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12-0212 (SOL)P.O. BOX 1504 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 12-000002127- Property Address: 5397'AVENIDA JUAREZ 5 APN: 774-143-023-11 -000000- Application description: SOLAR Property Zoning: COVE RESIDENTIAL Application valuation: 11439 l c&t�v °f �Q�w Architect or Engineer: BUILDING & SAFETY DEPARTMENT BUILDING PERMIT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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 Profes ionals Code, and my License is in full force and effect. License Class: B C10 C46 arise No.: 910836 I / Date: 0% ontractor: OWN -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 70001 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).: 1—) 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.). C_ 1 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 Address: LQPERMIT Owner: ORTIZ JOSE H & CINDY M 53975 AVENIDA JUAREZ LA QUINTA, CA 92253 VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 3/19/12 t Contractor: RENOVA ENERGY CORP 75181 MEDITERRANEAN AVEn PALM DESERT, CA 92211 'J (760) 568-34.13 FMAR f1Lic. No.: 910836 z0 2012 1 CITY O q - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - " -r.- - - - - 7 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: Carrier NORGUARD INS Policy Number REWC242277 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 LaborCode, I shall f hwith mply with those provisions. ate: D 03 Ap R Want: /7 ✓' WARNING: FAI RF TO CUORKERS' COM NSATION 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 Director of Building and Safety 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 1 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 his county to enter up n the above-mentioned propert for inspe tion purpos / I Date: ! /Z Signature (Applicant or Agent): Application Number . . . . . 12-00000212 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit Fee . . . . 22.50 Plan Check Fee 5.63 Issue Date Valuation 0 Expiration Date 9/15/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 EA ELEC PWR APP >1 TO <=10 ---------------------------------------------------------------------------- 7.50 Permit . . . SOLAR PERMIT Additional desc . Permit Fee 22.50 Plan Check Fee 5.63 Issue Date . . . . Valuation . . . . 11439 Expiration Date . . 9/15/12 Qty Unit Charge Per Extension BASE FEE 15.00' 1.00 4.5000 EA SOLAR COLLECTOR < 1000 4.50 1.00 3.0000 EA SOLAR EQUIP MISCELLANEOUS 3.00 ---------------------------------------------------------------------------- Special Notes and Comments 7.2kW SOLAR ARRAY - (30) 240W'SUNPOWER PANELS W/ (1) 7000W SUNPOWER INVERTER [510SF] 2010 CALIFORNIA ELECTRICAL CODE. March 19, 2012 3:09:16 PM AORTEGA ---------------------------------------7------------------------------------ Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473) 1.00 Fee summary Charged Paid Credited - Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 45.00 .00 .00 45.00 Plan Check Total 11.26 .00 .00 11.26 Other Fee Total i.00 .00 .00 1.00 Grand Total 57.26 .00 .00 57.26 0 LQPERMIT Bin.# Qty Of Qutntd Building 8r Safety Division P.O. Box 1504,18-495 Calle Tampico La.Qldnta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: e5 3 —fir) � V = N 2 D A � Owner's Name:. . A. P. Number. Address: ro -� u Px 2z Legal Description: City, ST, Zip: a ck Z Contractor: Telephone: "' as, % J>.>.r ,M,. Address: -1 5 1 x 1 M ,� e Project Description: o T noxi City, ST, Zip: .�. A 1 t_ x S --r t r-�L C, le P,"-, Telephone: -7 Loo — 50 —34 1 City Tic. #; State Lic. # : (D �4Z / 240 W ata "A"aL Arch., Engr., Designer ------------- 0' be. 01X7 *+Wl xox Address: City., ST, Zip: Telephone: P State Lic. #: Name of Contact Person: �� `�� shy r� Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo Sq. Ft.: qmo# Stories: # Units: Telephone # of Contact Person: (—i U o 5 (e Estimated Value of Project: � 1 \ � 4t 3 00 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd TRACMG PERMIT FEES Plan Sets Plan Check submitted C� Item Amo at . Structural Cala. Reviewed, ready for corrections Plan Check Deposit. r Truss Cates. Called Contact Person Plait Check Balance Title 24 Cold. Plans picked up Construction Flood plain plan Plans resubmitted.. Mechanical Grading plan V Review, ready for correctionsAssue Electrical �. Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up f S.M.L H.O.A. Approval Plans resubmitted Grading IN HOUSE:- 'Review', ready for correction saeDeveloper Impact Fee Planning Approval. Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue 0 School Fees Total Permit Fees .7 1 . ..