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BPLB2015-002378-495 CALLE TAMOICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: . Application Valuation: 4 \ COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BPLB2015-0023 55306 SHOAL CREEK ' 775142017 SOLAR THERMAL POOL HEATING SYSTEM $14,847.00 Applicant: . MOHR POWER SOLAR, INC. OUTSIDE CITY LIMITS LA QUINTA, CA 92253 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 -0108665 Date: `f—'y—� Contractor:yn2' 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 Divisiori of the Business and Professions Code) or that he or she is exempt therefrom and th 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) 777-7125` FAX (760) 777-7011 INSPECTIONS (760) 777-7153; Date: 4/8/2015 Owner: PGA WEST RESIDENTIAL HOMEOWN P 0 BOX 1060 LA QUINTA, CA 0 Contractor: MOHR POWER SOLAR, INC. OUTSIDE CITY LIMITS LA QUINTA, CA 92253 (951)736-7000 Llc. No.: :LIC -0108665. 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: _ IPolicy Number:_ I certify that in the performance of the work for which this permit is issued, II 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 th�o^se provisions. Date: L! r 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 THOUSANDDOLLARS ($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 u on the above• mentioned property for inspection purposes. Date: Signature (Applicant or Agent): • FINANCIAL INFORMATION ` ` g'�DE3CRIPTIO X, r � ACCOUNT ; QTY AMOUNT PAID' y `wx' PAID DATE z y 3 w... . BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 3=PAIDBY r' METHOD' r ',.CHECK#-4r*'CLTDBY s.a; c� ,'•. _..0 $'RECEIPT# Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 q. -:DESCRIPTION 2 `` ACCOUNTS QTY ;, y x� AMOUNTS PAID , PAID DATE: m`� ?'; PERMIT ISSUANCE 101-0000-42404 0 .$91.85 $0.00 i"'^Y, . 'Y D ' }.� PAID BY '.4 Y' yyT 73 ''. j ..._ S RECEIPT- '` �{ i3 k i L T 3 CHECK # CLTD 13 i,J t, r F•� g�.r "`'R ®METHOD 4:y s ,. y .# ..� Total.Paid forPERMIT ISSUANCE: $91.85 $0.00 §" DESCRIPTION w *.m,A00O.UNT >rf �� x ` 'PA'ID�� DATE s f4 iN ,QTYAfVIOUNT wPAlf) WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $12.09 $0.00 k q 411PAIQ' BY 3 j�. ' �< = METHODT ;` x # CHECK # a $ `CLTD BY ti a „°` RECEIPT a g . +t, v ' k DESCRIPTION ACCOUNT l QTYx AMOUNTS' e P: g f PAID DATE' �. pr ; s ,PAID' WATER SYSTEM INST/ALT/REP PC 101-0000-42600 0 $12.09 $0.00 PAID: BYE ;: x =METHOD '� ' 'RECEIPT # `' <; €CHECK # CCTV BY; a Total Paid forPLUMBING FEES: $24.18 $0.00 TOTALS:• 00 • k • J ' 4. Description: SOLAR THERMAL POOL HEATING SYSTEM ADDITIONAL Type: PLUMBING Subtype: Status: APPROVED Applied: 2/17/2015 KHE Approved: 2/17/2015 JFU Parcel No: 775142017 Site Address: SS306 SHOAL CREEK LA QUINTA,CA 92253 Subdivision:•TR 20717-3 Block: Lot: 10 Issued: Lot.Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $14,847.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 - Details: SOLAR THERMAL POOL HEATING SYSTEM. 2013 CODES. 