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11-0414 (SOL)IIIIIII VIII III VIII (III 15 IE P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00000414 Property Address: 54240 AFFIRMED CT APN: 767-320-999-301 -32879 - Application description: SOLAR Property Zoning: LOW DENSITY RESIDENTIAL Application valuation: 10000 T&�1440" BUILDING & SAFETY DEPARTMENT BUILDING PERMIT Owner: DARGATZ RODNEY 54240 AFFIRMED LA QUINTA, CA VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 6/14/11 L 92253 Contractor: V a Applicant: Architect or Engineer: SALVESON, KENT E. 28391 AVENIDA LA MANC %j�{� SAN JUAN CAPISTRANO, 679"1/Ig 1 (949)291-7393 � 2011 �Ir Lic. No.: 777413 LICENSED CONTRACTO DECLARATION WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under visions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following declarations: Section 7000) of Division 3 of the Business and Professio , and my License is in full force and effect. _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided Lice n CI ss: C20 CA�ontractor: 2 e : 777413 for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ate _ 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 WNER-BUILDER DECLARATION insurance carrier and policy number are: I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier EEEEMPT Policy Number EXEMPT following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to I certify that, in the performance of the work fo hich this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the person in any manner so as to become su t to the is compensation laws of California, permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State and agree that, if I should become s o the workers' compensation provisions of Section License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or 3,700 of the Labor Code, I s om ly with those provisions. 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 ($500).: te: 7 I plicant: (_ 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 WARNING: FAILURE TO SECURE WOR ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL Contractors' State License Law does not apply to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND and who does the work himself or herself through his or her own employees, provided that the DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.). APPLICANT ACKNOWLEDGEMENT (_ 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this application. property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed 1. Each person upon whose behalf this application is made, each person at.whose request and for pursuant to the Contractors' State License Law.)• whose benefit work is performed under or pursuant to any permit issued as a result of this application, (_) I am exempt under Sec. , B.&P.C. for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City 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 Address: kr LQPERMIT of La Ouinta, 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 wor not commenced within 180 days from date of issuance of such permit, or cessation of w for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is r t. I agree to comply with all city and county ordinances and state laws relating to building construction eby authorize representatives of this you y to a er upon the above-mentioned property for inspec ses. I_rd/te/ y Si ture (Applicant or Agent): Application Number . . . . . 11-00000414 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . . 30.00 Plan Check Fee 7.50 Issue Date . . . . Valuation . . . . 0 Expiration Date 12/11/11 Qty Unit Charge Per Extension BASE FEE 15.00 2.00 7.5000 ---------------------------------------------------------------------------- EA ELEC PWR APP >1 TO <=10 15.00 Permit SOLAR PERMIT Additional desc . Permit Fee . . . . 25.50 Plan Check Fee 6.38 Issue Date Valuation . . . . 1.0000 Expiration Date 12/11/11 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 4.5000 EA SOLAR COLLECTOR < 1000 4.50 2.00 3.0000 EA SOLAR EQUIP MISCELLANEOUS 6.00 ---------------------------------------------------------------------------- Special Notes and Comments - 12.8kW SOLAR ARRAY - (56) 230 WATT PANELS W/ (2) 7000W SUNNY BOY INVERTERS [985SF] 2010 CALIFORNIA ELECTRICAL CODE. June 13, 2011 4:41:45 PM AORTEGA ---------------------------------------------------------------------------- Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited ----------------- Due ---------- Permit Fee Total ------------------------------ 55.50 .00 .00 55.50 Plan Check Total 13.88 .00 .00 13.88 Other Fee Total 1.00 .00 .00 1.00 Grand Total 70.38 .00 .00 70.38 LQPERMIT Bin # Qty of La Quints Building & Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quints, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: q1; q Owner's Name: A. P. Number: ff Address: il 2 U � Legal Description: Contractor:/ Address: Z g 3 �'� �� � ��cr �%% City, ST, Zip:2 j Al t z. .;.;•.:;..::afi::;>::z;;::• :, >: Telephone: / / � Project Description: City, ST, Zip: Telephone: r / %f 1417 I,/ State Lic. # : 77 7 'Y/3 City Lic.SVMW Arch., Engr., Designer: 100 0-C `, SAW Z*4o W 6W Address: City., ST, Zip: Telephone: State Lic. # ;ass;;:;:. :w•:s :":3;/ ° ..iJ.i: .c��'%•j: Y$sErJ° .4j:G:ti:�sr;: ?'? rv' <�. f Construction Type: Occupan Project type(circle one): New Ad Xter Repair Demo Name of Contact Person: Sq. Ft.: # tones: '# Units: Telephone # of Contact Person: 3 '13 Estimated Value of P oject: APPLICANT: DO NOT WRITE BELOW THIS L # Submittal Req'd Recd TRACKING PERMIT FEES Plan Sets Plan Check submitted em Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit o+ Truss Calcs. Called Contact Person5 S 4011 Plan Check Balance . Title 24 Cales. Plans picked up Construction Flood plain plan Plans resubmitted 11 i) Mechanical Grading plan 2" Review, ready fo o ecti s/issue 5 JKJ Electrical ��� ilia. Subcontactor List Called Contact Person 5,� Plumbing �►+ Grant Deed Plans picked up S.M.I. "— H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '^' Review, ready for correctio ssue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees r Total Permit Fees 5 51%9- 5"A QCz 11,V+T e -vv ) 5 1q`owl- `4* " * C~11 1.1 `sevl - Q„ M -f -co 1%Vs w l w�rrn �Wp