12380 (SFD)Building
Address 53-920 Diaz
Owner Jaitel6 Belknap
C&tyl 4 4 a "0
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Address '
Contractor
Belknap Cons`ructfon
Acdr: S. Box 297
cValM Desert, .,1ps, 92260 Tel. 564-2783
State Lic. City
& classif.B 652815 Lic. # 2fl45
Arch., Engr., Bob Harman
Designer
Ad�dWyl Sunni Dunes Tel. 320-1211
cityaIm Spr' i.ngs, StateZ& 92.264 ic.
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
4ffect.
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).
O 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.)
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
t 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
dCopy 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, alter 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.
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-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 12380
BUILDING: TYPE CONST. OCC: GRP
A.P. Number
Legal Description
Project Description
774-152-009
Lot 16 Block
200
i
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line t
Sq. Ft. 1408
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Permit does not include
block walls
or pool.
u
z
OCT\\"" J�
I
Validation:
9
I I U\\ V
Estimated Valuation
$84,694.00
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
233. i
Const.
572.00
Mech.
55.50
Electrical
120.78
Plumbing
144.00
S.M.I.
9.50
Grading
20.00
Driveway Enc.
.00
I ay
1,924.2
TOTAL
3 �7' . 09
-3,009.09
REMARKS
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line t
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date rmit
Validated by:
OCT\\"" J�
I
Validation:
I I U\\ V
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING TEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
c{
SLAB GRADE J
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
A
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. I SO. FT. ®
GAS (FINAL)
WALL SQ. FT.
DRINKING FOUNTAIN
SO. FT. ®
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
GRADING
CU. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP. /— OS.
( C !
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
12
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
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 COND. SOLAR
SETBACK
GROUND PLUMBING _
3
LV UNDERGROUND
A.C. UNIT
COLL. AREA
c{
SLAB GRADE J
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
A
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. l/
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE — 3 49
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
CU. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. 1 �6c� G
FRAMING l2-1.0
FINAL INSP. /— OS.
( C !
ROOFING
12
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND 2Y! ?3
�`l7
FINISH GRADING
FINAL INSPECTION/
v
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
.gym �c-�za
P.O. BOX 1504 APPLICATION ONLY
Building 7&105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner .�
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address A.P. Number
Tel. ,J� �/l
� / Legal Description
ContraFlor " A D 1Project Description
Add
5K
1t AM M�aaJ IZlpQoia (.1 1'7 i,NA6�La 7831
State Lic. r / City
& Classif.
Arch., Engr.,
Designer
Address n n Tel.
State
Lic. #
Ll • ENSED CONTRACTOR'S DECLARATION
irm
1 hereby affthat I a"r 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 1 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) or
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).
E-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, 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 or sale.)
I 1 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.)
l 1 am exempt under Sec. B. & P.C. for this reason
Date -S esu . 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
n Copy is tiled 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 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.
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-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING DIVISION
Sq. Ft.
Size
No.
Stories
No. Dw.
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
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
FINAL DA1
Issued by:_
Validated t
Validation:
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
CONSTRUCTION ESTIMATE
NO, ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE
"2ND FL. SO. FT, @
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT. @
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT. @
OTHER APPJEQUIP.
DRINKING FOUNTAIN
SO. FT. @
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION g
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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 8.T.U.
SO. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1%a c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR @ 3/,c
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
MESH
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 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 APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
g plus xsx
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
`CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESJINITIALS
GARDEN WALL FINAL
10/19/93 06:36' 0909175 5104
RfiCORDING REQUESTED BY
AND WHEN RECORDED MAN. THIS DEED AND UNLESS UNFAWISE SHOWN BELOW
1WL TAX STATEMENT V.
James C. Belknap, Jr.
Straet
A40`0ss73-300 Fiddleneck Lane
eq a
State Desert
CA 92260
MAIL TAX STATEA"TO
Same
SUM
Ald=$
City b
S.18
mLEBRDERNO-1994854 EscsDWND.2-16404
1 ST AMEX '1'1'L 1 N S
0
QCT
with
SPACE ABOVE THIS LINE FOR RECORDER'S USE
GRANT DEED
573�- `rte 9--)yt L--
T7THE UNDERSIGNED GRANTORS) DECLARE(S)
WJ UU2/UUL
DOCUMENTARY TRANSFER TAX IS $ 24.20
0 computed on full 'value of property conveyed, or
❑ computed on full value less value of liens or encumbrances remaining at time of sale.
❑ unincorporated area
City Of La Quinta , AND
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
RICHARD POOLE and CAROLYN M. POOLE; husband and wife as joint tenants
hereby .GRANT(s) to
JAMES C. BELKNAP, JR_, Trustee of THE JAMES BELKNAP SEPARATE TRUST DATED
MAY, 1992_
the following described real property in the City of La Quinta
County of Riverside , State of California:
Lot 16, Block 200 of Unit No. 19, Santa Carmelita at Vale La Quinta, as
per map recorded in Book 19, Pages 33 and 34 of Maps, in the office of
the County Recorder of said County.
EXCEPT therefrom one -sixteenth of all coal, oil, gas and other mineral
deposits contained in said land, as reserved in Patent from the State of
California, recorded July 26, 1934 in Book 182 Page 463 of official
Records of Riverside County, California.
Dated oct. 1, 1993
STATE OF GALWeRMAOr4P&_6"V'f .
•
COUNTY OF --- ---
iOn ,, � T' '� Zm before me,
Ar e J V IV -4.1 ri'ti, WoMe ie , personally appeared
Richard Poole
Carollyn M. Poole
I personally known to me (or proved to me on the basis of satisfactory
evidence) to be the persons) whose name(s) is/are subscribed to the
i within instrument and acknowledged to me that he/shelthey executed the
same in his/her/their authorized capacity(ies), and that by his/her/their
signature($) on the instrument the person(s), or the entity upon behaR of
yr•
wnich the perSon(s` acted, executed the instrument. 0FF1';!A �L SEAL
wiTNESS my h and official se�.1.
e L 7
Signature �rF!,
NOT V PUBLIC IN AND FOR SAID AKATE
I I
GO -441 (REV 11/926) MAIL TAX STATEMENTS AS DIRECTED ABOVE.
or 0; A.
CALVIN C. KAMINSKAS
Asslslant Commissloner a
(7`141275-3000 '
OFFICE OF
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissloner
83-612 Avenue 45 Suite 7
Indio, CA 92201
(619) 342-8291
DATE
DEVELOPER'S NAMES
ADDRESS s
DAN RILEY
Sealer, Welghls & Measures
(714) 275.3030
CASE M. �- - O
A
TELEPHONE: ((o1Q) 4GC -CX%F
aa_ I�L3
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be notified
immediately.
Thank you for protecting and preserving the Coachella Valley's pest -free environment.
%!TricuYural Commissioner's Office
ccs Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 275-3012
r,
Ill
ug
nf 14a Wuinta
�uildin� rzn� �S�zfet�r �i�i�tvn
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 53-920 Avenida Diaz
Use Classification Single Family Dwelling Bldg. Permit No. 12380
Group R3 Type Construction VN Fre Zone Use Zone SR
Owner of Building James Belknap Address 73-300 Feddleneck Lane
City Palm Desert, CA 92260 Lonnie Day
By I .
Dote: January 28, 1994.
Building Official
POST IN A CON8PI000u! PLACE
I�
of RAY
CALVIN C. KAMINSKAS
Assistant Commissioner o `•�
(714) 275.3000
MY_iso
OFFICE OF
AGRICULTURAL COMMISSIONER
JAMES O. WALLACE, Commissioner
83-612 Avenue 45 Suite 7
Indio, CA 92201
(619) 342-8291
DAN RILEY
Sealer, Weights & Measures
(714) 275-3030
DATE 1M CASE NO. P� L G - OS 3 C
DEVELOPER'S NAME: 0-K (:I:, b"; CC ^� A O�c�
ADDRESS: �, 0 �bX' -22
1,A Qom- -►,> Gl Zzs
TELEPHONE: ( ) (.o 14 - b .
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ from plant material listed, this office must be notified
immediately.
Thank you for.protecting and preserving the Coachella Valley's pest -free environment.
1
Agri V
tural Commissioner's Office
cc: Indio and Riverside
4080 LEMON STREET, ROOM 19, RIVERSIDE, CALIFORNIA 92501 — FAX (714) 275-3012
0