14160 (SFD)P.O. BOX 1504 N o . ` 14160
Building 53-655 Ave. Ramirez 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
James Belknap
Mailing P.O. Box 297
Address
City Zip
Palin Desert, 92261
Contractor
Belknap Construction
Addr. CD.ess }Box2 9'
el.
(619)564-2783
all Desert, M 92261 (619)564-2783
State Lic. B 652815 City 2845
& Classif. Lic. # ...2845
.. ,
Arch:, Engr:,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile 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 or 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.)
❑ I, 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
O 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 peimil 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 you should 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's 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.
I agree 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.
q mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State; Zip
i
11LDING: TYPE CONST. VN OCC. GRP.
P. Number 774-121-020
R3
Legal Description Lo`' 8 Block 232
Project Description SFD
Sq. Ft. No. No. Dw.
Size 1410 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
IPermit includes 8' of 5' high: garden
black wall and 12' of 42D wall for
enclosure. Pool and/or additional
I walls to be obtained separat>al.y.
Estimated Valuation $87t648.70
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
249.16
Const.
585.50
Mech.
62.00
Electrical
122.€3 9
Plumbing
138.00
S.M.I.
8.70
Grading
20.00
Driveway Enc.
.00
Infrastructure
I, 926.4.1
P reclse Pl-a-r
25.00
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
c Re Pop: Line
ESidt Set�ck fr enter Line
Side eerSetback from Pro Line
FINAL DATE
Issued by:—
Validated by:
Validation:_
CONSTRUCTION ESiFMATE 4
NO. ELECTRICAL FEES
NO. PLU14BING FEES •
NDERGROUND
0
A.C. UNIT
IST FL. SO. FT. p $
UNITS
L
t '
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. p
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. p
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. p
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. SQ. FT. p
TEMP. POLE
WALL SQ. FT. p
DRINKING FOUNTAIN
WATER HEATER
URINAL
SQ. FT. p
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
GRADING
cu. yd.
$ plus
FLOOR DRAIN
MECHANICAL FEES
'
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
aG G
7 6
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U. -
SO. FT. p c
BATH TUB
SQ. FT. p c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID p 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR p 3/ac
HOUSE SEWER
INSULATIONISOUND
t
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEEPL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
NDERGROUND
0
A.C. UNIT
COLL. AREA
SLAB GRADE
L
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus
x$ _$
LUMBER GR.
'
FINAL INSP. `s / y��
n
FRAMING / Q
r
FINAL INSP. �./� ��
ROOFING
VENTILATION
aG G
7 6
;� ,/ /J`
`f% L M l�/C-S
/O
` //� T 7(�// !� �� _pp`(,/(�j
2
!/
�Xi/c' �, % 69 —w
REMARKS:
FIRE ZONE ROOFINGi��
FIREPLACE
�ij"
•��� /� L i•
SPARK ARRESTOR
GAR. FIREWALL
LATHING4PWA/ ,27
MESH
INSULATIONISOUND
t
FINISH GRADING
FINAL INSPECTION
CERT. OCC. , 3
r�
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 114
NOTICE: Indio; CA 92201
Document Cannot Be Duplicated 619'--7753500
Date 9/30/94 Type of Permit I La Qqinta
No. 13098,' Permit #1141,60
Log
Owner Name James,* B*eikhap
No :5$65$Street Avenida .' R__'a*m-':'itez
city La Qu'iii.ta Zip St�d� Area 111
.... 14 Y
APN #-'Tract,41 Lot"i Sqtt Footage Fo tage 11410,
Type of Develop . ment' [Single ,Family Residence. No. of units
Comments
At the present time, quare feet, ffie'l)ese - A, Sands. UrnifieDistrict. School Disct does -not collect fees on
'
garage§/carp, . orts; covered patios/walk ws,;Y
aresidentialadditio'ns under 500 s
�r`structures
trucid. 0 1.i- -
detached accessory s ': ' res'or . rep. acerr�end mobilehornes.' It has been determined
.. q. .1 1 replacement I �... I -
the .above-named owner exempt `from- paying school fees at this -time due to the
' I I � % .. . 1 .9
following reason:
EXEMPTION NOT A -VP L.WABLE
This certifies
ifies that school -"facility :f 6es, imposed pursuant: to G overnihent,-.CQde 53080
in the amount of or .,have been paid to D.S.U.S.D. for
the propertylisted above aril qi iingj1d't, 'permits 'iftd/6' r ; Ceitifkatiis ofm
occupancy for
j4V .e
i A
this square footage in this'.Propos.ed project znay now, belssued.
Fees Paid By Tames C.Be�lknap,564r2783
Telephone..
Name-oh%-tti "c"he16k
By Dolores A. Ballestekos,
Superifiter4enit
Fee collected /exempted y La ine rthur
e
I'd me O,,-
Payment'
.Signature
Check.Ab. 1047
Collector: Attach copy Of 'cb unty or city plan check Abblicationlorm to distikt,copy for all waivers.
