11-0088 (SOL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00000088
Property Address: 477:95 DUNE. PALMS RD
APN:. 600 -020 -041 -
Application description: SOLAR
Property Zoning: REGIONAL COMMERCIAL
Application, valuation: 15943
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Applicant: Architect or Engineer:
Co�rra�yvL
414
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LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
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 Professionals Code, and my License is in full force and -effect.
License Class: B, C10. C46 License,No:i 910836
1C Date: Z S r 1 Contractor:
OWNER -BU - RATION
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 permitto
construct, after,'improve, demolish, or repair any structure, prior to.its issuance, also requires the, applicant for the
permit.mfile a signed statement that he or she is licensed pursue 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 morwthan five hundred dollars (8500)::
1 m
1 I;:as owner of the property, or my eployees 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 herseH:through his or her o%4n,employees;.provlded that the
improvements are not htended'or offered for sale. If, however, the building. or improvement is sold within
one yearoPcompletion, the owner -builder will have the.burden,of proving that he or she.did not build or
improve for the -purpose of sale.).
1 ) I,.as owner.of',the property, am exclusively contracting with licensed contractorsao construct -the project (Sec.
7044, Business'and Professions Code:The Contractors' State License Law does not apply to an owner of
property who bui(ds'orimproves thereon, and,who contracts for the projects with�a contractor(s) licensed
pursuant,to the Contractors' State License Law.).
(_) I am exempt underSec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
1 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'J•
Lender's Name: _
Lender's Address:
LQPERMIT
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: :1/25/11
Owner:
COACHELLA VALLEY HOUSING COALI
45701 MONROE ST 1-
INDIO, CA 92201 0 6
2 �'t
Contractor: JH� 211 f
RENOVA ENERGY CO P
75181 MEDITERRAN AV �-&—_-
PALM DESERT, CA may' Fr%��'' '>: C;. f
(760) 56.8-3413 -----
Lia. No.: 9.10836
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 self4risure1or 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 NORGUARD INS Policy Number REWC128450
_ I certify that, in the performance, of the work for which this permit is Issued, 1 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 subjectto the workers' compensation provisions of Section
3709 of the Labor Code, 1 ahall rthwith comPN with those,provisions.,
Dew:IaPPlicent:
WARNING: FAILURE TO SECURE W KERS' COMPENSATION C ERA IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES. AND CIVIL NES' TO ONE HUNDRED THOUSAND
DOLLARS Ist00i0001. IN ADDITION TO THE COST OF COMP ON, DAMAGES AS PROVIDED FOR IN
SECTION 3708 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.
I . 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 permitissued,as a result of this application,
the owner, and the applicant; each agrees for 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 followingissuance 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 county to
enter upon the above-mentioned property for i ct(on pulp es.
Date: _�T 49nature (Applicant or Agent):
I
Application. Number . . . . . 11-00000088
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 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]
2010 CALIFORNIA ELECTRICAL CODE.
[BUILDING: 5200 - CARPORT: 11]
***REDUCED PLAN CHECK FEE***
January 25, 2011 10::20:18 AM AORTEGA
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.
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 15.63. .00 .00
45.63