09-0307 (SOL)„t
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
L. Application'Number:09 0000'03Of7
Property=Adi ress:
5T8.84 AVENIDA OBREGON
APN:
773 -164 -025 -8 -000000 -
Application description:
SOLAR
Property Zoning:
COVE RESIDENTIAL
Application valuation:
58938
Aepp�lic=ant:/
T iht nF 4v 4”,
Architect or Engineer:
BUI.LDING & SAFETY DEPARTMENT
BUILDING PERMIT .
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed underprovisionsof Chapter 9 (commencing with
. Section 7000) of Division 3 of the Business and Professionals Code, and my License is iri full force and'effect.
License Class:' C10 Li nse No.: 572842
Date: -((-C1/Contractor .•. i
w' -OWNER -BUILDER DECLARATION .'.
I hereby affirm under penalty of.perjury,that•I am exempt from the Contractor.'s State License Law'.forthe
following reason ISec..7031-.5,: Business and Professions` Code: ;Any city or county requires a permit to
construct, alter, improve, demolish, or repair anystructure, 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,provisionsof 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 sheds 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).:
( 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,:Business and Professions Code: The
Contractors' State License Law does not apply. to an owner of property who builds or improves thereon,
and whotloesthe work himself or herself through his or her own employees, provided that.the ,
improvements are not intended or offered forsale. If, however, the building' or improvement is sold,within
• one yearof completion, the owner -builder will have the burden of proving'that he or she did not build -.or.
improve'for. the purpose of sale.).
(_ 1 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.owiter of
. property who builds,or improves thereon, and who contracts -for the projects with a contractor(s)aicensed
pursuant to the Contractors' State License Law.).
1 _ 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
workfor which this permit is issued (Sec. 3097, Civ. C.). '
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
STEVEN SAFT/CAROLYN KRAUSE
51884 AVENIDA OBREGON
LA QUINTA, CA 92253
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 4/09/09
Contractor:
KDB CUSTOM LIGHTING & ELECTRIC C
5659.7.DUARTE. STREET. - ��►f��
YUCCA VALLEY, CA 92284 GlT•����a
-tR }
t ".r_
(760) 369-7'447
Li.c. No.: 572842
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 EXEMPT Policy Number EXEMPT
I certify that, in the performance of the work' for which this permit. is issued; )'shall. not employ any
person in anymanner so as tobecome subject-to'the workers''compensation laws of California, -
and agree that;:if.I should become subjict to.th_e workers'- compensation pr6.visions of Section
[[jj— � _',,p37�000 f he Labor Code,
/I hall forthwvitthhhcco ply with those provisions.
ate:'T• (0"1 V 1pplicant:.. (1�C..�..'/V• ��.
WARNING: FAILURE TO_SECUREWORKERS' COMPENSATION COVERAGEiS UNLAWFUL', AND:SHALL
. SUBJECT AN EMPLOYER.--TO'CRINI (NAL PENALTIES AND CIVIL FINES UP TO ONE'HUNDRED THOUSAND
DOLLARS ($100,000).' IWADDITION T.O'THE.COST OF COMPENSATION, DAMAGESAS.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'o.n 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 underor following' issuance of this permit.
2.. Any permit issued as'b 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. 1 agree to comply with all
city and county ordinances and state laws relating to building c struction; and hereby authorize representatives
o/f�this county to enter up n the above-mentioned property fQ nspectionr/per/4ys�ess..
I/ L7ateignature (Applicant or Agentl:
�v
Application Number . . . . . 09-00000307
Permit SOLAR PERMIT
Additional desc SOLAR SYS W/650 SF ARRAY AREA
Permit Fee . . . . 19.50 Plan Check Fee
4.88
Issue Date . . . . Valuation . . .
0
Expiration Date 10/06/09
Qty Unit Charge. Per
Extension
BASE FEE
15.00
1.00 4.5000 EA SOLAR COLLECTOR < 1000
----------------------------------------------------------------------------
4.50 :
PermitELEC-MISCELLANEOUS
-1
Additiona.desc INVERTOR & 2 DISCN-TS
Permit Fee 17.25 Plan.Check Fee
4.3'1
Issue `Dat`e' Valuation
0 "
Expiration-.Date .: ,' 10/06/09.
Qty Unit- Charge Per
Extension.
BASE ,FEE'
15.00
3.00 .7500 PER ELEC-DEVICE/ FIXTURE IST 20
2.25
00 18.50.00, EA ELEC.SVC <=660V/<=200A1.
1_: --------------------
.00.
--------------------------- ---------------- --------------
Special Notes"and-'Comments
SOR`:EL�ECTRIC PANEL: INSTAL_ LATION _(650
LA
SF'"ARRP,Y-'AREA) 2-007"CODES.
-----.-----------------------------------.---------------------.----------------
Other =Fees BLDG,. STDS ADMIN. (SB14,73) '
1.00
Fee summary Charged Paid' Credited
Due. -
Permi.tFee Total 36.7.5` 00', .00.
36.7.5
P1an.Check_ Total 9: 19. .00 .00
9.19 .
Other".Fee Total 1.'00:, .00 00
1:00
Grand• Total 46..94: ..00 .00
46.94
LQPERA11T .. .