11-0085 (SOL)P.O. BOX 1504
78495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-0.0000085
Property Address:
47795 DUNE PALMS RD
APN:
600 -020 -041 -
Application description:
SOLAR
Property Zoning:
REGIONAL COMMERCIAL
Application valuation:
15943
Applicant: Architect or Engineer:
C+KZ�c�twl►r V1.4
• "VOICE (760) 777-7012
4 4 FAX (760) 777-7011
BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date:. 1/25/11
Owner:
COACHELLA VALLEY HOUSING COALI
45701 MONROE ST 1—G
INDIO, CA 92201
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 o the Business ar4 Professionals Coqllr, and my License is in full force and effect.
License Cl ss` C10 C46 : 910836
l Date .) J " Contractor
/�
OWNER=BUISXIWECLARATION
I hereby affirm under penalty of perjuryet I am exempt from:the Contractor's State License Law for the
following reason (Sec. 7031.5, Business arid, Professions Code: Any city or county thatsequires a permtt 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 wittf 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 7091.5 by
any applicant for a permit subjects the applicant to's civil penalty of not more than.five hundred dollars (9500).:
1—) 1, as owner of the property, or my employses.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 herselfthrough his ocher own employees, provided that the
Improvements are notintended 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 purposeof sale.).
(_) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business andlProfessions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts fon thwprojects with a contractor(s) licensed
pursuint to the Contractors' State Ucense.Law:).
( ) I am exempt under Sec. B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury drat 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:
L,QPERMtT
Contractor:
RENOVA ENERGY CORP
75181 MEDITERRANEAN AVENUE
PALM DESERT; CA 92211 e
(760)568-3413 O
Lic. No.: 910836
JAN 2 211
WORKER'S COMPENSA ,ON'DECL1jf�(h� 1.
I hereby affirm under penalty of perjury one ofthe,following deci ration
I have and will maintain a certificate of consent toae -insure for workers' compensation, as provided
for by Section 9700 of the Labor Code_, for the performanoe'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 NORGUARD INS _ Policy Numbar'-REWC128450
I certify that, in theperformance 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
ll 1 e 700 of the Labor Code, I "hall fo with com""1 those provisions.
(Date: l L.J (I Applicant:
WARNING: FAILURE TO. SECURE RKER COMPENSA ON VERAGE.IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER'TO CRI NAL PENALTIES AND 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 anthis 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 pursuaTnito 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 act or omission related to the work being
performed under;or following issuance. of this permit.
2. Any permit'issued as result of this application becomes null andvoid.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 1 have read this application and state that the -above informationis correct. I agree to comply with all
city. and county ordinances and state laws relating to building construction, and. hereby'authorize representatives
of this county to nterupon the above-mentioned property for insp ion p ores.
goats: %� Signature (Applicant or Agent):
Application Number . . . . . 11-00000085
Permit . . . SOLAR PERMIT
Additional desc . .
Permit Fee . . . . 19.50 Plan Check Fee
4.88
Issue Date . . . Valuation
15943
Expiration Date . . 7/24/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 4.5000 EA SOLAR COLLECTOR < 1000
-----------------------------------------------------------------------------------
4.50
Permit -. . . ELEC-MISCELLANEOUS
Additional desc . .
Permit Fee 22.50 Plan Check Fee
5.63
Issue Date Valuation . . .
. 0
Expiration Date 7/24/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 7:.500.0 EA ELEC PWR APP >1 TO <=10
- - --
7.50
Special Notes and Comments
2.7kW PV SYSTEM - (10) 270W PANELS W/
(1)SMA SUNNY ;BOY 3000 INVERTER [209SF]
.20.10 CALIFORNIA ELECTRICAL CODE.
[BUILDING: 820.0 - CARPORT: 161
January 25, 2011.10.:10::54.AM AORTEGA
--------------------------------------------------------------------------------
Other Fees . . . . . . BLDG STDS ADMIN (SB.1473)
1.00
Fee summary Charged Paid Credited
--------- -- ----------
Due
-------- ---------- ------------
Permit Fee Fee Total 42..00 .00 .00
42.00
Plan Check Total 10.51 .00 .00
10..51
Other Fee Total" 1.00 .00 .0.0
1.00
Grand Total 53.51 .00 .00
53.51
LQrEMre