11-0092 (SOL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: 11-00000092
Property Address: 47795 DUNE PALMS RD
APN: 600-020-041- -
Application description: SOLAR
Property Zoning: REGIONAL COMMERCIAL
Application valuation: 191318
T4ht 4 4 Q"
Applicant: Architect or Engineer:
LICENSED CONTRACTOR'S DECLARATION
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
1 herebyaffirm under penalty of perjury that I am licensed.rindet provisions of Chapter 9 (commencing with
Section 7000)L of Division 3 of the, Business and Professionals Code, and my License is in full force and effect.
License Class: B CIO C46 License Oo.: 910.836
1-. Date 2 contractor•
OWNER DECLARATION
1 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 countythat 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 sheJs,licensed pursuant 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 more then five hundred dollars (8600).:
1 _ 1 I, as owner of the property, or my employees with wages acthek 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 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 for the purpose,of sale.).
(_ ► I; as owner of the property; am exclusively contracting with licensed contractors to construotthe project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not applyto 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 License Law.),
1=1 I em exempt. under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION. LENDING AGENCY
I hereby affirm under penalty of perjury that thereris 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:
LQPERMff
Owner:
COACHELLA VALLEY HOUSING
45701 MONROE'ST 1-G
INDIO, CA 92201
VOICE (760) 777-7012
FAX (760) 777-7011.
INSPECTIONS (760) 777-7153
Date:
1/25/11
Contractor:
RENOVA-ENERGY CORP
15,181 MEDITERRANEAN AVENUE
PALM DESERT, CA 92211
(760)568-3413
Lie. 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 wsetf4nsure 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 insuranoei as required by Section .3700of 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 REWC328450-
__ I certify that, in the performance'of the work forwhichthis permit is issued, I shall not employ any
person in any mannerso 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
700 of the Labor. Code, 1 shall forthwith comply with ose provisions.
f(bate: Applicant:
WARNING: FAILURE TO SECURE/RKERS' COMP ON COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UB TO ONE HUNDRED THOUSAND
DOLLARS (8:100,000). IN ADDITION TO THE.COST OF COMPENSATION, 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.
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, 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 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 maps ion purposes.
Pate: 1 /7s%gnature (Applicant or Agent): er
Application Number . . 11-000.00092,
Permit . . .
SOLAR PERMIT
Extension
• BASE FEE
Additional desc .
15.0'0
1.00 15.0000 EA ELEC PWR APP
>10 TO <=50
Permit,Fee . . . .
23.50
Plan Check Fee
5.88
Issue Date . . .
Valuation . . . .
1913.18
Expiration Date . .
7/24/11
20.10 CALIFORNIA ELECTRICAL CODE.
Qty Unit Charge
Per
Extension
January 25, 2'011 1D:35c38 AM AORTEGA.
BASE
FEE
15.00
1.0.0 7,5000
EA SOLAR
COLLECTOR 1,001-2000
7.50
1.00 1.0000
EA SOLAR
COLLECTOR EA ADDL 1000
1.00
Permit . . .
Additional desc . .
Permit Fee . .
Issue Date . . .
Expiration Date . .
ELEC-MISCELLANEOUS
30.00
7/24/'11
Plan Check Fee 7.50
Valuation, 0
Qty Unit Charge Per
Extension
• BASE FEE
15.0'0
1.00 15.0000 EA ELEC PWR APP
>10 TO <=50
15.00
--------------------------------------------------------------------
Special Notes and Comments
32.4kW PV SYSTEM - (,120) 270W PANELS W/
(1)PV POWERED PVP30KW INVERTER.[2,5089F]
20.10 CALIFORNIA ELECTRICAL CODE.
[BUILDING: 9100 - CARPORT: 1-31
January 25, 2'011 1D:35c38 AM AORTEGA.
-----------------.-.--------------------------------------------
Other Fees . . . . . . BLDG SIDS
ADMIN (SB1473)
------------
8.00
Fee summary Charged Paid
Credited
- -
Due
- -
Permit Fee Total 53.50 .00
.0.0
53.50
Plan Check Total 13.38 .00
.00
13.38
Other Fee Total 8.00 .00
.00
8.00
Grand Total 74.88 .00
.00
74.88
�l