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11-0329 (SOTB)P.O. BOX 1504 ^� 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Application Number: Property Address: APN: Application description: Property Zoning: Application valuation: 711-00000329 56048 PALMS DR 7647030 -005 - STRUCTURES OTHER THAN BUILDI LOW DENSITY RESIDENTIAL 8000 Architect or N /& -------------------------------------------------- LICENSED CONTRACTOR'S DECLAR4TION 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: C53 license No.: 916827 ate ntractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I 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 1$5001.: (_ 1 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, 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 himself or 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 ofprovingthat he or she did not build or improve for the purpose of sale.). - (_) 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 pursuant to the Contractors' State License Law.). I—) 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: Q Lender's Address: ! 1 LQPERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 4/01/11 Owner: BERNARD KROOKS 56048 PALMS DRIVE LA QUINTA, CA 92253 Contractor: COMPETITIVE WEST POOL CONSTR PO BOX 5865 LA QUINTA, CA 92248 (760)625-2512 Lic. No.: 916827 ------------------ 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. 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 PRAETORIAN INS Policy Number 302628300 _. 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, all forthwith comply with those provisions. /e:plicant: WARIUNI FAILURE TO SECURE WOR S' 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 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 co ty enter upon the above-mentioned property for' spection purposes. 'date: gnature (Applicant or Agent): Application Number 11-00000329 Permit BUILDING PERMIT Additional desc .. Permit Fee . . . . 99.00 Plan Check Fee 64.35 Issue Date . . Valuation . . . . 8000 Expiration Date .9/28/11 Qty Unit Charge" Per Extension ' BASE FEE 45.00 6.00 9.0000 THOU BLDG 2,001-25,000 54.00 Permit ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . 15.75 Plan Check Fee 3.94 Issue Date . . . . Valuation . . . . 0 Expiration Date 9/28/11 Qty Unit Charge Per. Extension BASE FEE 15.00 1.00 .7500 PER ELEC DEVICE/FIXTURE 1ST 20 .75 Permit PLUMBING Additional desc . Permit Fee 18.00 Plan Check Fee 4.50 Issue Date Valuation 0 Expiration Date 9/28/11 Qty Unit Charge Per Extension : BASE FEE 15.00- 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 ---------------------------------------- ---------------------------- �. Special Notes and Comments BBQ STRUCTURE & FIRE PIT. INCLUDES FLEX LIGHT & GASLINE. 2010 CODES. -------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1413) 1 00 ENERGY REVIEW FEE 6.44 STRONG MOTION (SMI) - RES .80 Fee summary Charged Paid, Credited Due Permit Fee Total 132.75 .00 :00 132..75 P1an:Check Total. 72.79 .00 .00 7.2.79 Other Fee Total 8.24 00, .00 8.24. Grand Total 213.78 .00 .00 213.78 LQPERMIT . March 25, 2011 Bernard and Robin Krooks 36 Random Farms Drive Chappaqua, NY 10514 Re: 56-048 Palms Drive [.Application Approved--Backyard-Barbeque-and-Fire-Pit Dear Homeowner, The Architectural Committee, at their most recent meeting is in agreement with the application you submitted for the installation of the backyard barbeque and fire pit. The Committee appreciates your cooperation in complying with our Rules and Regulations, which are in place for all members. Notwithstanding this agreement, you must comply with all requirements of the CC&R's and all Architectural Rules and Guidelines, unless specifically waived in writing by the Architectural Control Committee. The Village at the Palms Homeowners Association and Architectural Control Committee acknowledge that any and all agreed changes to the original design that may bea condition of this approval will be at the homeowner's expense. The correction of any damage cEused by this agreed construction will also be at the homeowner's expense. It is the homeowner's responsibility to obtain any permits, which may be required. Additionally, the Board of Directors encourages that you use a licensed and ins-ired contractor. This approval does not release the homeowner from meeting any county, state or federal requirements such as building permits, workmen's compensation, or other waivers or permits. Again, we appreciate your, cooperation. These procedures allow us to maintain. our properties in a manner to the benefit of you as the homeowner and of the community as a whole. Sincerely, ACC Control Committee Monarch Management Group, LLC 39755 Berkey Drive, Suite A Palm Desert, CA 92211 . 760-776-5100 F 760-776-5111 t City Of La Quints Building U Safety Division Permit # (; P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA. 92253 - (760) 777-7012 Building Permit APPlication and Tracking Sheet Project Address: D n �.J 1 � Owner's Name: Name of Contact Person: C-I-Ep_(S C(t-09n.4 Telephone # of Contact Person: .7 A s-- 1-7 # Submittal Plan Sets Structural Calcs. Tryss Calcs. Title 24 Calcs. Flood plain plan Grading plan Subcontactor List Grant Deed H.O.A. Approval IN HOUSE:- Planning Approval Pub. Wks. Appr School Fees as . APPLICANT: DO NOT' Req'd Recd TP Plan Check submitted Reviewed, ready for co Called Contact Person Plans picked up Plans resubmitted god Review, ready for a Called Contact Person Plans picked up Plans resubmitted. Review, ready for co Called Contact Person Date of permit issue 0 Address:..51 City, ST, Zip: Telephone: .............:. Project Description: �h/e Construction Type: Occupancy: '. Project type (circle one):New Addlu • Alter Repair Demo Sq. Ft.: # Stories: #Units: Estimated Value of Project: 8 B00 NRITE BELOW THIS LINE ACKING PERMIT FEES Item Amount -rections Plan Check Deposit Plan CheckBalance Constructian Mechanical rrections/issue Electrical' Plumbing S.M.1. Grading •rections/issue Developer Frnpact Fee A.I.P.P. Total Permit Fees 0