SOL-14-92478-495 CALL4UW----
EJAMPICO
LA QUINTA, CALIFORNIA 92253
c&t�t4449&& V
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
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- CC46. B. C10. C20,'A License No.: 8881044
Date:' ` Contractor:
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 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 Na
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'
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.
Date: "L Applicant�LL �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-
mentioned roperty for inspection purposes.
Date: Signature (Applicant or Agenzz_a_-2�
Date: 9/9/2014
Application Number:
SOL -14-924
Owner:
Property Address:
44030 CAM INO AZUL
JANISCH, ALLEN JOHN
�--
APN:
604180042
44030 CAMINO AZUL
Application Description:
10.4kW PV SYSTEM - (41) 255W PANELS/(2) INVERTERS
LA QUINTA, CA 92253
d.
Property Zoning:O
Q W
C3
Application Valuation:
$47,000.00
Q N
Applicant:
Contractor:
o
LLW
c
SOLARCITY CORPORATION
SOLARCITY CORPORATION
Q W
v
3055 CLEARVIEW WAY
3055 CLEARVIEW WAY
ATTN ZOE STEELE
ATTN ZOE STEELE
SAN MATEO, CA 94402
SAN MATEO, CA 94402
(650)963-5100
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 Class- CC46. B. C10. C20,'A License No.: 8881044
Date:' ` Contractor:
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 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 Na
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'
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.
Date: "L Applicant�LL �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-
mentioned roperty for inspection purposes.
Date: Signature (Applicant or Agenzz_a_-2�
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE 101-0000-20306
0
$2.00
$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
$23.83
$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
$23.83
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PV SYSTEM - MISC EQUIPMENT
101-0000-42403
0
$23.83.
$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
$23.83
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forELECTRICAL: $95.32 $0.00
DESCRIPTION -
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forPERMIT ISSUANCE: $90.57 $0.00
TOTALS:00
Description: 10.4k ( PV SYSTEM - (41) 255W PANELS/(2) INVERTERS
Type: SOLAR Subtype: Status: APPROVED
Applied: 6/23/2014
Approved: 9/9/2014 AOR
Parcel No: 6041800 2 Site Address: 44030 CAMINO AZUL LA QUINTA,CA 92253
Subdivision: TR 245 7 Block: Lot: 27
Issued:
Lot Sq Ft: Building Sq Ft: Zoning:
Finaled:
Valuation: $47,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: No. Stories: No. Unites:
Details: 10.4kW SOLAR ARRAY - (41) 255W TRINA SOLAR PANELS W/ (2) ABB PVI-3.6-OUTD-S-US-Z-A INVERTERS AND (1) 125A SUB -PANEL
[738SF] 20 3 CALIFORNIA ELECTRICAL CODE.
III
CHRONOLOGY rYPE STAFF NAME
CHRONOLOGY
ACTION DATE
COMPLETION DATE
NOTES
E-MAIL
AJ ORTEGA
9/9/2014
9/9/2014
EMAILED SARA SMITH AND JOEY POWELL FROM SOLARCITY
THAT PLAN IS APPROVED AND PERMIT IS READY TO ISSUE.
CONDITIONS
NAME TYPE_
*:. NAME.
ADDRESSI
i
CITY
STATE.;
ZIP,;.
PHONE
APPLICANT
SOLARCITY CORPORATION
3055 CLEARVIEW WAY
SAN MATEO
CA
94402
(760)275-9082
CONTRACTOR
SOLARCITY CORPORATION
3055 CLEARVIEW WAY
SAN MATEO
CA
94402
(760)275-9082
OWNER
JANISCH, ALLEN JOHN
44030 CAMINO AZUL
LA QUINTA
CA
92253
(760)275-9082
Printed: Tuesday, S
r 09, 2014 11:49:57 AM
CMSySTEMS
aT•c
ow �$
r6'rOF
SEQID . INSPE ION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE DATE
SOLAR FINAL"
PROJECTSPARENT
REVIEWS
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES
DATE
NON-STRUCTURAL I AJ ORTEGA 1 8/28/2014 1 9/8/2014 1 9/9/2014 1 APPROVED
Printed: Tuesday, Se�tember 09, 2014 11:49:57 AM 2 of 2 CJ
SYSTEk1S
CLTD
DESCRIPTION
-V ACCOUNT
QTY
AMOUNT ~.
PAID
PAID DATE
RECEIPT#
CHECK# m
METHOD
PAID BY,
.
BY
BSAS SB1473 FEE
101-0000-20306
0
$2.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$2.00 $0.00
BSA:
PV SYSTEM - ARRAY,
101-0000-42403
0
$23.83
$0.00
FIRST 20
PV SYSTEM - ARRAY,
101-0000-42600
0
$23.83
$0.00
FIRST 20 PC
PV SYSTEM - MIS
101-0000-42403
0
$23.83
$0.00
EQUIPMENT
PV SYSTEM - MIS
101-0000-42600
0
$23.83
$0.00
EQUIPMENT PC
I Total Paid for ELECTRICAL: $95.32 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
• • 00
SEQID . INSPE ION TYPE INSPECTOR SCHEDULED COMPLETED RESULT REMARKS NOTES
DATE DATE
SOLAR FINAL"
PROJECTSPARENT
REVIEWS
REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED STATUS REMARKS NOTES
DATE
NON-STRUCTURAL I AJ ORTEGA 1 8/28/2014 1 9/8/2014 1 9/9/2014 1 APPROVED
Printed: Tuesday, Se�tember 09, 2014 11:49:57 AM 2 of 2 CJ
SYSTEk1S
Bin # City Of La QCiI[1ta
Building &r Safety Division
Dermic # P.O. Box 1504, 78-495 Calle Tampico.
La Quinta, CA 92253 - (760) 777-7012
` Building Permit Application and Tracking -Sheet
Project Address: `'/ U 5G Mrminn f✓V 1 • Owner's Name:
A. P. Number:
Address: / U,1_)() a / U 100
Legal Description:�V V260I400 kc• Wo, . v-
City, ST, Zip: L I rA-CA Z��
Contractor: 1 a `% ,
'
.. .
Address: -5.5 �0 a r ' LQ W W
Project Description: U V60 f MOM J K
City, ST, Zip:Son I"l a p l ��6 Z
Telephone.tfv
Reviewed, ready for corrections ^I
State Lic. #N 10 City Lie. #::::
y : •� ' • S' V3 •'L • 1
Arch., Engr., Designer-
esignerAddress:
Address:
Called Contact Pcrsoh`c�
City, ST, Zip:
Telepp hone:
: ::':';^ :: ^:;:°<;:`;:: ; :::::::
::.:,�;;;::;::;:<•,<;::
><'
........:....::.................. ................. .....
Construction Type: Occupancy:
State Lic. #:
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: 1 1
Sq. Ft_:
_T
# Stories:
# Units:
Telephone, # of Contact Person: 05 �� 5 �
�Q� . )�-
Estimated Value of Project:
i IAPPLICANT: DO NOT WRITE BELOW THIS LINE '
ff
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections ^I
yuf,,
Plan Check Deposit
Truss Cala.
Called Contact Pcrsoh`c�
Plan Check Balance.
Title 24 Calcs.
'PIans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2"' Review, ready for correctio (issue
Electrical
Subconlactor List
Called ContactPerson
Plumbing
Grant Decd
Plans picked up
S.M.I.
Ii.O.A. Approval
Plans resubmitted
Grading
IN HOUSE.
'"' Review, ready for correctionslissue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fces
Total Permit Fees