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BSOL2015-0092LICENSED 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 Clas % C46 10 A License .: 88 4 Dat Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the CY'acir'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 ($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. 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 of proving that 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 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 Lender's Address: 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' compens , as provided for. by Section 3700 of the Labor Code, for the performance which this permit is issued. T h ve and will maintain workers' compensation insurance, as required by Se 0 of the. Labor Code, for the performance of the work for which this permit is issued. 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 hould become subject to the workers' compensation provisions of Se cti of a La Code, I shall forthwith comoly with those orovisions. �� f /1 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C RAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN15 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 Pwstrela^to uilding construction, and hereby authorize representative f thiner pon°,t abovementiongd propeTty for inspection purposes. A (Applicant or Quieftr VOICE (760) 777-7125 78-495 CALLE TAMPICO U FAX (760) 777-7011 LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: 7/20/2015 Application Number: BSOL2015-0092 Owner: Property Address: 52800 AVENIDA CARRANZA RIGOBERTO SANTOS APN: 773322003 52800 AVENIDA CARRANZA CDU(= Application Description: 7.42kW PV SYSTEM - (28) 265W PANELS/(1) INVERTER LA QUINTA, CA 92253 Property Zoning:Application Valuation: $16,398.20 Applicant: Contractor: SOLARCITY CORPORATION SOLARCITY CORPORATION3055 CLEARVIEW WAY 3055 CLEARVIEW WAY ATTN ZOE STEELE ATTN ZOE STEELE SAN MATEO, CA 94402 SAN MATEO, CA 94402 (650)963-5630 Llc. No.: 888104 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 Clas % C46 10 A License .: 88 4 Dat Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the CY'acir'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 ($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. 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 of proving that 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 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 Lender's Address: 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' compens , as provided for. by Section 3700 of the Labor Code, for the performance which this permit is issued. T h ve and will maintain workers' compensation insurance, as required by Se 0 of the. Labor Code, for the performance of the work for which this permit is issued. 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 hould become subject to the workers' compensation provisions of Se cti of a La Code, I shall forthwith comoly with those orovisions. �� f /1 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C RAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN15 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 Pwstrela^to uilding construction, and hereby authorize representative f thiner pon°,t abovementiongd propeTty for inspection purposes. A (Applicant or DESCRIPTIONSz=' ` 4' <! ACCOUNT! '< TYh AM UNTOi s.PAID r x +t <� y,sit.✓.=�x .0 .�,<r <.. ,,. BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 .� r �,y" p y �. k ['r�, -. y. .::.: f`s.¢ ^� .54 >-t=z:. X x.. 'x�Ci - � h 4 PAID BY T':L �T : -j;a _ y'Si,.. y{ & rPt�, METHOD . r..•4t .::...-?4-Sti'� §kT1S'E:v� �k .Y .£ 4 > 9. i� =RECEIPT #� HECK #gi CLTD BY.; � ��i � � P a.... Total Paid for BUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 ..:€ -';e 'x`,4,z €�;,kDESCRIPTIONg'�,'-;�sa :.^se t ACGOWNT'. <�,�.qr: SPAID +cox .:.k'i; P,AIDDATE a�}�" QTY 4 AINIOUNTx� t'T r F,.,.S,k .1f, ..., .k ', :-.a;.iF _ :.-, PV SYSTEM - ARRAY, FIRST 20 101-0000-42403 0 $24.17 $0.00 (`: '#d qq yyNy € umt' i ` °h '`y � "�U' >:,�yy,�"� PAID BY� iY��S `5 k. ' ? - Sr' y,� 'Mx"M S'z''!_ METHOD '4'`" "`` nF 3d.4b .'=Y,�r^ GgX' .., ` . t �RECEIP�T�# q 1 CHECK aid. 3�>.:?.,_.4",...'