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BSOL2016-009078-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description: Property Zoning: Application Valuation: 440�&r COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BSOL2016-0090 79909 DANDELION DR 604493001 VALENZULA / 9.8kW PV SYSTEM - (38) 260W PAN+P300 OPT/(1) INV $21,736.00 Applicant: VIVINT SOLAR DEVELOPER LLC -3301 N THANKSGIVING WAY STE 500 LEHI, UT 84043 �p MAY 2 A 2016 CITYOFL40UINTA 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 Class: C46, C10 License No.: 973756 Date, Contractor: t/l✓ OWNER -BUILDER DECLARATION 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 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.). (_) 1, 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 5/20/2016 Owner: SERGIO VALENZUELA , 92253 Contractor: VIVINTSOLAR DEVELOPER LLC 3301 N THANKSGIVING WAY STE 500 LEHI, UT 84043 (855)877-2974 Llc. No.: 973756 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 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 with those provisions. _ J - 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 and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above-mFeenn 'oned property for inspection purposes. - Date: 7 �a Signature (Applicant or Agent): FINANCIAL f ' + DESCRIPTION ACCOUNT = QTY AMOUNT PAID. PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 5/20/16 PAID BY METHOD = RECEIPT # CHECK # CLTD BY VIVINT SOLAR DEVELOPER LLC CHECK R15678 1862 RSE Total Paid for BUILDING STANDARDS ADMINISTRATION BSA:. $1.00 $1.00 DESCRIPTION ACCOUNT. QTY AMOUNT PAID PAID DATE PV SYSTEM - ARRAY, FIRST 20 101-0000-42403 0 $24.17 $24.17 5/20/16 PAID BY METHOD _ RECEIPT # CHECK # CLTD BY VIVINT SOLAR DEVELOPER LLC CHECK R15678 1862 RSE DESCRIPTION. ACCOUNT QTY AMOUNT PAID PAID DATE PV SYSTEM - ARRAY, FIRST 20 PC 101-0000-42600 0 $24.17 $24.17 5/20/16 PAID BY METHOD - RECEIPT # CHECK # CLTD BY VIVINT SOLAR DEVELOPER LLC CHECK R15678 1862 RSE Total Paid for ELECTRICAL: $48.34 $48.34 DESCRIPTION ACCOUNT = QTY ! AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 5/20/16 PAID BY METHOD RECEIPT # CHECK # CLTD BY VIVINT SOLAR DEVELOPER LLC CHECK R15678 1862 RSE Total Paid for PERMIT ISSUANCE: $91.85 $91.85 • + Description: VALENZULA / 9.8kW PV SYSTEM - (38) 260W PAN+P300 OPT/(1) INV Type: SOLAR Subtype: Status: ISSUED Applied: 4/20/2016 RSE Approved: 5/3/2016 AOR Parcel No: 604493001 Site Address: 79909 DANDELION DR LA QUINTA,CA 92253 Subdivision: TR 24197-2 Block: Lot: 38 Issued: 5/20/2016 RSE Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $21,736.00 Occupancy Type: Construction Type: Expired: 11/16/2016 RSE No. Buildings: 0 No. Stories: 0 No. Unites: 0 CHRONOLOGY TYPE STAFF NAME Details: 9.8kW SOLAR ARRAY - (38) 260W YINGLI PANELS + P300 SOLAREDGE POWER OPTIMIZERS W/(1) SOLAREDGE SE760OA-US-R INVERTER [665SF] 2013 CALIFORNIA ELECTRICAL CODE. __j Applied to Approved M Approved to Issued FINANCIAL INFORMATION Printed: Friday, May 20, 2016 2:27:22 PM 1 of 3 J C RwsysTrms ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES E-MAIL AJ ORTEGA 5/4/2016 5/4/2016 EMAILED PAULA THAT PLANS ARE APPROVED AND PERMIT IS READY TO ISSUE. NAME TYPE" NAME CONTACTSCONDITIONS ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT VIVINT SOLAR DEVELOPER LLC 3301 N THANKSGIVING WAY STE LEHI UT 84043 businesslicensing@vivi nsolar.com CONTRACTOR VIVINT SOLAR DEVELOPER LLC 3301 N THANKSGIVING WAY STE LEHI UT 84043 businesslicensing@vivi nsolar.com OWNER SERGIO VALENZUELA 92253 FINANCIAL INFORMATION Printed: Friday, May 20, 2016 2:27:22 PM 1 of 3 J C RwsysTrms INSPECTIONS PARENT PROJECTS REMARKS NOTES REVIM TYPE"' REVIEWER .... SENT DATE ...... ""' DUE DATE RETDUA ,,. ' , , NED STATUS CLTD DESCRIPTION ACCOUNT QTY. AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 5/20/16 R15678 1862 CHECK VIVINT SOLAR RSE 5/3/2016 APPROVED CHARACTERISTICS ARE SIMILAR TO THOSE DEVELOPER LLC , Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $1.00 BSA: PV SYSTEM - ARRAY, 101-0000-42403 0 $24.17 $24.17 5/20/16 R15678 1862 CHECK VIVINT SOLAR RSE FIRST 20 DEVELOPER LLC PV SYSTEM -ARRAY, 101-0000-42600 0 $24.17 $24.17 5/20/16 R15678 1862 CHECK VIVINT SOLAR RSE FIRST 20 PC DEVELOPER LLC Total Paid for ELECTRICAL: $48.34 $48.34 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 5/20/16 R15678 1862 CHECK VIVINT SOLAR RSE. DEVELOPER LLC ,Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: INSPECTIONS PARENT PROJECTS Printed: Friday, May 20, 2016 2:27:22 PM 2 of 3 JsysirrMs REMARKS NOTES REVIM TYPE"' REVIEWER .... SENT DATE ...... ""' DUE DATE RETDUA ,,. ' , , NED STATUS TE LOAD CALCULATION SHEET NOT PROVIDED SPECIFICALLY FOR THIS PLAN, BUT SYSTEM IST BLDG NS (1 WK) AJ ORTEGA 4/20/2016 4/27/2016 5/3/2016 APPROVED CHARACTERISTICS ARE SIMILAR TO THOSE SUBMITTED CONCURRENTLY AND CONDUCTOR SIZES HAVE ALSO BEEN VERIFIED BY REVIEWER. Printed: Friday, May 20, 2016 2:27:22 PM 2 of 3 JsysirrMs NTrn Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED DOC 5/4/2016 AJ ORTEGA SOLAR PLAN BSOL2016-0090 - SOLAR 1 (APPROVED) PLAN (APPROVED).pdf Printed: Friday, May 20, 2016 2:27:22 PM 3 of 37 srsTr;ois Bin # . Crty ouints _ Buttdtng 8t Safety Duron P.O Box 1504,78-495 Calle Tamp1w 4 QLdnta, CA 92253 -:(760) 777.7012 e) Building Permit Application' and Tracking Sheet Permtt # ZSCY200 • - Project Add=: 0 l , a r, Owner's Name: S /Zo?,O? A.P:Number (,' a3 Address: -1 '109Da h !� I �a Legal Description: pCity, Contractor. v,• R- Sa: a v e Cb e r L t C Address C J • plett za ST, Zip: /a C Telephone: . lNe« Description: - �� deafla City, ST, Zip: A t a C# 9 a 3 Telephone —7 e b/ ' ;,A ✓ /�. State Lia N: 3 City Lic. #:L' IC- / J r41 Arch., Bug, Designee - Addre= CI% ST, Zip: - - - Telephone: Construcffon Type' Occupancy: Project type (circle one): New Addn. Alter Repair Demo Sq. FL: # Swries # Uniq State Lia #: Name of Contact Person Q �, F� �` Telephone # of Contact Person: ,• Estimated Value of Project:: `� 3 APPLICANT: DO NOT WRITE BELOW THIS LINE R Sobmittal , • • Wd 'Reed TRAC1WQ PERMT FEES - plan Seb — - Plan Checksubmltted• Item Amonat Structural Cale& _ Reviewed, ready for eorreenons � Check Deposit, . Tress Cates. Caller Contact Person Plan Check Balance Mae 24 ales. plans piekid up onstraction Flood plain plan . Puss resabmitted ' harikal Giading plan 7! Review, tardy for correcaanal rine Ieeblcal ` 8nlxoataetor ISst Called Contact Person Plgmbfug Grant Deed Plana picked up SA4.1 ]LOA Approval Plans rrsabmltted Cradlag Review; ready for correenondloue Developer Impoet Fee Plaaalag Approval. Called Contact Person A.U.P. Pub. Wks. Appr ' Date of permit issue School Fees To a1 Permit Fees r oma s�-r o F frit. > A�rr #C44a rM .