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11-0452 (SOL)P.O. BOX 1504. 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: 11-00000452 Property Address: 53630 AVENIDA NAVARRO APN: 774-135-007-18 -000000- Application description: SOLAR Property Zoning: COVE RESIDENTIAL Application valuation: 25000 Applicant: Architect or Engineer: 14A. ------------------ LICENSED CONTRACTOR'S DECLARATION • ��IVIN� BUILDING & SAFETY DEPARTMENT BUILDING PERMIT 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 Professionals Code, and my License is in full force and effect. J License Class: B1 License No.: 550864 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 1$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.). (_ 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 VOICE. (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Date: 8/25/11 Owner: SLATER DARLENE/BRANDON 53630 AVENIDA NAVARRO LA QUINTA, CA 92253 Contractor: D d BLS CONSTRUCTION IN AUG 77-770 ROBIN ROAD MUG 2 C 20�� PALM DESERT, CA 922 1 V (760)275-9116. Lic. No.: .550864 C1_T.y.90F:40u11u*e 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 STATE FUND Policy Number 1932584-2011 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 1 should become subject to the workers' compensation provisions of Section 3700 of the Lab�on```rrr f,�Qwean I shall forthwith comply with those provisions. 0 Date4khl Applicant: 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 15100,0001. 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 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 county to enter upon the above-mentioned property for. inspec ' urposes. Dater Signature (Applicant or Agent): f/ Application Number . . . 11-00000452 Permit SOLAR PERMIT" r Additional desc . Permit Fee . . 22.50 Plan Check Fee 5.63 Issue Date Valuation . . . . 25000 Expiration Date 2/21/12 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 Permit . . . ELEC-MISCELLANEOUS Additional desc . Permit'Fee 22.50 Plan Check Fee 5.63 Issue Date Valuation . . . . 0 Expiration Date 2/21/12 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 7.5000 -EA ELEC PWR APP >1 TO <=10 7.50 - , Special Notes and Comments 4.6kW SOLAR ARRAY - (20) 230w CANADIAN SOLAR PANELS W/ (1) 420OW POWER -ONE PVI INVERTER [34.OSF) ADDITION TO EXISTING 1.3kW PV SYSTEM [PERMIT 10-00341 2010 CALIFORNIA ELECTRICAL CODE. August 25, 2011 5:01:32 PM AORTEGA ---------------------- ----------------------------------------------------- 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 -11.2.6 .00 .00 11.26 Other Fee Total 1.00 ..00 .00 1.00 Grand Total 57.26 .00 .00 57.26 - • LQPERMIT - Bin # CI y Of La Quinta Building &r Safety Division P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 Building Permit Application and Tracking Sheet Permit # Project Address: ��'3D "gkNlQ4 '*14V -)*2D Owner's Name: A. P. Number: Address: 53- 30 IfW41140-1' pK40,9s22a Legal Description: City, ST, Zip: Contractor:S Telephone: —16y 31 < Address: 77 770 /(!?06.^/ Project Description: /If /Z .City, ST, Zip: A -b-( �OfP�j G/� g'ZZ// I �i�/ST/moi �YSfPiy7 "- Telephone: State Lic. # : City Lic. #; Arch., Engr., Designer: Address: City., ST, Zip: Telephone: �>•::.::.:.}::•;:..Y:«:.>.<:..::.:,:..>.:.«..<..i.::.Construction State Lic. #: ;<s ;;« Name of Contact Perso . 0 0//--11 Type: Occupancy: eY: Project type (circle one): New Add'n :Alter Repair Demo S Ft.: �— # Stories: # Units: JTelephone # of Contact Person: © -7 %�I Estimated Value of Project: 625,C00 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Recd EI V PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. A 1 Reviewed, ready for correcNAY 3 2 ry1�` Plan Check Deposit ^ Truss Calcs. Called Contact Person �� a Plan Check Balance • ^ Title 24 Calcs. Pians picked up BY: l� II Construction 5•� �� Flood plain plan Plans resubmitted A WIMP Mechanical —� Grading plan 2qd Review, ready f correctio /issue Electrical Subcontactor List Called Contact Person Plumbing / Grant Deed Plansu icked P P A 18U S.M.I. H.O.A. Approval Plans resubmitted Grading IN HOUSE:- '"' Review, ready f recti issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue 1$'Q1. Ito School Fees U 1>%4' �- r Total Permit Fees UT Iv,• CG*a.IUOA 'LW4 314640' 1AW 19 -Olu "601hE� b14It6tl • P�a.�,rtrt� 6170 "<<- -S&A'1 9ft- 714utt UABP7 WrTri woc,uOrs-c-i Al (.0jo-eo-