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
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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
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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