Embossed Original- Building Dept./Applicant Copy A' hcant/Re�eipt Copy Pp Accounting
RECcc
ORDING REQUESTED BY
�R^it s C
t t
AND�EfJ � 1W64 EDMA1L°4HFS DEED AND,-AR&£•BS DFfERtQHSE- (� Y
t SHOWN BELOW,.MAIL TAX STATEMENT TO P1 K W V
w a`
o rn
_Name F_ 71
,^ James. C BelknapJr. W
Street,!,
(y. nddiess 33
73300 Fidd3eneck Lane O. a �. Q $ Mt
city s LU CD
Palm Desert; CA' 92260 o J
:r State I 3 W Q "
Zip
e Title Order No Escrow No. i. -1708S SPA IS LINE;F LU
to .Grant Deed:
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY.TRANSFER TAX Is $, 52..80.
+� ❑uninco rated area Ctty of
:77 121 020" & 774-121=021
Parcel No.
®-computed on full value of interest`or property conveyed; or.
Q 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,
' r INGA A. JOHNSON, "a, widow
Y
3 hereby GRANT(S) to
JAMES.' C. BELKNAP, JR., Trustee" of TSE: JAMES BELKNAP SEPARATE TRUST,
dated .May 5, _ 1992
M the :following described real property iri the . City of La Quin to
county of Riverside,, state, of'Califorrtia:
r Lots 8.: d.9 oc��anta .Ca' elita at ;Vale La Quinta;, Unit 22,.
-map rded in `Book 20, page 24 of Maps,: in the Office of
a = the County Recorder of Riverside ,Courit.y.
Dated January -151, 1994' '
STATE OF CALIFORNIA .
COUNTY OF: tN%t1'C—
On before me, .
Ken Waring ,
a Notarrn(y Public in and`f�r5aid;Co,unty and•Staie, personally appeared
Inga -A: Jo�inson
personally kno".to me (or proved to me -ori the basis of satisfactory
evidence) to be.,the persop(� whose name(s�Is/�subsc�ibed to,the
within instrument and acknowledged to me that tyeVshe/tgaq"executed
the same in t iS her/t"W` authorized capacity(i�aj; and that by. bis/herhljeiT
SignaturbW.ondhe Instrument the,'pi iK; or theentlty:uponibehalf
of which the per,§on(6f.acied, executed the-In§trument.
WITNESS my band and official.,se
Signature t
OFFICIAL NOTARY SEAL
KEN WARING
Notary Putilic -California
RIVERSIDE COUNTY
=Ny Coniin.Eicpires FEB 28,1995
MAIL TAX" STATEMENTS TO, PARTI SHOWN*6N' FOLLOVYING LINE; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE
Name'- - --Streei.Address ' City &.State
s
i
CALVIN C. KAMINSKAS
Nsblonl Commisslonor ° ��=- � •
(7141276-30M
01TICE or-
AGRICuu,ui- /\L COMMISSIONER
JAMES O.'WALLACE. Comrnlssloner
(T3-612 Avenue 45 Suite 7
Ividib, CA 92201
(619) 342-6291
DA14 RILEY
Sealer, Welighls & Meast
(714) 275.3030
DJ�'IE CASE NO. C_ �2 '\A t
DEVELOPER'S NAMES AxAli
ADDRUSS r
-.oar3
5 3-� m
5 Cu(z 1 Wz-
Dear Developer:
After reviewing your landscapilig Plans, {�all. plant mai.terial listed is riot in
violation of quaraiil-ine laws governing the .Coachella Valley. If substitutions
do occur avid they differ fro6i plant mal-erial 1'is.ted, this office must be notified
imnediately.
'Tt>Ian)cynu:for protecting and preserving Lhe Coachella Val-ley's pest -free envirorxr>F
Agr cultural Camixiss3oner s FL -ice
.cci Indio and Riverside
APPROM . y�
F B
` ?-u � :Q
[SATE:
L
4080 LEMON SiRCET, ROOM 19, IZIVEi2SIUE, CALIFORNIA 92601 - r -AX (714) 275.3012
tt
I; OF
Ott r 11 _ct oh, ijl t
This Certificate issued pursuant to the'requirements of 'S-ection 306,of the, Uniform..Bu lding. !
..Code certifying that at the time "of issuance this structure was in compliance with the various i t
s ordinances of the City regulatingbuilding construction or use, For the, following: I 'I!
BUILDING ADDRESS 53-655 Avenida Ramirez I R'
Use classification Single Family Dwelling Bldg. Permit No. 14'160 I I!
! Group R3 Type Construction VNFire Zone Use Zone SR III
ames- Belknap ,address P.O. Box 297
Owner of Building J1 _ !
City La Quinta, CA 92253. Daniel"P. Crawford Jr.
BY:Vil
I Date: February 13, 1995
'! Building Official ---
- -- ►lAC[
POST IN A CON!}ICuaU!
I ..
� �
�
- - --