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0005-255 (RPL)CO C'! 0 oz� CID O o CID Ill w H d r� z LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of 4 ,hapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and,effec License # Lic. Class Exp. Date 658996 053 11130/3( Signature of Contractor v OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exdmpt from the Contractor's License Law for the following reason: ( ) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure isnot intended or offered for sale (Sec. 7044,. Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section , B&P.C. for this reason Date Signature of Owner 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 & policy no. are: Carrier ITATR NAND Policy No. 1344032-00 (This section need not be completed if the permit valuation is for $100.00 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 F e� so as to become subject to the w kers' mpensation laws of C and agree that if I should become ject tote orkers' compo dosions of Section 3700 of the Labor Code, I f Ch comply with t� ovisions. Date: Applicant Warning: ailure to secure Workers'ensation coverage is unlawful and shall subject an employer to criminal pes and civil fines up to $100,000, in addition to the costof compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation.. I certify that I have read this application and state that the above information is correct. I agree to comply with at 'and State laws relating to t e building co,$struction, and hereby auth a representatives of this City to ter .pon tKe above-mentioned prop ,.f�ns�{p/e�c ion purposes. j Signature (Owner/Agent) '' �' " r Date BUILDING PERMIT PERMIT# DATE VALUATION LOTS TRACT JOB SITE APN ADDRESS 48-2W CAS7J'AS _ OWNER CONTRACTOR / DESIGNER / EN (NEER Name JON 11OCKENBUR, Y FAMILY r'001.3 C;ON61 UCTION 19-251 LOOKOW LANE 53300 AVEPIDA RAM.ITM HT,TN_ TL9MN EF.ACT4 C.A. 92646 LA QU"fA C"A 9225 % (760)564�365 C'ELO 2593 USE OF PERMIT POOL AND/OR 1zPA. POOL &SPA ONLY - ALARNISA BARRIERS SMALL BE IN PI A►CL AT P11F,-PI,AVi RR INS.PWTION POOL 1!.QUIPMENT [r CL WURIr: IS NOT INCLUDED IN THIS PPRMIT. VALUATION 15,009.00 LS ES1rD&Xdrn COST or coxgmljcl:noW ]PSC FEE SUNWARY PLAN CHFCK F'F.;E 101,-000-439.318 $103.30 CONSTRUCTION FF Z 101-000-418-000 $162.04 MECHANICAL FER -- POOL 101-000-421-000 524:00 ;?L C7'IJC;AL tiEE -- FOOL 101-000-420-000 $45.00 PLUMBING F'EF.. -- POOL 101.000.419-000 S270 ; SUB-TC.ITAL, COW3TJZ(TCI`10N' AM PLAN CHECK $363,30 LFSs PRE -PAM,, ` $0.00 TOTAL Pk--1L2Mff 1W.�(�' 1)UCt NOW RECEIPT DATE BY I1 DATE DATE FINALED INSPECTOR �� '/r D I�,ISPECTIC�N REL�R© OPERATION DATE T INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wail Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS _ SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final I I Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL. APPROVALS Temp, Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) COMMENTS: -45- me i Front Yard ti Front wall --� Driveway 1 hp Purex Pump 1.5 hp Jet Pump 320 cfm Purex Filter 400,000 btu Purex Heater Existing AC Units -- Ad joing Courtyard 0- Waterfall 7' Spa, 10 Jets y Common Wall Garage Pebble Tec Interior, Flagstone Woterllne Flagstone Decking .a Hockenberry Home Bedroom 48205 Casitas Rancho La Quanta Bedroom Atrium Spa f EEAPPRED OV CHARGED F THE ED WILL BE ?LANs AND IOB CARD SCHEDULED THE SITE FOR A S?ECTIM .140 EYEPnONS! U QUANTA G►� OF&SAFETY DEPT. gU1�DiNG Ov E� 1:011 coNSTAPPR aucT1oN oor N 1/4 "= it \ Yain4 JDO�0& Construction Pools Spas Fountains (760)564-3655 Lic. #658996 N WED 12:25 FAX 760 346 9918 D R M Ia OO2 February 24, 2000 Mr. and Mrs. Jon Hockenberry 19251 Lookout Lane Huntington Beach, CA 92646-2107 Re: 4.8205 �asita Drive Dear Mr. and Mrs. Hockenberry, The Rancho La Quinta_Architectural Committee has reviewed your submittal. of plans for the installation of a spa at -your Casita home. The plans were approved with the installation of the spa equipment in the existing service yard that contains the two air conditioning condensers. Thank you for your submittal and patience m our review of your plans. Sincerely, Mindy Gutierrez, Property Manager The Rancho La Quinta Master Association cc: Family Pools