire Zone Use Zone SR James Belknap P.O.-Box 297 Owner of Building Address City Palm Desert, CA 92260 �. Bye Lonnie Day Dote: May' 31, 1994 . Building Official POST IN A CON9PI000u! PLACE . .. •: ..- .... .y..« ....: i. J.._.....n . r K. .t,�', •:5.r e:: : h,.e' . .. w 1�..:1'i'.G- .. ��.. n'S�z:J[f.ws. 2�_..;%tee d...:'..:«a.��w%..,:�'r` '. ..r. ..�... .�. �. ._ _ a: ... � _ ....a.'.-«. ; ttr,nay.ki.e�..s...�....:.s-.t...., II I v i l l i fl,11 __ i� `�� -moi � %�� �\�—•S_-•'iiE i"�/j � ::� � � �I 2 TIN d. Ila Oututa ut to � P tb�tr This Certificate issued pursuant to the requirements of Section 306 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 .53-585 •Avenida Ramirez 4 use Classification -Single Family Dwelling Bldg. Permit No. 12814 Group R3 • Type Construction VN Fire Zone Use Zone SR James Belknap P.O.-Box 297 Owner of Building Address City Palm Desert, CA 92260 �. Bye Lonnie Day Dote: May' 31, 1994 . Building Official POST IN A CON9PI000u! PLACE . .. •: ..- .... .y..« ....: i. J.._.....n . r K. .t,�', •:5.r e:: : h,.e' . .. w 1�..:1'i'.G- .. ��.. n'S�z:J[f.ws. 2�_..;%tee d...:'..:«a.��w%..,:�'r` '. ..r. ..�... .�. �. ._ _ a: ... � _ ....a.'.-«. ; ttr,nay.ki.e�..s...�....:.s-.t...., DESERT SANDS UNIFIED SCHOOL DISTRICT , y 82-87.9 Highway •111 NOTICE: Indio, CA 92201 Document Cannot Be Duplicated 619-775-3500 Date 2/16/94 Type of Permit La Quinta No. 12663 •Permit # Log Owner Name' James C. Belknap, Jr. No. 53585 Street Avenida Rameriz City La Quinta Zip 92253 Study Area 111 • ' APN # Tract # I Lot # 0 Square Footage 11583 Type of Development Single Family Residence' No. of units 0 Comments - 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, .i 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 1.65 x 1583 or $ 2,611.95 have been -paid to D.S.U.S.D. for the property listed above and that building permits and/or Certificates o Occupancy for this square footage in this proposed project may now be issued. Fees Paid By James C. Belknap, Jr. Telephone. 341-2271 Name on the- check By Dolores A. Ballesteros ; Superintendent Fee collected /exempted by Vickie J. Durrett - Payment -Received Signature „r "Check, -N0.''752 Collector: Attach a copy of county or city plan check application form to district copy fvr all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting Name F_ C.) l st -1 street James C. Belknap, Jr. Add(e" 73 -300 Fiddleneck Lane'litC 0 1 o a r ej w it h Palm Desert, CA 92260 gi r,;,;q 41P E. CONIERLY _j County Recorder Title Order No.::� �Ewrow No. 2 -16 9 9 9 LF A VN Sam iq R Grant Deed THE UNDERSIGNED GRANTOR(s) DECLARE(s) e -4 DOCUMENTARY TRANSFER TAX IS j. 26.95m 12 EZ— 0 — unincorporated are, IM City of La Qu in ta Parcel No. 774 -121 -P -T-8, 0,A 0 - D 6_ 91 Computed on full value of interest or property conveyed, or El Computed on full value less value of liens or encumbrances remaining at time of sale, aid FOR A VALUABLE CONSIDERATION,/ receipt of which is hereby acknowledged, WILLIAM . R. RILEY, an unmarried man hereby GRANT(S) to JAMES C. BELKNAP,. JR., Trustee of THE JAMES BELKNAP dated May 5,, 1992 SEPARATE TRUST, the following described Teal Property in the City of La Quin to county of -Riverside state of California: Lot 5 in Block 232 of Santa Carmelita at Vale La Quinta, Unit No. 22,_ as per map recorded in Book 20, page 24 of maps, in the Office of the County Recorder. of Riverside County, Dated January 6, 199 1 4 ,STATE OF CALIFORNIA COUNTY OF Riverside S.S. On _. -January 20, 1994 before me, Robert A. Lyman a Nota fincand for If idCounty acid State, 'personally appeared V111 am z ey , personally known to Me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose names) is/are subscribed to the within instrument and acknowledged to P081c.)T A. LYMAN me that he/she/they executed CO?/M. # 992617 z the same in his/her/their authorized capacity(ies), and that by his/her/th6ir z Q < Notary Public — RNERSIDE COUNlY signature(s) a;tr�q instrument the Person(s), or the entity upon behalf Colifof-.,.)io > which he ('s of wh h I s) �clek, executed the instrument. Comm. Expires APR 26. 1997 WITNESS M Signature FOLLOWING LINE; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE wi2liam R. Riley" MAIL TA� SI�ATEMENTS TO PAR Name Street Address City & State