05-3280 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 05-00003280
Property Address: 51040 AVENIDA VELASCO
APN: 773-065-026- -
Application description: DWELLING - SINGLE FAM
Property Zoning: COVE RESIDENTIAL
Application valuation: 117651
Applicant:
Td4t aFlWw
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Architect or
Lic. No.: OOR SQUARE FOOT
-------------------A0--------------------'---------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: B C36 C42 License No.: 205031
Date:4&--A6 Contractor: �
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that.) am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she 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 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, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himselfor herself through his or her own employees, provided that the
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 or she did not build or
improve for the purpose of sale.).
1 _ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuanttothe Contractors' State License Law.l
( 1 I am exempt under Sec. , B.&P.C. for this reason
Date
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERAIIT
Owner:
GRISWOLD HENRY C
30110 CROWN VALLEY PKY 203
LAGUNA NIGUEL, CA 92677
Contractor:
BELKNAP, DOUGLAS W
P.O. BOX 297
PALM DESERT, CA 92261
(760)902-7444
Lic. No.: 205031
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 10/26/05
-----------------------------------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
0, for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND Policy Number 1576785
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,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Code, I shall forth h comply with those provisions.
Date: I'V"wb Applicant:
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.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
I whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
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 county to enter upon the above-mentioned property for inspe n purposes.
Date: to- IC Signature (Applicant or Agent): �
Application Number . . . . . 05-00003280
Permit .
. . . . .
BUILDING PERMIT
Additional
desc
Permit Fee
. . . .
702.50
Plan Check Fee
456.63
Issue Date
. . .
Valuation . . . .
117651
Expiration
Date
4/24/06
Qty
Unit Charge
Per
Extension
BASE
FEE
639.50
18.00
-------------------
3.5000
----------------------------
THOU BLDG
100,001-50.0,000
7 ---------------------------
63.00
Permit ...
. . . .
MECHANICAL
Additional
desc
Permit Fee
52.50
Plan Check Fee
13.1 ' 3
Issue Date
. . . .
Valuation.
0
Expiration
Date
4/24/06
Qty
Unit Charge
Per
Extension
BASE
FEE
15.00
1.00
9.0000
EA MECH
FURNACE <-100K
9.00
1.00
9*.0000
EA MECH
B/C*<=3HP/100K BTU
9.00
2.00
6.5000
EA MECH
VENT FAN
13.00
1.00
------------------------
6.5000
---------------------------------------------------
EA MECH
EXHAUST HOOD
6.50
Permit .
. . .. . .
ELEC-NEW RESIDENTIAL
Additional
desc
Permit Fee
.
104.79
Plan Check Fee
26.20
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
4/24/06
Qty ..Unit
Charge
Per.
Extension
BASE
FEE
15.00
1875-00,
.0350
ELEC
NEW RES 1 OR 2 FAMILY
65.63
458.00
.0200
ELEC
GARAGE OR NON-RESIDENTIAL
9.16
1.00
----------------------------------------------------------------------------
15.0000
EA ELEC
TEMPORARY POWER POLE
15.00
Permit .
. . .
PLUMBING
Additional
desc
Permit.Fee
. . . .
129.00
Plan Check Fee
32.25
Issue Date
. . . .
Valuation . . . .
0
Expiration
Date
4/24/06
Qty
Unit Charge
Per
Extension,.
BASE
FEE
15.00
10.00
6.0000
EA PLB FIXTURE
60.00
LQPERAIIT
LQPERAIIT `
Application Number 05-00003280 .
Permit . . . . PLUMBING
Qty Unit Charge Per
Extension
1.00 15.0000 EA PLB BUILDING SEWER
15.00
1.00 7.5000 EA PLB WATER HEATER/VENT
7.50
1.00 3.0000 EA PLB WATER INST/ALT/REP
3.00
1.00 9.0000 EA PLB LAWN SPRINKLER SYSTEM
9.00
6.00 •.7500 EA PLB GAS PIPE•>=5
4.50
1.00 15.0000 EA PLB GAS METER
15.00
Permit GRADING -PERMIT ;
Additional desc .
