14970 (SFD)ti P
P.O. BOX 1504 No. 14970
Building 78-495 CALLE TAMPICO
,,Address 53-695 Ave. Ramirez LA QUINTA, CALIFORNIA 92253
Owner James Belknap
Mailing BUILDING: TYPE CONST. Wa OCC. GRP. R3
Address P.A. Box 297 774'-221-021
A.P. Number
CityZip
Palm Desert, 92261
Contractor
Belknap Construction
Address
F.D. Box 297
Palm Desert, C NIp92261
State Lic.
& Classif. B 652815
Arch., Engr.,
Designer
Address
;I. ' ' . Lot 9 Block 232
564--2763 Legal Description
Project Description SFd
Tel.:
564--2'83
City
Lic. # 2845
City. Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I heretiy affirm that 1 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 _
OWNEWBUILDER DECLARATION
I 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, atter, improve, demolish, or repair any structure, 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).
0 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, 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 contractors) licensed pursuant to the Contractor's License Law.)
❑ I 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.)
Pq)RN o. Company
Copy is filed with the city, O 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 the 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: lt, after making this Certificate of Exemption you should become
subject to the Workers' Compensatton provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
WARNING: FAILURE To SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP- TO ONE
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.
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.
1 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-:,
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Sq. Ft. 1400No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit dors
not include block
walls
or tool.
Estimated Valuation
$85,756.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
24o.73—
4o+Const.
Const.
3 16 .50
Mech.
55.5U
Electrical
120.70
Plumbing
138.00
S.M.I.
8.58
Grading
20.00
Driveway Enc.
.00
Infrastructure
11,891.00
Precise Plan
2
\
TOTAL
3,326.03
3,076.03
REMARKS
ZONE: BY:
Minimum Setback Distances:
'Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
Issued by: Date
Validated bv:
Validation:
INSPECTOR
gy V -1V
i
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. fLUMBI
1ST FL. SO. FT. ® $
UNITS
2ND FL. SO. FT. a
YARD SPKLR SYSTEM
SLAB GRADE .�
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
STORAGE TANK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
DUCT WORK
DRAINAGE PIPING
CAR P. SO. FT. ®
GAS (ROUG METER LOOP
WALL SO. FT.
DRINKING FOUNTAIN
SO. FT. ®
GAS (FINAL) TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER SERVICE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD.
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FRAMING
IKITCHEN 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
/
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
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 CON D. SOLAR
SETBACK _e111110-5-111
GROUND PLUM 10s UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE .�
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS l�
SEWER R SE ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
/
GAS (ROUG METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM f
WATER SYSTEM
GRADING
LUMBER GR.
FINAL INSP. � 4 of
cu. yd.
FRAMING
INAL INSP.
$
plus
x$ -$
ROOFING ���
/oma /Jv �/1'�
REMARKS:
/lv.SO �i+�S(JL/{T/i7✓
VENTILATION
/
/La
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
G 6i
LATHING//9fG�/G/Z'�/�D�,�
�O/��T ��/J��G{!/
.(i✓?
MESH
INSULATION/SOUND
FINISH GRADING
t,CERFINAL INSPECTION7,)-
CERT.
T. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
'P.O. BOX 1504
Building 3LA QUINT
Address A CAL CALIFORNIA 92253
-.'
Owner
malting V
Addressa9
City) Zip Tel.
Contractorr \
A
�Cit( Zip (O� TeSG� " a 9-�
D on
State LIC. / City
& Ctassif. lP S o� gt' S Lic. #
Arch,, Engr.,
Designer
Address Tel.
City Zip 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
I 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, alter, improve, demolish, or repair any structure, 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).
t.' 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, 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.)
l l 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 1 am exempt under Sec. B. 8 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
[3 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 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 it work thereunder is suspended for 180 days.
1 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-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING DIVISION
t
APPLICATION ONLY
`,
BUILDING: TYPE CONST. V N OCC. GRP. e 3
A.P.,Number
Legal Description
Project Description .y .
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: DateLl
—Peary+
tl
Validated by: j i "�-
!I
Validation: 'h MAR 9.9
Sq. Ft. ``[['' r)Ig
Size 1 T
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
2-5-0 --
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: DateLl
—Peary+
tl
Validated by: j i "�-
!I
Validation: 'h MAR 9.9
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. @ $
2ND FL. SO. FT. Qq
POR. SO. FT. @
GAR. SO. FT. @
CAR P. SD. FT. !A
WALL SO. FT.
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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. B c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
S0. FT. RESID @ 11A c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
USE SEWER
REMARKS:
VENTILATION
#GASPIPING
PERMIT FEE
PERMIT FEE
RMIT 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 PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
-
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL: DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated 619-77573500
Date 4/4/95 Type of Permit I La_ Quinta
No. 13393 := Permit #
Log
Owner Name James Belknap,. ,
No. 53-695 Street Ramirez
city La Quinta -Zip 92253 Study Area 112
APN # Y Tract Lot_#=9 uareFootage � Sq g a 1400
.0 � .
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, coverect.patios/walkways, residential additions under. 500 'square feet,
detached accessory structures or replacement: bbilehome§.It has been determined
the above-named owner is exempt from, paying school fees at� this tirne due to the
following reason:
EXEMPTION NOT}APPLICABLE
This certifies that school facility, fee's: imposed p
x.
in the amount of 1.72 , x 1``400: or $ 2,408
the property listed A'bbvetand that building peri
. this square footage in;tlsproposed project mai
:fib
uant to Go
have-
�rnment`Code 53080. .
