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BSCL2014-003678-495 CALLE TAMPICO LA QUINTA, CALIFORNIA Td4r4 4Qumrw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BSOL2014-0036 Property Address: 54778 TANGLEWOOD APN: 775052012 Application Description: 3.25kW PV SYSTEM - (13) 250W PANELS/(1) INVERTER Property Zoning: Application Valuation: $15,000.00 Applicant: D T A K ELECTRIC INC g 1654 ILLINOIS AVENUE STE 18 GCC 3 204 PERRIS, CA 92571 CITY OF LA QUINTA COMMUNITY DEVELOPMENT DEPAftfMENT 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: CSO License No.: 947912 Date: 12 - 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 DivisionN 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 Address: VOICE (760) 777-71.5 FAX (760) 777-70_1 INSPECTIONS (760) 777-71-53 Date: 12/1/20=4 Owner: RAY, BURDICK M 18 CHAPARRAL CT LA QUINTA, CA 92253 Contractor: T A K ELECTRIC INC 1654 ILLINOIS AVENUE STE 18 PERRIS, CA 92571 (951)970-3150 Llc. No.: 947912 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 bti 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: _ 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 those Tisions. ate: - I Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TC ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR COC E, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOWLEDGEMENT , IMPORTANT: Application is hereby made to the Building Official for a permit subject ko 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 if work.for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is corr--ct. I agree to comply with all city and county ordinances and state laws relating to builcing construction, and hereby authorize representatives of this city to enter upon the above• mentioned property for inspection purposes. _ Date: 12 Signature (Applicant or Agent)�� FINANCIAL INFORMA•TION k7 , N 1, , 1�. U Nt, v.0 I !7 PAID DATE 4M'66NT� BSAS SB1473 FEE 101-0000-20306. 0 $1.00 $0.00 ID BY"•",METHOD ECEI CHECK.#, CLTD, BX-;' Total Paid for BUILDINGSTANDARDS ADMINISTRATION BSA $1.00 $0.00 DESCRIPTION .,.`• �7*06NT - -'��4r�66NT�14�,f 2,7 77, 7 -PAID _PAID DATE` PV SYSTEM - ARRAY, FIRST 20 101-0000-42403 0 $24.17. $0.00 c""PAID BY ' ,,, %- METHOD ,RECEIPT # 44 ' DESCRIPTION ACCOUNT A , QTY � • 4MQ6NT,.,f"r,-, tk-w,;, 7,s PAID DATE: PV SYSTEM -ARRAY, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 �.Al D BY:4-,- METHOD 5V !��4,RECEI�T,�� H P BY Total Paid for ELECTRICAL: _$48.34 $0.00 DESCRIPTIONS PT' ACCOUNT `QTY i..AID'DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Y*�,,PAID_ BY �WETH, D-,-` '4 4 0 RECEIPT 'CHECK %CLTD BYx Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS: $141.19 $0.00 • Description: 3.25kW PV SYSTEM - (13) 25OW PANELS/(1) INVERTER Type: SOLAR Subtype: Status: APPROVED Applied: 11/5/2014 KHE Approved: 11/24/2014 JFU Parcel No: 775052012 Site Address: 54778 TANGLEWOOD LA QUINTA,CA 92253 Subdivision: TR 21846-3 Block: Lot: 3 Issued: Lot Sq Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $15,000.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 11/17/2014 Details:. 3.25kW SOLAR ARRAY - (13)250W HYUNDAI HIS-M250MG (BK) MODULES W/ (1) SOLAREDGE SB3000TU-US-22 INVERTER [208SF] 2013 CALIFORNIA ELECTRICAL CODE. T. Applied 1:6 Approved i M. r ` <•' � tee` ' �*� � a � y� ADDITIONAL CHRONOLOGY CHRONOLOGY TYPE ' STAFF,NAME ACTION DATE;; mCOMPLETION DATE' NOTES f . .:,. 4 CONTACTED NADIA WITH T.K.A. ELECTRIC TO NOTIFY. HER E-MAIL JAKE FUSON 11/17/2014 11/17/2014 PLAN REVIEW WAS DONE AND REVISIONS WERE REQUIRED. EMAILED HER THE REDLINED_ PLANS AND FIRST CORRECTION LIST. PLAN CHECK SUBMITTAL KAY HENSEL 11/5/2014 11/5/2014 RECEIVED ' ' LEFT MESSAGE W/ NADIA CONTRERAS AT T.A.K. ELECTRIC t TELEPHONE CALL JAKE FUSON 11/24/2014 11/24/2014 NOTIFYING HER PLANS WERE APPROVED AND PERMIT READY TO ISSUE. . CONDITIONS Printed: Monday, December 01, 2014 12:44:14 PM 1 of 3 C SYSTEMS PARENT PROJECTS ',vl."