11-0089 (SOL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
11-000.00089
Property Address:
47795 DUNE PALMS RD
APN:
600-020-041- -
Application description:
SOLAR
Property Zoning:
REGIONAL COMMERCIAL
Application valuation:
11160
T444t 4 4 Q"
Applicant: Architect -or Engineer:
bLA
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
I hereby affirm under penaltyof perjury that Ian
licensed under' provisions of. Chapter's (commencing with
Section 7000).of Division 3 of the Business and Professionals Cade, and my License is in full force and effect;
Li cl B C10 C46 errse No.: 910836
tt
D. . Co'ntractor:
•` . OWNER -8 D TION
I hereby affirm under penaltyof perjury that I am exam om'the ntractor's Statetioeme Law for the
following reason (Sec. 7031.5, Business and Professions nyciry 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 Cornractor's State
License Law (Chapter9 (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 toe civil penalty of not more than five hundred dollars (9500)::
1 _.) 1, asowner of the property, or my -employees with wages as: their solwcompensation, will do the work, and
the structure is not intended br'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 awn employees; provided that the
improvements. are notintended 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.).
1 _ 1 I, as.owner of the property, am -exclusively contracting with licensed contractors to constrict 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 projeciswith a contractor(s) licensed
pursuant to the Contractors' State License Law:).
1 _) j em exempt.underSec. , 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:
COACHELLA VALLEY
45701 MONROE ST
INDIO, CA 92201
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
HOUSING COALI
1-G'
Contractor-
RENOVA ENERGY CORP
75181 MEDITERRANEAN A
PALM DESERT, CA 92211
(760)568-3413
Lic. No.: 9.10836
Date: 1/25/11
WORKER'S COMPENSATIONDECLARATION
I hereby affirm.under penalty of, perjury one ofthefollowing declarations:
I have and will maintain a aartificate.of consent to self -insure for workers' compensation; as,provided
ct
for by Seion370o 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 perfoinlance 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 l should become subject to the workers' compensation provisions of Section
3700'of'the.Labor Code; I. shall forthwith comply with those provisions.
K Data: 6�zw/ Applicartt
WARNING: FAILURE TO SECURE RKERS' COMPE COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS Is ioo,0001. 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, indemnifyand.hold harmless the City
of Le Ouinta, its officers, agents and employees for any act or omission related to the work being
performed'underor following issuance of this permit.
2. Any permit'Issued asa 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 reed this application and state that the above information,iscorrect. 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 inspection, purposes.
Date: Signature (Applicant or Agentl;. L
Application Number . . . 11-00000089
Permit . . . SOLAR PERMIT
Additional desc . .
Permit Fee 19.50 Plan Check Fee
1.22
Issue Date Valuation . . .
. 11160
Expiration Date 7/24/11
Qty Unit Charge Per
Extension
BASE FEE
15.00
1.00 4.5000 EA SOLAR COLLECTOR < 10QO
-----------------------------------------------------------------------------
4.50
Permit . . . .ELEC-MISCELLANEOUS
Additional des_c .
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
1.89kW PV SYSTEM - (7) 210W PANELS W/
(1)SOLECTRIA PVI 2500 INVERTER [146SF]
2010 CALIFORNIA ELECTRICAL CODE_.
[BUILDING: 5100 - CARPORT: 10]
*-**REDUCED PLAN CHECK FEE***
January 25, 2011 10:23:13 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
2.6.3
Other Fee Total 1.00 .0:0 .00
1.0.0
Grand Total 45.63 .00 .00
45.63
LQPERMIT