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BSOL2016-008878-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BSOL2016-0088 Property Address: 79080 ARBOLA CIR CIR APN: 604271005 Application Description: STEWART / 6.2kW PV SYSTEM - (24) 260W'PANEL+P300 OPT/(1) INV Property Zoning: Application Valuation: $13,728.00 Applicant: VIVINT SOLAR DEVELOPER LLC 3301 N THANKSGIVING WAY STE 500 LEHI, UT 84043 MAY 2 0 201 CITYOFLAQUINTA 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, License CSO LiN9 756 �I II n n Date Contractor: 1 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date:. 5/20/2016 Owner: LESLIE STEWART 79080 ARBOLA CIR LA QUINTA, CA 92253 Contractor: VIVINT SOLAR DEVELOPER LLC 3301 N THANKSGIVING WAY STE 500 LEHI, UT 84043 (855)877-2974 L•Ic. 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 work 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: OWNER -BUILDER DECLARATION Carrier: _ Policy Number: _ I hereby affirm under penalty of perjury that I am exempt from the Contractor's State I certify that in the performance of the work for which this permit is issued, I License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any shall not employ any person in any manner so as to become subject to the workers' city or county that requires a permit to construct, alter, improve, demolish, or repair compensation laws of California, and agree that, if I should become subject to the. any structure, prior to its issuance, also requires the applicant for the permit to file a workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith signed statement that he or she is licensed pursuant to the provisions of the comply with those provisions. 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 Date: Applicant: 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ($500).: AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO (_) 1, as owner of the property, or my employees with wages as their sole ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF compensation, will do the work, and the structure is not intended or offered for sale. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not INTEREST, AND ATTORNEY'S FEES. 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 APPLICANT ACKNOWLEDGEMENT are not intended or offered for sale. If, however, the building or improvement is sold IMPORTANT: Application is hereby made to the Building Official for a permit subject to within one year of completion, the owner -builder will have the burden of proving that the conditions and restrictions set forth on this application. he or she did not build or improve for the purpose of sale.). 1. Each person upon whose behalf this application is made, each person at whose (_) I, as owner of the property, am exclusively contracting with licensed contractors request and for whose benefit work is performed under or pursuant to any permit to construct the project. (Sec. 7044, Business and Professions Code: The Contractors' issued as a result of this application , the owner, and the applicant, each agrees to, and State License Law does not apply to an owner of property who builds or improves shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and thereon, and who contracts for the projects with a contractor(s) licensed pursuant to employees for any act or omission related to the work being performed under or the Contractors' State License Law.). following issuance of this permit. (_) I am exempt under Sec. B.&P.C. for this reason 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. 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. Q. - Lender's Lender's 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 property for inspection purposes. Date: �U Signature (Applicant or Agent): R4,& DESCRIPTION FINANCIAL INFORMATION 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 TOTALS: Description: STEWART / 6.2kW PV SYSTEM - (24) 260W PANEL+P300 OPT/(1) INV Type: SOLAR Subtype: Status: ISSUED Applied: 4/18/2016 SKH Approved: 5/3/2016 AOR Parcel No: 604271005 Site Address: 79080 ARBOLA CIR CIR LA QUINTA,CA 92253 Subdivision: TR 23913 Block: Lot: 74 Issued: 5/20/2016 RSE Lot Scl Ft: 0 Building Scl Ft: 0 • Zoning: Finaled: Valuation: $13,728.00 Occupancy Type: Construction Type: Expired: 11/16/2016 RSE No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 6.2kW SOLAR ARRAY - (24) 260W YINGLI PANELS + P300 SOLAREDGE POWER OPTIMIZERS W/(1) SOLAREDGE SE760OA-US-R INVERTER [420SF] 2013 CALIFORNIA ELECTRICAL CODE. Applied .to Approved J Approved to Issued FINANCIAL INFORMATION Printed: Friday, May 20, 2016 2:21:36 PM 1 of 2. SYSTEMS CHRONOLOGY CHRONOL OGY 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. CONTACTS NAME TYPE NAME ADDRESS1 .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 LESLIE STEWART 79080 ARBOLA CIR 1. LA QUINTA CA 92253 FINANCIAL INFORMATION Printed: Friday, May 20, 2016 2:21:36 PM 1 of 2. SYSTEMS DESCRIPTION ACCOUNT' QTY AMOUNT PAID PAID DATE RECEIPT# CHECK# METHOD PAID BY CLTD ORIGINAL SENT DATE NOT SET AT SUBMITTAL, 1ST BLDG NS (1 WK) AJ ORTEGA 5/3/2016 5/10/2016 BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 5/20/16 R15678 1862 CHECK VIVINT SOLAR RSE 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 DEVELOPER LLC RSE Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS: $141.19 $141.19 PARENT PROJECTS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED DATE REVIEWS STATUS REMARKS NOTES ORIGINAL SENT DATE NOT SET AT SUBMITTAL, 1ST BLDG NS (1 WK) AJ ORTEGA 5/3/2016 5/10/2016 5/3/2016 APPROVED PROJECT FOUND AND REVIEWED ON THE SAME DAY. Printed: Friday, May 20, 2016 2:21:36 PM 2 of 2 N?SYS7EtiAS f Cit}/ d La QUthta Btdfdtng 8c Safety Division Permit # P.O. Box 1504,78-495 Calk Tampico La.Qidnta, CA 92253 -:(760) 777-7012 Building Permit' ApPlication'and Tracking Sheet • ProjedAdd[ess: -7 (7 A Y 0 It I lam• _ Ownes's Name . A P. Number. Q (• 00 S_ Address::? Cl it . Legal Description: - City, ST, Zip:C� 9 a�3 i Contractor U i h_. Solo Vel e r L L . C - Telephone: ( Address �I. (� . .I d e/L7 iG 1 J P/c,Z� Project Description: City, ST, Zip: C 9 a t a Sa c. pv /S .' .1 Telephone K GV i ih ✓ . ✓�Pl p/ State Lic, fi : 3 City, Lie. ktjj / . ark - Asch.. Engr, Designer - i Address: CIty., ST, Zip: Telephone: Construction Type: Oxupaacy: State Lic #: Project type (circle one): New Add'n Altei liepaa Demo Name of Contact Person a J -W/ra /l' Sq. FL: #Stories: !i Unit Telcpae # of Coatatx Person: ! h9ti' . Estimated Value of i'rojeet:: 3 .' APPLICANT: DO NOT WRITE BELOW THIS EINE sR ; Submittal Req'd Rcc'd -TRACING PERMIT FEES Plgu Seb Plan Check submitted. Item AaaenRt StrgMural Gies _ Reviewed, ready for correction Plan Check De posit . Tines Gles. Ir Glled Contact Person P[an Check Balance, a, H Mile 24 Cake. Plane picked upGRatavction i r Flood plain plan Plans resubmitted. �'J• Mecharikal t i Giadiog pla XReview, ready for correctio su ' Electrical ' 811he0atatter List Called Contact Peraou - Yluanb[ng ` Grant Deed Plans p(ciced up 9M.L &OA. Approval Plans resabmitkd Grading DOUSE' Review; ready for correcdomilssne 'Developer Impact Fee , Planning Approval. Called Contact Penon _ A.LP.P. ' ti Pub. Wl®. Appr ' Date of peahRit issue - School Few F Total Per F D S£'�' t,g 'TatV Tr APR 15 :2016 r' ' `CITY OF LA OUINTA COMMUNITY DEVELOPMENT