BSOL2014-0011LICENSED 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: License No.: :LIC -0108752
Date: Contractor: 14-,Q -
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.).
(_) 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 Add
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
ssued. 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 hose ovisions. D
pate: 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 ($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 property for inspection purposes.
l
Date: t Signature (Applicant or Agent): v
VOICE (760) 777-7125
78-495 CALLE TAMPICO
D
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/29/2014
Application Number: BSOL2014-0011
Owner:
Property Address: 51414 CALLE ILOILO
SENTHIL PARVATHARAJAN
APN: 770165005
51414 CALLE ILOILO
Application Description: 4.1kW PV SYSTEM
- (16) 255W PANELS+ ERS/(1) INVERTER
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: $9,016.00
a
Applicant:
29 214
SEp
Contractor:
SOLARCITY CORPORATION
SOLARCITY CORPORATION
0 OUTSIDE CITY LIMITS
OF LA NTA TMENT
0 OUTSIDE CITY LIMITS
LA QUINTA, CA 92253
OOMMUNN yELOWENTOEP�
LA QUINTA, CA 92253
(650)638-1030
LIc. No.: :LIC -0108752
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: License No.: :LIC -0108752
Date: Contractor: 14-,Q -
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.).
(_) 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 Add
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
ssued. 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 hose ovisions. D
pate: 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 ($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 property for inspection purposes.
l
Date: t Signature (Applicant or Agent): v
FINANCIAL INFORMATION
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION'
ACCOUNT
CITY
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
CITY
AMOUNT
PAID
PAID DATE
PV SYSTEM - ARRAY, FIRST 20 PC
101-0000742600
0
$23.83
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for ELECTRICAL: $47.66 $0.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
TOTALS:$0.00
Description: 4.1kW PV SYSTEM - (16) 255W PAN ELS+OPTI M IZERS/(1) INVERTER
Type: SOLAR Subtype: Status: APPROVED
Applied: 9/8/2014 SKH
Approved: 9/29/2014 AOR
Parcel No: 770165005 Site Address: 51414 CALLE ILOILO LA QUINTA,CA 92253
Subdivision: DESERT CLUB TR UNIT 2 Block: 3 Lot: 20
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $9,016.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
CHRONOLOGY TYPE
Details: 4.1kW SOLAR ARRAY - (16) 255W KYOCERA PANELS+SOLAREDGE P300 OPTIMIZERS W/ (1) SOLAREDGE SE3000A-US-ZB-U-AFCI
INVERTER [288SF] 2013 CALIFORNIA ELECTRICAL CODE.
Printed: Monday, September 29, 2014 10:58:28 AM 1 of 3 C��CVCTFMC
CHRONOLOGY
CHRONOLOGY TYPE
STAFF NAME
ACTION DATE
COMPLETION DATE
NOTES
E-MAIL
AJ ORTEGA
9/26/2014
9/26/2014'
1ST REVIEW COMMENTS SENT BY EMAIL TO MELISSA WITH
SOLARCITY.
E-MAIL
AJ ORTEGA
9/29/2014
9/29/2014
EMAILED MELISSA AT SOLARCITY THAT PERMIT IS READY TO
ISSUE.
CONDITIONS
CONTACTS
NAME TYPE
NAME
ADDRESSI
CITY
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
SOLARCITY CORPORATION
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
(650)638-1030
CONTRACTOR
SOLARCITY CORPORATION
0 OUTSIDE CITY LIMITS
LA QUINTA
CA
92253
(650)638-1030
OWNER
SENTHIL PARVATHARAJAN
51414 CALLE ILOILO
LA QUINTA
CA
92253
(650)638-1030
Printed: Monday, September 29, 2014 10:58:28 AM 1 of 3 C��CVCTFMC
PERMIT NUMBER
Permit Details
City of La Quinta BSOL#2014-00.11 s
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
SOLAR FINAL*"
REVIEWS
REVIEW TYPE
REVIEWER
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
9/29/2014
9/29/2014
APPROVED
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $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
Total Paid for ELECTRICAL: $47.66 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$90.57
$0.00
Total Paid for PERMIT ISSUANCE: $90.57 $0.00
TOTALS:• •0
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
SOLAR FINAL*"
Printed: Monday, September 29, 201410:58:28 AM 2 of 3
�J��CVCTFM C
REVIEWS
REVIEW TYPE
REVIEWER
SENT DATE
DUE DATE
RETURNED
DATE
STATUS
REMARKS
NOTES
NON-STRUCTURAL
AJ ORTEGA
9/8/2014
9/22/2014
9/26/2014
REVISIONS REQUIRED
1ST REVIEW COMMENTS SENT BY EMAIL TO
MELISSA WITH SOLARCITY, SEE ATTACHED
NON-STRUCTURAL
AlORTEGA
9/29/2014
9/29/2014
9/29/2014
APPROVED
Printed: Monday, September 29, 201410:58:28 AM 2 of 3
�J��CVCTFM C
Permit Details PERMIT NUMBER
City of La Quinta
BSOL-2-01WOO, 1
Printed: Monday, September 29, 2014 10:58:28 AM 3 of 3�CVCTFMC
ATTACHMENTS
Attachment Type
.—CREATED
OWNER-
DESCRIPTION
PATHNAME
SUBDIR
ETRAKITENABLEEV
BSOL2014-0011- 51-414
'
DOC
9/26/2014
AJ ORTEGA
SOLAR 1ST REVIEW
CALLE ILOILO 1ST
-
0
COMMENTS
REVIEW
COMMENTS.pdf
Printed: Monday, September 29, 2014 10:58:28 AM 3 of 3�CVCTFMC
e
Bin # ..
City. Of. Ld Quints
BuikUng 8r Safety Dwon
P.O. Box 1504,-78-49S Calle Tamplco
4.Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
`,,5a-Ze�l4-
Cx� l I
Project Address: 'S I LI I I �. U
Owner's Name:. �
A. P. Number.
1�
j
Address: S/ lie 1' 01 J U
Legal Description:
City. ST, Zip: Lj I• N G !T 9-7z S
Contractor. �i5 (�� G
Telephone:
Address: 3oss Ir ew
Project Description: "
City, ST, Zip: SCIA0 4e_QT U
SO 10, S'
Telephone:
Ve-r
State Lia #: g g(w 104 City Lic. #;
Arch, EW.. Designer.
Address:
City., ST, Zip:
Telephone:
Construction Type:. Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
Sq. FL: # Stories: # UnitF.
State Lic. #:
Name of Contact Person: H. `l �� o
Telephone # of Contact Person: . p — C._DL)31Z
Estimated Value of Project 0
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Satimittal
ReVd
Reed
TRACKING PERMIT FEES
Plan Sets
Plan Cheng submitted a Item Amount
Struduhd Calls.
Reviewed, ready for corrections Plan Check Deposit.
Truss C21cs.
Caged Contact Person Pian Check Balance
Title 24 Cala.
Plans picked up Construction
Flood plain plan
Plans resubmitted.. N Mechartteal
Grading plan
E'! Review, ready for correctionsPissue Electrical
Subeoutactor List
Called Contact Person Plumbing
Grant Deed
Plans picked up SALT.
H.O.A. Approval
Plans resabmitted Grading
IN HOUSE.-
''' Review; ready for correctio I D veloper Impact Fee
Planning Approval
Called Coutaet Person A.LP.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees