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BSOL2015-014978-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT 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 B siness and Professions Code, and my License is in full force and effect. License I ss: C46 C10 A C20 Li CCat Contrac OWNER -BUILDER DECLARATIN I hereby affirm under penalty of perjury that I am exempt 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 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 Name Lender's Date: 9/22/2015 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' compensa 'on, as rovided for by Section 3700 of the Labor Code, for the performance Ici ich this permit is issued. and will maintain workers' compensation insurance, as required by 7 o the LaborCode, for the performance of the work for which this permit se ed. 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' ompensation provisions of Secti of th abor Code, I shall forthwith cc t tho rovisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATI 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 infor tion is correct. I agree to comply with all city and county ordinances and statelaws rePing ing to building construction, and hereby authorize representatives o is cit to me po�th abovWion for inspection purposesDate IF (Applicant or Agent) BUILDING PERMIT Application Number: BSOL2015-0149D U�U wner: Property Address: 77400 CALLE CHILLON ARLOS GARCIA APN: 774153023 7 400 CALLE CHILLON 2 Application Description: GARCIA/ (25)ROOF MOUNTED PANE U015 TER (1)IN ER 6.62 A QUINTA, CA 92253 Property Zoning: Application Valuation: $14,641.25 CITY OF LA QUINTA COMMUNITY DEVELOPMENT DEPARTMENT Applicant: Contractor: SOLARCITY CORPORATION SOLARCITY CORPORATION 3055 CLEARVIEW WAY 3055 CLEARVIEW WAY ATTN ZOE STEELE ATTN ZOE STEELE SAN MATEO, CA 94402 SAN MATEO, CA 94402 (650)963-4722 LIc. 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 B siness and Professions Code, and my License is in full force and effect. License I ss: C46 C10 A C20 Li CCat Contrac OWNER -BUILDER DECLARATIN I hereby affirm under penalty of perjury that I am exempt 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 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 Name Lender's Date: 9/22/2015 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' compensa 'on, as rovided for by Section 3700 of the Labor Code, for the performance Ici ich this permit is issued. and will maintain workers' compensation insurance, as required by 7 o the LaborCode, for the performance of the work for which this permit se ed. 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' ompensation provisions of Secti of th abor Code, I shall forthwith cc t tho rovisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATI 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 infor tion is correct. I agree to comply with all city and county ordinances and statelaws rePing ing to building construction, and hereby authorize representatives o is cit to me po�th abovWion for inspection purposesDate IF (Applicant or Agent) FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE BSAS x81473 fff 101-0000-20306 0 $1.00 $0.00 PAID BY METHOD RECEIPT # CHECK # CLTD BY Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $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 Total Paid for ELECTRICAL: $48.34 $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: GARCIA / (25)ROOF MOUNTED PANELS (1)INVERTER 6.625KW Type: SOLAR Subtype: Status: APPROVED Applied: 8/24/2015 SKH Approved: 9/21/2015 LUR Parcel No: 774153023 Site Address: 77400 CALLE CHILLON LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: 201 Lot: 12 Issued: UNIT 19 Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $14,641.25 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 6.6kW SOLAR ARRAY - (25) 265W KYOCERA PANELS W/ (1) ABB# PVI-600-OUTD-US-Z-A-AFCI INVERTER [443SF] 2013 CALIFORNIA ELECTRICAL CODE. All Summary 28: Applied to Approved Printed: Tuesday, September 22, 2015 10:42:33 AM 1 of 3 0707 srsreMs CHRONOLOGY TYPE STAFF NAME ACTION DATE COMPLETION DATE NOTES E-MAIL LUIS URIBE 9/1/2015 9/1/2015 SENT ELENA EMAIL. IST REVIEW IS COMPLETE. PLANS ARE READY FOR CORRECTIONS E-MAIL LUIS URIBE 9/21/2015 SENT ELENA AN EMAIL. NEED STRUCTURAL CALCS IN ORDER TO APPROVE THIS PERMIT. E-MAIL LUIS URIBE 9/21/2015 9/21/2015 SENT ELENA AN EMAIL. PERMIT IS READY TO BE ISSUED PLAN CHECK PICKED UP STEPHANIE KHATAMI 9/1/2015 9/1/2015 ELENA RESUBMITTAL AJ ORTEGA 9/17/2015 9/17/2015 PLANS RESUBMITTED BY SOLARCITY - ELENA LOYA - C ` NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL APPLICANT SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO CA 94402 Printed: Tuesday, September 22, 2015 10:42:33 AM 1 of 3 0707 srsreMs Permit Dena City of La Qu i n-1 PERMIT N.U.MB.ER 6S0 2015-014 o . NAME TYPE NAME ADDRESSI CITY STATE ZIP PHONE FAX EMAIL CONTRACTOR SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO CA 94402 PAID PAID DATE RECEIPT # OWNER CARLOS GARCIA 77 400 CALLE CHILLON LA QUINTA CA 92253 OW239MIDI @2MAjM REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED DATE STATUS REMARKS NOTES CLTD DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY 9/24/2015 9/21/2015 APPROVED BY BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING 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 for ELECTRICAL: $48.34 $0.00 PERMIT ISSUANCE 101-0000-42404 1 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 INSPEC--TIONS Printed: Tuesday, September 22, 2015 10:42:33 AM 2 of 3 (71 L1 i..I l ',YSTEMS REVIEW TYPE REVIEWER SENT DATE DUE DATE RETURNED DATE STATUS REMARKS NOTES NON-STRUCTURAL - 1 WK LUIS URIBE 8/24/2015 8/31/2015 9/1/2015 REVISIONS REQUIRED SEE ATTACHED CORRECTIONS LIST NON-STRUCTURAL- 1 WK LUIS URIBE 9/17/2015 9/24/2015 9/21/2015 APPROVED Printed: Tuesday, September 22, 2015 10:42:33 AM 2 of 3 (71 L1 i..I l ',YSTEMS Permit Det�alls PERMIT NUMBER Cit of l�Wqinta 6541.2015-0149 Y Printed: Tuesday, September 22, 2015 10:42:33 AM 3 of 3 SY57: M S Attachment Type CREATED OWNER DESCRIPTION PATHNAME SUBDIR ETRAKIT ENABLED BSOL2015-0149 -1ST DOC 9/1/2015 LUIS URIBE 1ST REVIEW REVIEW CORRECTIONS 0 CORRECTIONS LIST LIST.docx Printed: Tuesday, September 22, 2015 10:42:33 AM 3 of 3 SY57: M S sin. # Permit # Project Address. C► / Of Quin Buik&g 8l. Safety Division P.O. Box 1504,78-495 Cage Tampico La.Quinta, CA 92253 -1760) 777-7012 Building Permit Application' and Tracking Sheet owner's Name: A. P. Number. Addrcssa-a�n C AjV Cha Legal Description: Contractor Solar City City, ST, zip: La Puinta, CA Telephone Address: 3055 Clearview Way. ProjegDescription: roof mounted solar panels . city, ST, zip: San Mateo, CA, 94402 inverter(s)` Telephone: 650-638-1028 State Lia # : City Lia 1888104 Arch, Eng., Designer Address: City, ST, Zip. Telephone: State Lia #: . r' Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: # ries: # Units: Name of Contact Person: Elena LO a y Telephone # of Contact Person: 442)256-1134 Estimated Value of Proj APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd Recd TRACK NG PERMIT FEES Plan Sets Pian Cheek submitted.Item Amount Strgetund Cates. Reviewed, ready for corrections Plan Check Deposit. . 'Muss Cato. Called Contact Person Plan Check Balance Title 24 Cates. Plans picked up Construction Flood plain plan Plans resubmitted.. Mecharitcal Giading plan 2'! Review, ready for correctionarasue Electrical Subcontaetor List Called Contact Person Plumbing Grant Deed Plans picked up S LL LLOAL Approval Plans resubmitted Grading IN HOUSE:- ''d Review, ready for correctionslissue Developer Impact Fee Planning Approval. Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit Issue School Fees Total Permit Fees