� Llr lwi.I1 C...I r... T/f.GIaf1C..%. C...CLS'IaIa:GG.IL-I1.ATGaitf\LILf\.A_T.r .RETURNED'I �; ,.= r�At1.��.� °�' �'� .,�...'A:�� '_;” --"a .•.L..r«�. --4� Printed: Monday, December 01, 2014 12:44:14 PM- 2 of 3 V SYSTEMS •NTACTS '�'NAME•TYPE ' ` " '„' "NAME,`!; - -: _� ' ADDRESSl ' hCITY• ' STATE ZIP. '- -PHONE, FAX''' 'ENTAIL «: ,. k APPLICANT T A K ELECTRIC INC 1654 ILLINOIS AVENUE PERRIS CA 92571 STE 18 CONTRACTOR T A K ELECTRIC INC 1654 ILLINOIS AVENUE PERRIS CA 92571 .. STE 18 OWNER RAY, BURDICK M 18 CHAPARRAL CT LA QUINTA CA 92253 I• FINANCIAL •• , >DESCRIPTION";=ACCOUNT , `' 'QTY= `AMOUNT PAID r•:' PAID DATE; RECEIPT # CHECK#i" METHOD PAID BYE,, bLT e BY, R BSAS 561473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid forBUILDING 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 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:00 PARENT PROJECTS ',vl."� Llr lwi.I1 C...I r... T/f.GIaf1C..%. C...CLS'IaIa:GG.IL-I1.ATGaitf\LILf\.A_T.r .RETURNED'I �; ,.= r�At1.��.� °�' �'� .,�...'A:�� '_;” --"a .•.L..r«�. --4� Printed: Monday, December 01, 2014 12:44:14 PM- 2 of 3 V SYSTEMS ssREVIEW:TYPE.REVIEWER :.SENT DATE .. . �,.,. .. n,:'. DUE DATE n.. `.:`.,�;yw,-+-.a. �,r-�'..`y) F ? DATE 'aSTATU5x4::s rtREMARKS ? -; * a , ;°:1NOTES-.< -- s s,Y '� y,r 3. ycp�, ' 4"1 ., yy,, �-9✓' Y -YV h y, �tST)v (y , } r- d�r,! ^a. ,Wh ^ ±• .lft ^ � nA"':+�'A.i ... ..#. .�+.^3. ' h..:e '.**'Si�. �M R-"f�.w "'_1sJ: S.sa�-`•'"�Y. -r °3'.. "�. .�':�"..d:T ... �'�k. `, � . NON-STRUCTURAL JAKE FUSON 11/5/2014 11/12/2014 11/17/2014 REVISIONS REQUIRED SEE ATTACHED REVIEW. NON-STRUCTURAL JAKE FUSON 11/24/2014 12/1/2014 11/24/2014 APPROVED Printed: Monday, December 01, 2014 12:44:14 PM 3 of 3 i C SYSTEMS - 4 - BOND INFORMATION J ATTACHMENTS Attachment T e , ,;�. CREATED w -,,DESCRI TPTION UBIR ,, AOWNER BLED Y= DOC 11/17/2014 JAKE FUSON SOLAR FIRST REVIEW ood = 547781st 0 docx Printed: Monday, December 01, 2014 12:44:14 PM 3 of 3 i C SYSTEMS - 4 - Bin.# QtY of LCI QuiCtta BA tng gt Safety Division P.O. Box 1504,78-495 Calle Tampico La.Qi inta, CA 92253 -:(760) 777-7012 Building Permit Application` and Tracking Sheet Permit #tea p b Project Address: �j Owner's Name:. A. P. Number. Address: .5 i3�1 Legal Description: Contractor. �. City, ST, Zip: uav 000 2_2_j Telephone: Address: 5 �. . O `SALL 4— te Project Description: P City, ST, Zip: 2� ` ��vft rJ0 ' ' Telephone 1�� 2OO '��<l .�� z Qa�> `"> j State Lic. # : City Lie # Arch, Eng., Designer. Address: City, ST, Zip: Telephone: r State Lic. #:ra ` Name of Contact Person: ! �� Construction Type:. Occupancy: Project type (circle one): New Add'n Alter Repair Demo. . - Sq. Ft.: # Stories:# Units: Telephone # of Contact Person: 5 ( OO Estimated Value of Projectl 15W) APPLICANT: DO NOT WRITE BELOW THIS UNE # Submittal Req'd "Reed TRACMG PERMIT FEES Plan Sets Plan Check submitted Reviewed, ready for corrections If//7 Item Amount Plan Check Deposit.. . Structural CaIcs. Truss Cates. Called Contact Person EMA 11_ t ! 7 Plan Check Balance Title 24 Celts. Plans picked up Construction Flood plain plan Plans resubmitted.. (I Mechanical Grading plan r4 Review, ready fory5lEp64lcb8 issue l 12 Electrical SabcoutactorUst Called Contact Person I I Z Plumbing Grant Deed Plans picked up S.M.L H.O.A. Approval Plans resubmitted Grading IN ROUSE:- '"' Review; ready for correctionslissue Developer Impact Fee Planning Approval Called Contact Person A.LP.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees