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BSOL2015-0065LICENSED 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. Licen a Cl ss: 46 B C10 A Lice se : 88 04 r 1 Date: Contracto oil OWNER -BUILDER DECLARATIO I hereby affirm under penalty of perjury that I am exempt fr 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.). ( ) 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 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 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' comp n tion, as provided for by Section 3700 of the Labor Code, for the performance 221 w for which this permit is issued. Ihave and will maintain workers' compensation insurance, as required by 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 houId ome subject to the workers' co pe sation provisions of Section 370 of he L o Code, I shall forthwith comply�wiDt tho rovisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONC VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE D 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 o o enter on the above mentione pro ertyfor' spection purposes. Date: Signature (Applicant or Age t): Twit 4 4 Qu!Kro VOICE (760) 777-7125 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 fAX (760) 777-7011COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153 BUILDING PERMIT Date: . 6/1/2015 Application Number: BSOL2015-0065 Owner: Property Address: 49465 BRIAN CT QUINTON DALL APN: 602290046 49465 BRIAN CT _ ' Application Description: QUINTON / 68 ROOF MOUNTED PANELS AND (3) INVERTERS 17.68 KW LA QUINTA, CA 92253 a Property Zoning: C-) C Application Valuation: $39,072.00 Applicant: Contractor: 0, a � SOLARCITY CORPORATION SOLARCITY CORPORATION v 3055 CLEARVIEW WAY 3055 CLEARVIEW WAY _o D L-%9 ATTN ZOE STEELE ATTN ZOE STEELE SAN MATEO, CA 94402 SAN MATEO, CA 94402 - L: (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. Licen a Cl ss: 46 B C10 A Lice se : 88 04 r 1 Date: Contracto oil OWNER -BUILDER DECLARATIO I hereby affirm under penalty of perjury that I am exempt fr 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.). ( ) 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 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 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' comp n tion, as provided for by Section 3700 of the Labor Code, for the performance 221 w for which this permit is issued. Ihave and will maintain workers' compensation insurance, as required by 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 houId ome subject to the workers' co pe sation provisions of Section 370 of he L o Code, I shall forthwith comply�wiDt tho rovisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONC VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE D 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 o o enter on the above mentione pro ertyfor' spection purposes. Date: Signature (Applicant or Age t): FINANCIAL .• 1 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $2600 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $2.00 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PV SYSTEM - ARRAY, FIRST 20 101-0000-42403 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PV SYSTEM - ARRAY, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PV SYSTEM - MISC EQUIPMENT 101-0000-42403 0 $48.34 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PV SYSTEM - MISC EQUIPMENT PC 101-0000-42600 0 $48.34 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for ELECTRICAL: $145.02 $0.00 DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:00 Description: QUINTON / 68 ROOF MOUNTED PANELS AND (3) INVERTERS 17.68 KW Type: SOLAR Subtype: Status: APPROVED Applied: 5/29/2015 SKH Approved: 6/1/2015 JFU Parcel No: 602290046 Site Address: 49465 BRIAN CT LA QUINTA,CA 92253 Subdivision: TR 29053-1 Block: Lot: 23 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $39,072.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 COMPLETION DATE Details: 17.68 kW SOLAR ARRAY - (68) 260W KYOCERA KU2606XPA PANELS W/ (2) ABB PVI-4.2-OUTD-S-US-Z-A INVERTERS & (1) ABB PVI-3.6- OUTD-S-US-Z-A INVERTER + MAIN SERVICE PANEL UPGRADE TO 225A + 125A SUBPANEL [1,224 SF] 2013 CALIFORNIA ELECTRICAL CODE. Printed: Monday, June 01, 2015 2:06:00 PM 1 of 3 CRSYSTEMS CHRONOLOGY CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES E-MAIL JAKE FUSON 6/1/2015 6/1/2015 NOTIFIED MELANIE W/ SOLAR CITY THAT PLANS WERE APPROVED AND PERMIT WAS READY TO ISSUE. PLAN CHECK SUBMITTAL RECEIVED STEPHANIE KHATAMI 5/29/2015 5/29/2015 CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO CA 94402 CONTRACTOR SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO CA 94402 OWNER QUINTON DALL 49465 BRIAN CT LA QUINTA CA 92253 Printed: Monday, June 01, 2015 2:06:00 PM 1 of 3 CRSYSTEMS Printed: Monday, June 01, 2015 2:06:00 PM 2 of 3 OrWySTEMS INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES SOLAR FINAL" BLD CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY BY BSAS SB1473 FEE 101-0000-20306 0 $2.00 1 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $2.00 $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 PV SYSTEM -MISC 101-0000-42403 0 $48.34 $0.00 EQUIPMENT PV SYSTEM - MISC 101-0000-42600 0 $48.34 $0.00 EQUIPMENT PC Total Paid for ELECTRICAL: $145.02 $0.00 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid forPERM1T ISSUANCE: $91.85 $0.00 TOTALS:•• Printed: Monday, June 01, 2015 2:06:00 PM 2 of 3 OrWySTEMS INSPECTIONS SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED DATE DATE RESULT REMARKS NOTES SOLAR FINAL" BLD Printed: Monday, June 01, 2015 2:06:00 PM 2 of 3 OrWySTEMS Printed: Monday, June 01, 2015 2:06:00 PM 3 of 3 -CYC7 SYSTEMS Bln.# Of %ci QUfitta Btdkgng 8r Safely Division P.O. Box 1504,-78-495 Calle Tampico La.QLdnta, CA 92253 - (760) 777-7012 Building Pennit Application'and Tracking Sheet Permit # s3t)Laa5 -W_ ProjectAddress: Owner's Name:. I A P. Number. Address: (f rj7 Legal Description: I?) City, ST, zip: La, Quinta, CA Contractor Solar City - Telephone: Address: 3055 Clearview Way. Pmje4Descrip6oiiq roof mounted solar panels . city, sT, zip: San Mateo, CA, 9440.2 . -_invert e d; Telephone: 650-638-1028 ` State Lia # : 888104 City Lic. C.`IV Arch-, Engr., Designer- esignerAddress: Address: City, ST, Zip: Telephone: Construction Type: , occupancy: State Lia #: Project type (circle one): New Add'n Alter Repair Demo Name of contactPerson Elena Loya Sq. Ft: # Stories: # Units: Telephone # of Contact Person: (442)256-1134 Estimated value of Project APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Wd Reeld TRACMG PERMPPFEES Plan Sets Plan Check submitted Item Amount StrgcturalCaics. Reviewed, ready for ISSUE Plan Check Deposit. . Truss Cates. Called Contact Person Plan Cheek Balance - Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted Meeharileai Grading plan Z'! Review, ready for correctionsfissue Electrical Subcoetaetor List Called Contact Person Plumbing Grant Deed Plans pteked up &bLL H.O.A. Approval Plans resnbmtlted Grading IN ROUSE:- Review; ready for eorreetlonsfissae Developer Impact Fee Planning Approval Called Contact Person AJ.P.P. Pub. Tib. Appr Date of permit issue School Fees Total Permit Fees m!FM Now MAY 2 9 2015. 0ItY OF LA-QUINTA COMMUNITY DEVELOPMENT