�. t ;r r DESCRIPTION `' ' , + Lhz a, "ACCOUNT '� 1.4 X 1 Tl(=5 AMSx, T FP• �,.<,....�«�;w AeDDATEy :4r'du .a xo.. °-Lr ,.1Sa?av'3ra.,,. �1..xfiFaCJ c. �3 `5•t f'�,.t»5 i..t '>2—.:v> _ su.,,. 'mac f.r. -`. �r.O.UN A PV SYSTEM - ARRAY, FIRST 20 PC 101-0000-42600 0 $24.17. $0.00 " �` CHECKr#�CITDBY �"�.'i`�.x. - Total Paid forELE�C�TRICAL• $48.34., $0.00 IIH.,n• 4✓�`y�6,kF. f4. .x �',s _;. l �K4� L��i-`. .,-� � � A631-1 DESCRIPTION t� -. •aft"'' t _Y .`- ...:-Y:rJ '` fi.��k �w'2(i'S, �#ACCOUNT �t •i' �•�.N.i� :-.:, � 7 A,� AMOUNT F. �RS.i ��';✓'-r��i, �PAiID � of ��...�.': 3"£/. .>°1. DATE r�31-1 u "�G 3,rr...,.�..w_,.-'.�.�,�3..r., a ,x „QTY C, .. x.�x.,,3"ix, §t, �.3✓.=a:iy,..: PPAID '?..��iv.. -a..5 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 :.Y6Y� � a 'b lr`4r y`)? �, E3 e'L°" BYs ,�::�..r,Syh '��Cihi L^' �' ?r..; f, l ''.'�4". Y xT�k METHOD � i`L :�.�»3k. 1 .'�: y 4 y RECEIPT#� �,� �....,�.:..h Z -.•$ �;C'--•4§TG aPAID .r3_4 .x}t M .r.,.Y r. <_L .v_'b'A.e'vL1 .. 4 .:�7.rx >;i L Ytv ..:w�: 3 .,b CHECK>#xCLTD kY, ..i. +.',. BY ✓sV Total Paid forPERMIT ISSUANCE: $91.85 $0.00 Description: 7.42kW PV SYSTEM - (28) 265W PANELS/(1) INVERTER ADDITIONAL Type: SOLAR Subtype: Status: APPROVED Applied: 7/6/2015 EVA Approved: 7/17/2015 LUR Parcel No: 773322003 Site Address: 52800 AVENIDA CARRANZA LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 157 Lot: 24 Issued: UNIT 16 CHRONOLOGY TYPE STAFF NAME Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $16,398.20 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 7.42kW SOLAR ARRAY - (28) 265W KYOCERA PANELS W/ (2) ABB PVI-3.0-OUTS-S-US-AFCI INVERTER [496SF) 2013 CALIFORNIA ELECTRICAL CODE. __j Applied to Approved Printed: Monday, July 20, 2015 12:09:58 PM 1 of 2 IrJ sys•rcnns ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE* NOTES E-MAIL LUIS URIBE 7/17/2015 7/17/2015 SENT EMAIL TO ELENA LETTING HER KNOW PERMIT IS READY TO BE ISSUED. PLAN CHECK SUBMITTAL ED VASQUEZ 7/2/2015 7/2/2015 RECEIVED CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO CA 94402 mplasse@solarcity.com CONTRACTOR SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO CA 94402 mplasse@solarcity.com OWNER RIGOBERTO SANTOS 52800 AVENIDA LA QUINTA CA 92253 CARRANZA Printed: Monday, July 20, 2015 12:09:58 PM 1 of 2 IrJ sys•rcnns INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES SOLAR FINAL" BLD FINANCIAL INFORMATION CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA:' PV SYSTEM - ARRAY, ' 101-0000-42403 0 $24.17 $0.00 FIRST 20 PV SYSTEM - ARRAY, 101-0000-42600 0 $24.17 $0.00 FIRST 20 PC Total Paid forELECTRICAL: $48.34 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:0• INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES SOLAR FINAL" BLD Printed: Monday, July 20, 2015 12:09:58 PM 2 of 2 SYS7EIv1S Bfn.# C/t}/ Of �.C? Quints Building 8r Safety Divlsl'on P.O. Box 1504,"78-495 Calle Tarnplto 4.Qlrinta, CA 92253 -:(760) 777-7012 o`t 2 Building Permit Application and Tracking Sheet Permit# 50 ,2 v l 5. - ject Address: fA- Owner's Name . O P. Number. Addy Legal Description: Contractor. Solar City City, ST, zip: La Quinta, CA Telephone: Address: 3055 Clearview Way.. ProjectDescriptio�:29roof mounted solar panels . City, ST, zip: San Mateo, CA, 94402 )--inverter(s)2 " W Telephone: 650-638-1028 State Lic. # : 888104 City Lia #, Arch., EW., Designer: Address: City., ST. zip: Telephone: Construction Type: • Occupancy: Project type (circle one): New Add'n Alter Repair Demo State Lie. #: Name of Contact Person: Elena Loya Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: (442)256-1 134 Estimated Value of Project ' APPLICANT: DO NOT WRITE BELOW THIS LIME p Submittal Req'd Rev'd TRACMG PERMIT FEES Plan sets Pian Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit. . Truss Calls. Called Contact Person Plan Check Balance Title 24 Calcs. Pians picked up Construction Flood plain plan Plans resubmitted Mechanical Giading plan Z'! Review, ready for correction tissue McMical Subeontactor List Called Contact Person Plumbing Grant Deed Plans picked up SALL H.O.A. Approval Plans resubmitted Grading IN I10USE:- 1j° Revlew, ready far correetionsfissae Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees