BSOL2015-023878-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
T,iilt'4 4v 0"Aro
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT
Application Number:
BSOL2015-0238
Property Address:
79770 AMERICA CT CT
APN:
604520021
Application Description:
IRISH / 3.99kW PV SYSTEM (14) 285W PANELS/(14) MICRO INVERTE
Property Zoning:
BEND, OR 92253
Application Valuation:
$16,000.00
Applicant:
m
MOSHE YACOBY ELECTRICAL CONTRACTOR
6301 ELLENVIEW AVE
M -n
WEST HILLS, CA 91307
LICENSED CONTRACTOR'S DECLARATION -
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Clas : Cr1`0 License No.: 465649
Date: 1 a v I � Contractor:
OWNER -BUILDER DECLARATION
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, 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 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 ahy applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(1 I, 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 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.).
(1 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 Law 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 License Law.).
(_J I am exempt under Sec. 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
Lender's Add
67
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 12/10/2015
Owner:
ALAN IRISH
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60640 THUNDERBIRD
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BEND, OR 92253
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Contractor:
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MOSHE YACOBY ELECTRI
�' NTRA1
6301 ELLENVIEW AVE
CC
WEST HILLS, CA 91307
(818)304-0810
Lic. No.: 465649
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.
4-1 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: Policy Number: _
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 subject to the .
workers' compensation provisions of Section 3700of a Labor Code, I shall forthwith
comply with those provisions. �C
Date: I d (S Applicant:
WARNING: FAILURE TO SECURE WORKERS' COM PEN AA ION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL 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 Building Official 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 Quinta, 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 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 city to enter upon the
above-mentioned property for inspection purposes.
Date: Signature (Applicant or Agent):
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT. QTY AMOUNT
PAID PAID DATE.
BSAS SB1473 FEE 101-0000-20306 0 $1.00
$0.00
PAID BY METHOD.. RECEIPT #
CHECK # CLTD BY
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00
DESCRIPTION
'ACCOUNT
QTY
AMOUNT
`PAID
PAID DATE
PV SYSTEM - ARRAY, FIRST 20
101-0000-42403
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
' AMOUNT
PAID
PAID DATE
PV SYSTEM - ARRAY, FIRST 20 PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid for ELECTRICAL: $48.34 $0.00
DESCRIPTION
ACCOUNT
QTY
• AMOUNT
; PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
PAID BY
METHOD
RECEIPT #•
CHECK #
CLTD BY'
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:• •0
Description: IRISH / 3.99kW PV SYSTEM (14) 285W PANELS/(14) MICRO INVERTE
Type: SOLAR Subtype: Status: APPROVED
Applied: 12/1/2015 SGU
Approved: 12/8/2015 LUR
Parcel No: 604520021 Site Address: 79770 AMERICA CT CT LA QUINTA,CA 92253
Subdivision: TR 24197-5 Block: Lot: 21
Issued:
Lot Sq Ft: 0 Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $16,000.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
NOTES
Details: 3.9kW SOLAR ARRAY - (14) 285W SUN WORLD MONO PANELS W/ (14) ENPHASE M250-60-2LL-S22/S23/524 INVERTER [252SF] 2013 .
CALIFORNIA ELECTRICAL CODE.
Printed: Thursday, December 10, 2015 10:20:10 AM 1 of 2 C
SYSTEMS
CHRONOLOGY
CHRONOLOGY TYPE
STAFF NAME
ACTION DATE
COMPLETION DATE <
NOTES
PLAN CHECK SUBMITTAL
STEPHANIE GUMPERT
12/1/2015
12/1/2015
RECEIVED
LEFT A MESSAGE FOR JESUS(818)251-0752. PERMIT IS
TELEPHONE CALL
LUIS URIBE
12/8/2015
12/8/2015
APPROVED AND READY TO BE ISSUED.
NAME•TYPE
NAME
ADDRESS1,7WEST
STATE
ZIP
PHONE
FAX
EMAIL
APPLICANT
MOSHE YACOBY ELECTRICAL
6301 ELLENVIEW AVELS
CA
91307
CONTRACTOR
CONTRACTOR
MOSHE YACOBY ELECTRICAL
6301 ELLENVIEW AVE
WEST HILLS
CA
91307
CONTRACTOR
OWNER
ALAN IRISH
60640 THUNDERBIRD
BEND
OR
92253
CT
Printed: Thursday, December 10, 2015 10:20:10 AM 1 of 2 C
SYSTEMS
INSPECTIONS
ATTACHMENTS
Printed: Thursday, December 10, 2015 10:20:10 AM 2 of 2 ,
SYSTLivtS
FINANCIAL
INFORMATION
DESCRIPTION
ACCOUNT QTY.
AMOUNT
PAID
PAID DATE RECEIPT # CHECK # METHOD PAID BY: _; CLTD
.
BY
BSAS SB1473 FEE
101-0000-20306 0
$1.00
$0.00
Total Paid for BUILDING STANDARDS ADMINISTRATION
$1.00
$0.00
BSA:
PV SYSTEM - ARRAY,
101-0000-42403
0
$24.17
$0.00
FIRST 20
PV SYSTEM - ARRAY,
101-0000-42600
0
$24.17
$0.00
FIRST 20 PC
Total Paid for ELECTRICAL:
$48.34.
$0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE:
$91.85
$0.00
TOTALS:00
INSPECTIONS
ATTACHMENTS
Printed: Thursday, December 10, 2015 10:20:10 AM 2 of 2 ,
SYSTLivtS