'en paid to D.8-Z.S.D. for
cates of Occupancy for
Fees Paid By _James C Belknap Telephone 341=2271
Name "on the check
By Dolores A. Ballesteros
Superintendent
Fee collected /exempted by Pauline Pearson ti
Payment Receiyed- `
Signature fl A .-. 1-\A r . g �t /1 A.�Y�: i.� 1289
{ check;'No:
Collector: Attach a copy of county or�city:plan check application form to:distrkt'copy for all waivers.
Embossed Original- Building Dept./Applicant Copy'- Applicant/Receipt Copy - Accounting
RECORDING REQUESTED BY
Recording Requas¢si By
&;td�oMPCrLr,Rr TS'*pc� IR�ti'-NL S PH R► N
AND W D AIL TH DEED ND, UNL S OCHE IN
SHOWN BELOW, MAIL TAX STATEMENT TO:
Name
F_ James C. Belknap, Jr. �
Street
:cc Address 73300 Fiddleneck Lane
_.
city & Palm:Desert, CA 92260
State II
Zip L— J
Title Order No. Escrow No. 2-17085
Grant Deed
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSFER TAX IS $ 52. 80
❑ unincorporated area City of
Parcel No. 774-121-020 & 774-121-021
® 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,
INGA A. JOHNSON, a widow
hereby GRANT(S) to
-) JAMES C. BELKNAP, JR., Trustee of THE JAMES BELKNAP SEPARATE TRUST,
dated May 5, 1992
!� the following described real property in the City of La Quinta
county of Riverside state.of California:
Lots 8 and 9, Block 232, Santa Carmelita at Vale La Quinta, Unit.22,.
as per map recorded in Book 201 page -24 of Maps, in the"Office of
.the County Recorder of Riverside County.
Dated
January 19, 1994
STATE OF CALIF
9RNIA
COUNTY OF t���1 CQ- klD� ) S.S.
On nLT- 1qadN before me,
Ken Waring
a Notary Public in and fDr said County and State, personally appeared
Inga A. Johnson
personally known to me (or proved to me on the, basis of satisfactory
evidence) to be the persori(py whose name(o is/4W subscribed to the
within instrument and acknowledged to me that tye/she/t "executed
the same in Wher/tlyeir authorized capacityW, and that by bis/her/tl &
signatureW on the instrument the persoW, or the entity upon behalf
of which the personK acted, executed the instrument.
WITNESS my hand and official se
t�Signature t
MAIL TAX STATEMENTS TO P
OFFICIAL NOTARY. SEAL
KEN WARING
•� Notary Public — California
` ♦., RIVERSIDE COUNTY
OF
Comm. Expires FEB 28,1995
SHOWN ON FOLLOWING LINE; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE
Name Street Address City & State
W co
>
Uj
_ a
,LZ,
U
LINE F, 'M
;
Grant Deed
THE UNDERSIGNED GRANTOR(s) DECLARE(s)
DOCUMENTARY TRANSFER TAX IS $ 52. 80
❑ unincorporated area City of
Parcel No. 774-121-020 & 774-121-021
® 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,
INGA A. JOHNSON, a widow
hereby GRANT(S) to
-) JAMES C. BELKNAP, JR., Trustee of THE JAMES BELKNAP SEPARATE TRUST,
dated May 5, 1992
!� the following described real property in the City of La Quinta
county of Riverside state.of California:
Lots 8 and 9, Block 232, Santa Carmelita at Vale La Quinta, Unit.22,.
as per map recorded in Book 201 page -24 of Maps, in the"Office of
.the County Recorder of Riverside County.
Dated
January 19, 1994
STATE OF CALIF
9RNIA
COUNTY OF t���1 CQ- klD� ) S.S.
On nLT- 1qadN before me,
Ken Waring
a Notary Public in and fDr said County and State, personally appeared
Inga A. Johnson
personally known to me (or proved to me on the, basis of satisfactory
evidence) to be the persori(py whose name(o is/4W subscribed to the
within instrument and acknowledged to me that tye/she/t "executed
the same in Wher/tlyeir authorized capacityW, and that by bis/her/tl &
signatureW on the instrument the persoW, or the entity upon behalf
of which the personK acted, executed the instrument.
WITNESS my hand and official se
t�Signature t
MAIL TAX STATEMENTS TO P
OFFICIAL NOTARY. SEAL
KEN WARING
•� Notary Public — California
` ♦., RIVERSIDE COUNTY
OF
Comm. Expires FEB 28,1995
SHOWN ON FOLLOWING LINE; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE
Name Street Address City & State
Grant Deed
CHICAGO TITLE COMPANY
WESTERN REGIONAL HEADQUARTERS
1717 WALNUT GROVE AVENUE
ROSEMEAD, CA 91770
. .(818) 307-7000
Grant Deed
CHICAGO TITLE COMPANY
WESTERN REGIONAL HEADQUARTERS
1717 WALNUT GROVE AVENUE
ROSEMEAD, CA 91770
(818) 307-7000
i.
Grant Deed
CHICAGO TITLE COMPANY
WESTERN REGIONAL HEADQUARTERS
1717 WALNUT GROVE AVENUE
ROSEMEAD, CA 91770
(818) 307-7000
oIf
VIII
ift�11' k
.,A
TiN of 149aI�uinttt
11114MM'dilb s�s''dfet�
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
53-695 Avenida
Ramirez
Use Classification
Single Family
Dwelling
Bldg. Permit No. 14970
Group R3
Type Construction
STN Fire Zone
Use Zone SR
Owner of Building
James Belknap
Address
P • 0. Box 297
City Palm
Desert, CA 92260,
By.
Richard Kirkland
-/
July 7, 1995
Dote:
Building official i
►0!T IN A CONQIICUOU! ►LACI