2/17/2015 . FINANCIAL INFORMATION Printed: Wodnocday, April 08, 3015 12128iS9 PM 1 of 2 SYSTEMS ADDITIONAL CHRONOLOGY CHRONOLOGYVPE �7 ', STAFF NAME-S =sACTION DATE:(9 : DATE `r NOTES ° :. ,.. �;COWIPLETION ,, PLAN CHECK SUBMITTAL KAY HENSEL. 2/17/2015 2/17/2015 . RECEIVED .. -. NOTIFIED FRANK WITH MOHR POWER SOLAR THAT PLAN TELEPHONE CALL JAKE FUSON 2/17/2015 2/17/2015 REVIEW WAS COMPLETE AND PERMIT READY TO ISSUE. CONDITIONS CONTACTS a ADDRES51 a CITYim ;NAME TYPE aNAME STATE ZIP ."" EPHONE FAX EMAIL 4 aa, , _ .. .. .. ... rie.f a- �.;va+ w APPLICANT MOHR POWER SOLAR, INC.' OUTSIDE CITY LIMITS LA QUINTA CA 92253 CONTRACTOR MOHR POWER SOLAR, INC. OUTSIDE CITY LIMITS LA QUINTA CA 92253 OWNER PGA WEST RESIDENTIAL HOMEOWN P 0 BOX 1060 LA QUINTA CA 0 FINANCIAL INFORMATION Printed: Wodnocday, April 08, 3015 12128iS9 PM 1 of 2 SYSTEMS DESCRIPTION. a ACCOUNT *F q TY AMOUNT . F PAID PAID RECEIPT " _ CHECK # METHOD PAID BY CLTD j _ L � _ BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 Total Paid for BUILDING STANDARDS ADMINISTRATION $1.00 $0.00 BSA: PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 Total Paid for PERMIT ISSUANCE: $91.85 $0.00 WATER SYSTEM 101-0000-42401 0 $12.09 $0.00 INST/ALT/REP WATER SYSTEM 101-0000-42600 0 $12.09 $0.00 INST/ALT/REP PC Total Paid for PLUMBING FEES: $24.18 $0.00 TOTALS: .$117.03 $0.00 PARENT PROJECTS BOND INFORMATION ATTACHMENTS Printed: Wednesday, April 0$, 2015 12;28;59 PM 2 of 2 SYSTEMS Bin ff . City of La Qui P:- `Building 8i' Safety Division P.O. Box 1504, 78-495 Calle Tampico.. La Quinta, CA 92253 - (760) 777-7012 Building PermitApplication and Tracking Sheet Permit !'" U Project Address: CCj --��Ocp Owner's Name: �^ K _ A. P: Number: Address: 9�3 ��t�CO ;JI!t0 �e a Legal Description:City, ST, Zip: ( Qtt�✓� �oCo�(J Contractor: (j V\� �v�.0 �Gl� S� Telephone: r:•,,, ;<>;:<>:::><::>;>, :; <.>>;::::a:: Address: 1��� 00AoAcI ProjectDescription: City, ST, Zip: LO (_Ov\-1 T {b � C-q:L oL SOL(- a oe, 'F� Telephone:Yl�7 State Lic. # :- City Lic. # Arch., Engr., Designer: Address: City., ST, Zip: Telephone: State Lic. #: ' Construction Type:' Occupancy: Add'n Alter Repair Demo ect tyPa circle one): Name of Contact Person: Sq. Ft.: # es: # Units: Telephone #,of Contact Person: 4 l . ©• I Estimated Value of ro'ect: 1.: 8 APPLICANT: DO NOT WRITE BELOW THI INE # Submittal Req'd Rec'd TRACMG R IT FEES. Plan Sets Plan Check'submitted Item Amount.' Structural Calcs. Reviewed, rcady:for, t3P*I.st✓F 2-/11 ..Plan Check Deposit Truss Cales.. Called Contact Person. ( Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood: plain plan Plans resubmitted . Mechanical , Grading.plan 2"° Review; ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I.; H.O.A..Approval Plans resubmitted Grading IN IiOUSE:- ' '`d Review, ready for corrcctions/issue Developer Impact'Fee Planning Approval Called Contact Person`vt Pub. Wks. Appr Date of perm.it issue School Fees CITY of. LA QUINT �1"Ptfmit. ccs