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