12-0707 (SOL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 12-00000707
Property Address: 60584 WHITE SAGE DR
APN: 764-270-999-108 -300231-
Application description: SOLAR
Property Zoning: MEDIUM HIGH DENSITY RES
ADDlication valuation: 28000
Applicant:
T-i&t - 4 4 Q"
Architect or Engineer:
OA,
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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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 Busing n ssionals Code, and my License is in full force and effect.
License Cla,ss: B, C10 C20� \ License No.: 888104
NDate:z", Contract
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).:
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.).
(_) 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
Owner:
MIKE DOYLE
60584 WHITE SAGE D
LA QUINTA, CA 9225
VOICE (760) 777-7012
- 760)777-7011
Q INS CTIOI 760) 777-7153
D7/12/12
AIL 1 � 2012
:IV rI'rY OF LA QUIN�fA
Contractor:
SOLARCITY CORPORATION
2896 METROPOLITAN PLACE
POMONA, CA 91767
(650)638-1028
Lic. No.: 888104
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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 ZURICH AMERICAN Policy Number WC967346703
_ 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 shout ubject to the workers' compensation provisions of Section
700 of the Labor Code I shall fortith comply �aitlail�ose provisions.
'7 C (\/]
/ Date: ! C. 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 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 buildegTbMw4,ption, and hereby authorize representatives
of this court y to nter upon the above -mention property cr inspects purposes.
Date: 74 (Applicant or Agent):
Application Number . . . . . 12-00000707
Permit . . .
SOLAR PERMIT
Additional desc .
Permit Fee . . . .
22.50 Plan Check Fee
5.63
Issue Date . . . .
Valuation . . .
. 28000
Expiration Date . .
1/08/13
Qty Unit Charge
Per -
Extension
BASE FEE
15.00
1.00 4.5000
EA SOLAR COLLECTOR < 1000
4.50
1.00 3.0000
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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
1/08/13
Qty 'Unit Charge
Per
Extension
BASE FEE
15.00
1.00 7.5000
EA ELEC PWR APP >1 TO <=10
7.50
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Special Notes and Comments
7.9kW SOLAR ARRAY - (33)
240W YINGLI
PANELS W/ (1) 7000W SUNNY
BOY INVERTER
(561SF) 2010 CALIFORNIA
ELECTRICAL CODE.
July 12, 2012 9:51:08
AM AORTEGA
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Other Fees . . . . .
. . . . BLDG STDS ADMIN (SB1473)
2.00
Fee summary Charged Paid Credited
Due
---------------------------
Permit Fee Total
------------------------------
45.00 .00 .00
45.00
Plan Check Total
11.26 .00 .00
11.26
Other Fee Total
2.00 .00 .00
2.00
Grand Total
58.26 .00 .00
58.26
LQPERMIT
Bin #
City of La Quinta
Building BE Safety Division
P.O. Box 1504, 78-495 Calle Tampico
1U CA-9
Permit #
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ProjectAddrcss:(p QFj54 W H 1 S e
Owner's Name: Ike o 2
A. P. Number:
Address: v5$
Legal Description: l 1 S.
City, ST, Zip: Z 5
Contractor:
Telephone: (
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Address:
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Project Description vz Q
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City, sT, Zip: Sox, NAa CA ald -7-
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State Lic. #:-%s City Lie. cbl
Arch., Engr., Designer.
1 4J
Address:
City, ST, Zip:
Telephone:
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Construction Type: tt&Occup—y; S
State Lic #:
Project type (circle one): New Add'n Alger Repair Demo
Name of Contact Person: e— 'VWgC)c te
Sq. Ft.:
#Units
Telephone # of Contact Person.
Estimated Value of Project O Cs 0
APPLICANT: DO NOT WRITE BELOW THIS UNE
#
Submittal
Req-d
Reed
TRACING PERMM FEES
Plan Sets
Plan Cheek submitted Item
Amount
Structural Calfs.
Reviewed, ready for corrections Pfau Check Deposit
Truss Cala.
Called Contact Person Plan Check Balanev
Title 24 Calcs.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2' Review, ready for corrections/issue Electrical
Subeontactor List
Called Contact Person Plumbing
Grant Decd
Pians picked up SALL
r_
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:-
'"' Review, ready for correctio rss eveloper impact bee
Planning Approval
Called Contact Person A.LP.P.
V
Pub. Wks. Appr
Date of permit issue O
nn
School Fees
Total Permit Fees