11-0052 (SOL)t
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
4
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Application Number: 11-00000052 Owner:
Property Address: 4'7795 'DUNE PALMS RD COACHELLA VALLEY HOUSING COALI
APN: 600-020-041- - 4570:1 MONR_OE ST 1-G'
Application description: SOLAR INDIO, CA 92201
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 11160
Applicant: Architect or Engineer:
CoKT�q�- �
LICENSED CONTRACTOR'S DECLARATION
I hereby -affirm under penalty of perjury that Iam lioensed.under provisions of Chapter 9 (commencing with
Section 7000) of Division 3`of-the Business and Professionals Code; and mV:Lioense is in full force.and effect. -
License Class: B C10 C46 Ucense No.; 910836
X Date: Contractor:
DwNER UIL CLARATION
I hereby affirm under penalty of perjury that I am axe from,the Contractor's State License Law for the.
following reason (Sec. 7031.5, Business and Professions Code' Any city or county thavrequires 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 Lew (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ProfessionsCode) 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 (066).:
1 _1 li as owner of the property, or my employees:with wages as their.sole compensation, will dothe work,:and
the structure .isnot intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State Ucense'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 forthe purpose of sale.).
(_ 1 1,!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,orimproves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to,the Contractors"State Uoense Law.).
(_ 1 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 ts;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:
WFERMIT
Contractor:
RENOVA ENERGY CORP
75181 MEDITERRANEAN A
PALM DESERT, CA 92211
(760)568-,3413
Lic: No.: 910836
Date: 1/25/11
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' compernationi as provided
for by Section 3700 of the Labor Code, for the performance. of the work for which this permit is
issued.
_ 1 have,and'will maintain workers',gompensation insurance, as required by'Section 3700 of the Labor
Code, for the performance of the.work for which this permitis issued. My workers' compensation
insurance carrier and policy number are:
Carrier NORGUARD INS Policy Number REWC128450
_ I certify that; in the performence.ofthe work for which this permit is issued, I shall not employ any
person in any manner so as to becomesubject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation, provisions of. Section
700 of the Labor Code, I shall f - hwit mply with.tho a'provisions.
KDate:
! JI .Applicant:
WARNING: FAILURE TO SECUREWOR RS' MPENSATt COV GE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TOGRIMIN PENALTIES AND Cl UP TO ONE HUNDRED THOUSAND
DOLLARS (9100,000). 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 of8uilding and Safety for a'permit, su_ bje_ ct to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose requesf and
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 Quints, its officers, agents and employees for any actor omission related to the work being
performed under or following issuance of -this permit:
2. Any permitissued 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 incorrect. I agree to comply with all
city and county, ordinances and state laws relating to building construction, and hereby authorize representatives
of this,cou ty to r upon the above-mentioned property for inspecti
�/purpo
PDate: t Signature (Applicantor Agent): - -
i
Application Number
Permit . .
Additional d_esc .
Permit Fee
Issue. Date
Expiration Date .
. . . 11-00000052
SOLAR PERMIT
. 19.50
7/24/11
Plan Check Fee . . 4.88
Valuation . . . 11160
Qty
Unit Charge
PerExtension
BASE FEE`
15:.00
1:00 7.5000 EA ELEC PWR APP
>1 TO <=10•
7.50
BASE
FEE
15.00
1.00
4.5000
EA
SOLAR
COLLECTOR < 1000
4.50
.00
1.0000
EA
SOLAR
COLLECTOR EA ADPL 1000
.00
.00
5.0000
EA
SOLAR
COLLECTOR > 2000.
.00
Permit . . .
Additional desc .
Permit Fee . .
Issue Date . . . ..
Expiration Date .
ELEC-MISCELLANEOUS
22.50
7/24/11
Pian Check Fee . . 5_.63
Valuation . . . . 0
Qty Unit Charge Per
Extension
BASE FEE`
15:.00
1:00 7.5000 EA ELEC PWR APP
>1 TO <=10•
7.50
.00 45.0000 EA ELEC PWk APP
>100
.00
-------------------------------------- I -----_
Special Notes and Comments
_
1.89kW PV SYSTEM - (7) 270W PANELS W/
(1)SOLECTRIA.PVI 2.500 INVERTER [146SF]
2010 CALIFORNI_AELECTRICAL CODE.
[BUILDING: 8300 - CARPORT:.16]_
January 25, 2011 9:49:39 AM.AORTEGA
------------------------------
--- --- -
------------
-----------------..
Other Fees . . . .. . . BLDG STDS
ADMIN (S81473)
1.00
Fee summary Charged Paid
Credited
Due
Permit
' e Total 42.00 .00
:00
42.00
-Fe
Plan ChecTotal 10.51 .00
.00
10.51
Other Fee Total 1.00 .00
.00
1.00.
Grand Total 53..51 .00
.00
53.51
Bin #
City of La Quinta
Building U -Safety Division .
P.O. Box 1504, 78-495 Ca11e Tampico
La Quinta, CA 92253 - (760) 777=701 ,2
"'`A"Building Permit Application and Tracking Sheet
Permit #
Project Address: 411q5
Owner's Name:
A. P. Number*0M
Address: _
�.o o SaiTC
Legal Description:
Contractor: (ZEAaA EAeR-C-,%ACO".
City, ST, Zip: IN
Telephone:
Address: `lS - I t
Project Description: M
City, ST, Zip:
Telephone; (_? too)
CA,%cJ g- APP
w-0
State Lic. #• : /O $3 fo
City Lic. #:
Arch., Engr., Designer:
Address:
City, ST, Zip:
Telephone:,
v:::>: ':'ii:ti;moi) iY .'•':'4:ii' •ir %:i:'•}'•:;^:'
::•.,,,g'.
:.'::>':.:.c;:;y is %;:r,•a}`:}.:`.}}r:{T:*;;;:G:.
::ir<YCiv}., •. ..... .rrt;�^�`iifr:"?;vY\: C:
Construction Type: Occupancy:
State Lic. #.
Project type (circle one): New Addt n Atter Repair
Sq. Ft.: # Stories: F#UnTts:
Demo
Name of Contact Person: H
Telephone # of Contact Person: o.
SS —
Estimated Value of Project; S -o
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACING PERMIT FEES
Plan Sets
Plan Cheek submitted 19J1 ( Item Amount
Structural Coles.
Reviewed, ready for corrections Plan Check Deposit
Truss Calcs.
Called Contact Person Plan Check Balance
Tide 24 Coles.
Plans picked up Construction
Flood plain plan
Plans•resubmitted Mechanical
Grading plan
2'! Review,.ready for correetioasiissue Electrical
Subcontactor List
Called CoutaetPerson Plumbing,
r
Grant Deed
Plans picked up S.M.I.
H.U.A. Approval
Pians resubmitted Grading
IN HOUSE:-
'"' Review, ready for correction ssa Developer Impact Fee
Planning Approval
Called Contact Person J.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fe
S 0 L Pr fZ / C V I4:-