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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