BSOL2014-0003If
78-495 CALLE TAMPICO Do f � W"A4 i VOICE (760) 777-7125
r✓
J LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT FAX (760) 777-7011
FAX
(760) 777-7153
BUILDING PERMIT
Date: 8/14/2014
Applicatiorning; BSOL2014-0003 Owner:
Property A51863 AVENIDA OBREGON NELSON, JONATHON M
APN:773163017 51863 AVENIDA OBREGON
Applicatio: 6.12kW PV SYSTEM - (24) PANELS/(1) INVERTER LA QUINTA, CA 92253
Property Z
Valuation: $13,500.00
Applicant:
SOLARCI CORPORATION
3055 CLEARVIEW WAY
ATTN ZOE STEELE
SAN MATEO, CA 94402
ti
AUG 14 2014
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
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 Professions Code, and
my License is in full force and effect.
License Cla s: C46 B C10 C20 +A Liceice�No.: 888 4888 4
Date: Contractor:
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 allege
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).: .
(_) 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. 7A44, 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 of proving that he
or she did not build or improve for the purpose of sale.).
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 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 Addre!
Contractor:
SOLARCITY CORPORATION
3055 CLEARVIEW WAY
ATTN ZOE STEELE
SAN MATEO, CA 94402
(650)963-5100
Llc. No.: 888104
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 o1
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: _ Policy Number:
_ 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 forthwith
comply wit tho /Jprovisions.
Bate: 7 Applicant:
WZ
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 Building Official 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 andst laws relating to buil ing
construction, and hereby authorize representatives of this i to enter on the ove-
mentioned rope ty�foor inspection purposes.
Date: ! / Signature (Applicant or Agent):
Tip,
ON
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Tota1:Paid foPERMIT ISSUANCE $90 57 $0.00
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B"" City. of La Quinta
Bin
�
City of La Quinta •. •
BulkUng 8z Safety Division
P.O. Box 1504,78-495 Calle Tampico
La.Quhta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet .
Pemlit #
Bim-' ` ' ao3
Project Address: �3 O
Owner's Name:
A. P. Number.
Address:�g�v,%
Legal Description:
City, ST, Zip: (�
Contractor. (� V /
Telephone:
Address: �� `/ u I N
Project Description:
City, ST, Zip: a Q CA a
J�
Telephone:1N49-4&• 0
w
1 'aaaa�' .G' SGioaodk' �s • ••�
State Lia #: 891.611City Lic, ii;
Arch., Eng., Designer.
.1 Aiw ryt%ATj11*
Address:
it
City, ST, Zip.
Telephone: Construction Type:. Oxancy
State Lia #: Project type (circle one): New Add'a Alter Repair Demo
Name of Contact Person: NA r/1 Sq. FL: # ries: # Univ:
Telephone # of Contact Person (� 2j�l� Estimated Value of Proi
APPLICANT: DO NOT WRITE BELOW THIS UNE
H
Submittal
Req'd
Reed
TRACKENG
]PERMIT FEES -
Plan Sets
Plan Check submiued
Item Amount
Strgdural Cales
Reviewed, ready for corrections
Plan Check Deposit. .
Turas Calcs.
Called Contact Person
Plan Check 11"nee
Title 24 Calea.
Plans picked ap
Construction
Flood plain plan
Plans resubmitted..
Mechanical
Grading plan
r Review, ready for corrections/issue
Electrical
Subeontaetor Lint
Called Contact Person
Plumbing
Grant Deed
Plans pidted up
S LL
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
Review; ready for eorreetio"doper
Imgact Fee
Planning Approval
Called Contact Person IV VU,
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
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