Permit Fee 15.00 Plan Check Fee
.00
' Issue Date . . . . Valuation
0
Expiration Date 4/24/06
Qty Unit Charge Per
Extension
BASE FEE
15.00
-----------------------------------------------------------------'-----------
Special Notes and Comments'
1875 S.F. SFD PERMIT DOES NOT INCLUDE
BLOCK WALL, POOL/SPA OR DRIVEWAY
APPROACH
---------------------------
Other.Fees . . . . . . •DIF COMMUNITY CENTERS -RES
97.00
DIF CIVIC CENTER - RES
366.00
ENERGY REVIEW FEE
45.66
DIF FIRE PROTECTION -RES
97.00
DIF LIBRARIES - RES
225.00
DIF PARK MAINT FAC - RES
5.00
DIF PARKS/REC - RES
502.00
STRONG MOTION (SMI) - RES
11".76
DIF STREET MAINT FAC -RES
15.00
DIF TRANSPORTATION - RES
1098.00
Fee summary Charged Paid Credited
Due
Permit Fee Total 1003.79 .00 .00
1003.79
_
- Plan"Check Total 528.21 250.00 .00
278.21
Other Fee Total 2462.42 .00 .00
2462.42 "
_ Grand Total 3994.42 250.00 .00
3744.42
LQPERAIIT `
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NNATER
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ESTABLISHED'IN 1918 ASA PUBLIC AGENCY
COACHELLA VALLEY WATER DISTRICT.
POST OFFICE BOX 1058 • COACHELLA, CALIFORNIA 92236 • TELEPHONE (760) 398-2651 • FAX (760) 398-3711
DIRECTORS:
PETER NELSON, PRESIDENT
PATRICIA A. LARSON, VICE PRESIDENT
TELLIS CODEKAS
JOHN W.McFADDEN
RUSSELL KITAHARA September 9, 2005
Douglas and Cecilia Belknap
42-355 Washington Street
Palm -Desert, CA 92211
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Dear Mr. and Mrs. Belknap:
Subject: Assessor Parcel Number 773-065-026
OFFICERS:
STEVEN B. ROBBINS,
GENERAL MANAGER -CHIEF ENGINEER
MARK BEUHLER,
ASST. GENERAL MANAGER
JULIA FERNANDEZ, SECRETARY
DAN PARKS, ASST. TO GENERAL MANAGER
REDWINE AND SHERRILL, ATTORNEYS
File: 0424.9085
In 1994, the City of La Quinta vacated the south half of Calle Tampico, and conveyed it to the adjacent
property owners. In the vacation'resolution, an easement was .reserved for existing public utilities. The
Coachella Valley Water District (District) has an 8 -inch domestic water line that provides potable
drinking water within the vacated area: This domestic water line is 15 feet south of your new north
property line. The water line has a 3 -foot minimum cover. We have enclosed a map showing'our
domestic water line in relationship to your property.
As an easement holder, we have the right to operate and maintain the pipeline without unreasonable
interference.. Pools, trees, block walls and any permanent structures would prevent the District from
performing its duties and perhaps endanger our pipeline.
We are advising that you may be liable if any damage occurs to the domestic water line due to any current .
or future improvements: In the event that we need to repair the line, any restoration to your
improvements will be at your expense.
We are certainly willing to work with you in the event you decide to make any changes or construct .
improvements within the easement area.. s
If you have any questions, please call Ruth Dearden, Right -of -Way Specialist, extension 2280,•or David,
Keeley, Senior.Right=of-Way Specialist, extension 2279.
Enclosure\l \as
bc: Jerry Eagan (with enclosure)
Redwine and Sherrill ,
1950 Market Street '
Riverside, CA 92501
Tim -Jonsson (with enclosure)
City La Quinta
Post Office Box 1504
La Quinta, CA 92253
Yours very truly,
Mark L. Johnson
Director of Engineering
Dan Farris, CVWD (with enclosureTRUE CONSERVATION
Carrie Oliphant, CVWD (with encloWATER WISELY
DK:ch\engVw05\sept\pwperty ownerscalle tampico
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Certificate of Occupancy
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0FT9�� Building & Safet Department
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'. This Certificate is issued pursuant to the requirements of Section 109 of the California Building
Code, certifying that, at the time of issuance, this structure was in compliance with the
provisions of the Building Code and the various ordinances of the City regulating building
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construction and/or use.
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BUILDING ADDRESS: 51-040 AVENIDA VELASCO
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Use classification: SINGLE FAMILY DWELLING Building Permit No.:. 05-3280
Occupancy Group: R-3 Type of Construction:. VN Land Use Zone: RC
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Owner of Building: DOUG BELKNAP Address: P.O. BOX 297
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City, ST, ZIP: PALM DESERT, CA 92261
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By: KIRK KIRKLAND
Date: MARCH 13, 2006
Building Official
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POST IN A CONSPICUOUS PLACE