BSOL2015-015278-495 CALLE TAMPICO C� A V VOICE (760) 777-7125
FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/2/2015
Application Number:
BSOL2015-0152
Owner:
Property Address:
54900 AVENIDA VALLEJO
DAVID JOSEPHINAGALVAN o
c
APN:
774302025
54900 AVENIDA VALLEJO
Application Description:
6.27kW PV SYSTEM - (22) 280W PANELS/(22) MICRO -INVERTER
LA QUINTA, CA 92253
Property Zoning:
m
m
Application Valuation:
$25,000.00
o
rn
Applicant:
Contractor:
c
KIRSHNER & SCHMIDT INC DBA ECO
KIRSHNER & SCHMIDT INC
0 c rt
360 E FIRST ST STE 800
360 E FIRST ST STE 800
TUSTIN, CA 92780
TUSTIN, CA 92780
Z
z
C
(714)824-0047
Llc. No.: 366984
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 Liceri'se,is in full force and effect.
License Clas : AB C12 C21 C33 C10. C46 License : 366984
Dat 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
($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
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 th rk for which this permit is issued.
ZI have and will maintain workers' compensation insurance, as required by
Secti 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 t ose provisions.
Da`Ye: —1 1� Applicants
i
WARNING: FAILURE TO SECURE WOR RS' 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 theapplicant,. 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 Pro erty for inspection purposes.
Date"/- ' Signature (Applicant or Agent: -
FINANCIAL INFORMATION
:.. :' �'
�' ACCOUNT - QTY' 'AMOUNT ` "' `P OI D ATE
-x PAID
,DESCRIPTIONf ...> r k e
%max Y r ,f x.
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$0.00
PAID BY `r�;<`
' 2 METHOD€*RECEIPT #*�
.,a CHECK # 4 CLTD BY '
rs4„
,
_
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
f'" y ry� �' °
# ACCOUNT '
tiQTY }„:
AMOUNT..
:3 Pi41D
tPAID DATE
x ;DESCRIPTION
,
PV SYSTEM - ARRAY, FIRST 20
101-0000-42403
0
$24.17
$0.00
T
t PAID BY” `r
* Y4 P
METHOD
RECEIPIT #�
CHECK #
CLTD BY.
<y"
�4
irk g'.'
,
DESCRIPTION �_ _x z
*14. ACCOUNV';4
'QTY
,AMOUNT
'. PAID *
DATE
�..r
: 1 t
,
,PAID
PV SYSTEM - ARRAY, FIRST 20 PC
101-0000-42600
0
$24.17
$0.00
r a
tPAID:BY "`:
��
METHOD
-
CHECK#
CLTDBY,'
s;,
r
uU:RECEIPT#`�""�:
Total Paid for ELECTRICAL: $48.34 $0.00
DESCRIPTION .: <" o
x. ACCOUNT
QTY
�,'a AMOUNTS
r PAID �
PAID DATE:
, .'r; z
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID�BY%c
METHOD ��
?RECEIPT #
CHECK #-
YCLTD BY
,..
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
TOTALS:••
Description: 6.27kW PV SYSTEM - (22) 280W PANELS/(22) MICRO -INVERTER
Type: SOLAR Subtype:- Status: APPROVED
Applied: 8/25/2015 PJU
Approved: 9/1/2015 LUR
Parcel No: 774302025 Site Address: 54900 AVENIDA VALLEJO LA QUINTA,CA 92253
Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: 312 ,_ Lot: 17
Issued:
UNIT 28
PLAN CHECK SUBMITTAL
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $25,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
RECEIVED
Details: 6.27kW SOLAR ARRAY - (22) 28OW SUNMODULE PLUS PANEL W/ (22) ENPHASE M250 MICRO -INVERTERS [396SF] 2013 CALIFORNIA -
ELECTRICAL CODE.
ADDITIONAL SITES
Printed: Wednesday, September 02, 2015 8:20:46 AM 1 of 2
sysrrnns
CHRONOLOGY
CHRONOLOGY TYPE _ ""; STAFF,NAME " _", E f ` ACTION DATE : ;
_
. - ,COMPLETION DATE
a
' M '+ NOTES
PLAN CHECK SUBMITTAL
PHILIP JUAREZ
8/25/2015
8/25/2015
RECEIVED
-
SPOKE TO DONA LET HER KNOW PERMIT IS READY TO BE
TELEPHONE CALL
LUIS URIBE
9/1/2015
9/1/2015
ISSUED.
•
•
•
NAMETYPE NAME F
ADDRE551
CITY...:. STATE
ZIP'
..'PHONE
.APPLICANT KIRSHNER & SCHMIDT INC DBA ECO
360 E FIRST ST STE 800 TUSTIN CA
92780
(818)304-0810
CONTRACTOR KIRSHNER & SCHMIDT INC DBA ECO
360 E FIRST ST STE 800 TUSTIN CA
92780
(818)304-0810
OWNER DAVID JOSEPHINA GALVAN
54900 AVENIDA LA QUINTA CA
92253
(818)304-0810 •
VALLEJO
Printed: Wednesday, September 02, 2015 8:20:46 AM 1 of 2
sysrrnns
BOND INFORMATION
Printed: Wednesday, September 02, 2015 8:20:46 AM 2 of 2
CM&WlYSTEMS
FINANCIAL
INFORMATION
DESCRIPTION =.' ` `. ACCOUNT *^ -zQTY
AMOUNT
* PAID PAID DATE „RECEIP_T # .CHECK #'. ;METHOD,, *PAID BYa _ CLBTD^
LL
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00
$0.00
BSA:
PV SYSTEM = ARRAY,
101-0000-42403
0
$24.17
$0.00
FIRST 20
PV SYSTEM - ARRAY,
101-0000-426.00
0
$24.17
$0.00
FIRST 20 PC
Total Paid forELECTRICAL:
$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
BOND INFORMATION
Printed: Wednesday, September 02, 2015 8:20:46 AM 2 of 2
CM&WlYSTEMS
' Clty La Quin
C Btdkong a Safety Division
Sv� P.O. Box 1504,78-495 Calle Tampico
La..Qtlinia, CA. 92253 -:(760).77T7012
Building Permit Application and Tracking Sheet
Petinft #
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ojectAddress: f Lq � e C>'
Owner's Name:. ;N A vi
P. Number. ,gal
rLeA-
Description:
Contractor:.`
Address: Ko ' SU
City, ST, ZiprJ
Telephone: -
Project Description:
City, ST, Zip: SSe1n 44G(D')o
gs
Telephone
�a `�vtf rl
CI�: 7i $ �t�h,�— ,
State Lic # City Lie'.!A
Arch, Bngr., esigner. 5 , b
Address: .
City, ST, Zip:
Telephone:
State Lie. #: Y
Construction Type: gd)4� Occupancy:
Project type (circle one): ew Add'n Alter Repair Demo
' Sq. FL: # Stories: ( # Units:
CR par
Name of Coitact Person:
Telephone # of Contact Person: ( (• 6.7 Cj
, Estimated Value of Proj�k
APPLICANT: "DO NOT WRITE BELOW THIS LINE -
#
Submittal
Req'd
Reed
TRACING
PERMIT FEES
Plan Sets
Pian Check submitted
Item . Amount '
Strrtcturw Calci.
Reviewed, ready for corrections
Plan Check Deposit. .
Trans Cales.
Called Contact Person
Pian Check Balance
Title 24 Calci.
Pians plaid up
Constriction
Flood plain plan
Plans resubmitted.',
Mechanical
Giading plan
2' Review, ready for corrections/issue
Electrical
Subeontaetor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
11.0.4— Approval
Plans resubmitted
Grading
IN HOUSE:-
""' Review; ready for corrections/issue
Developer Impact Fee
Planning Approval.
Called Contact Person
A.I.P.P.
Pub. Wks. Appr `
Date of permit issue
'
School Fees
,
`
Total Permit Fees .