11-0086 (SOL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-00000086
Property Address:
47795 DUNE PALMS RD
APN:
600-020-041- -
Application description:
SOLAR
Property Zoning:
REGIONAL COMMERCIAL
Applicationrvaluation:
15943
Tilf 4 VOICE (760) 777-7012
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
Applicant: Architect or Engineer:
i.KTleiA..wiM: AJ&
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter9.(commencing with
Section 7000) of'Division, 3 of the Business and Professionals.Code, and my Licenswis'in full force and effect.
Li Cl i B C16 1746' ucenseNo:: 910836'
Dater S I Contractor: -141-1
ER -B II ECLARATION
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; alsorequires the applicant for the
permit,to file a signed statemenuthat he or she is:licensed pursuantto the provisions of the Contractor's State
Ucense 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'applicent for a permit subjectsthe applicant to a civil penalty of not more than five hundred dollars (5500).:
I_), .1, 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'forsale (Seo. 7044, Business and Professions Code: The
Contractors' State. License Lew does pat to an owner of property who builds or improves thereon,,
and whodoes the work himself or herself through his or her ownemployees,. provided that the
improvements are novintended or offered'forsale. 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 Lew 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:LicerueILaw.).
I—) I :am exempt under Sec. B.BP.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
1 herebyaffirm 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:
D
D.
Contractor: I
RENOVA ENERGY CORP t JAN 2 2011
75181 MEDITERRANEAN A NUE
PALM DESERT, CA 922 1 CITYOPLAQUINTA
(760)568-3413
Lia: No.: 910836
-------------------
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.'af the Labor
Code, for the performance of the work for which this permit is issued. My workere' compensation
'insurance carrier and policy number are:
Carrier NORGUARD INS Policy Number REWC128450
_ 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 stibject,to the workers' compensation provisions of Section
3 00 of the Labor Code, i shall forth
wi + comply wi .those provisions.
CDate. I ZS I� Applicant:
WARNING: AILURE'TO SECURE' W KERS' MPENSAT ON. ERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PEN LTIES;AND C, INES UP TO ONE HUNDREDTHOUSAND
bOLLARS (5100,000). 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 Appiicatiomis 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, an&theapplicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Ouir ta, 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 offssuancwof such permit, or cessation of work for'1'80 days will subject
permit to cancellation. I
I.certify that I.have read this�application.and.state that the above information is correct. I agree comply with all
city and county ordinances:and state laws relating to building. construction, and hereby auth e, representatives
of this countyto a upon the above-mentioned property f inspectf urposes.
( Date:. 7 ,Signature.(Appiicant or Agent):
7>
Application. Number . ... . . 11-00000086
Permit . . . SOLAR PERMIT
Additional desc .
Permit Fee . . . . 19.50 Plan Check Fee
1.22
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
1.41
Issue Date . . . Valuation . . .
. 0
Expiration Date 7/24/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00, 7.5000 EA ELEC PWR "P>1 TO <=10
1.50
-----=----------------------------------------------------------------------
Special Notes and Comments
2.7kW PV SYSTEM - (1.0) 216W PANELS W/
(1)SMA SUNNY BOY 3000 INVERTER [20.9SF]
2010•CALIFORNIA ELECTRICAL CODE.
[BUILDING: 8100 - CARPORT: 161
*;**REDUCED PLAN CHECK FEE***
January 25, 2011 10:14:09 AM AORTEGA
-------------------_---------------------------------------------------------
Other Fees . . . . BLDG'STDS ADMIN (SB1473)
1.00
Fee summary Charged Paid Credited
Due
.Permit Fee Total 42.00 .00 .00
42.00
Plan Check Total 2.63 .00 .00
2.63
Other Fee .Total 1.00 .00 .00
1.00
Grand Total 45.63 .00 .00
45.63
LQPERMrr