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BSOL2016-0112M 78-495 CALLE TAMPICO T 0 D Zfv Qu"6 LA QUINTA, CALIFORNIA 92253 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BSOL2016-0112 Property Address: 44375 VILLETA DR APN: 604174015- 04174015Application ApplicationDescription: GOLDBERG / 7.4kW PV SYSTEM - (29) 255W PANELS/(1) INVERTER Property Zoning: Application Valuation: $16,342.95 Applicant: SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO, CA 94402 LICENSED CONTRACTOR'S DECLARATION 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 Professions Code, and my License is in full force and effect. License Class: C46, B. C30, A. C20. C39 ' License No.: 888104 Date: 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 Lawq(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 than five hundred dollars - ($500).: , ( ) 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. (Sem-. 7644, Business and Profession's 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.). ( ) 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 Name: • Lender's VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 .Date: 8/2/2016 Owner: GOLDBERG, REN 44375 VILLETA DR LA QUINTA, CA 92253 . Contractor: SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO, CA 94402 (650)963-4722 Llc. No.: 888104 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 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: ZURICH AMERICAN INSURANCE COMPANY Policy Number: EWS0182018 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 subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION 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): Date: 8/2/2016 'Application Number: BSOL2016-0112 Owner: Property Address: 44375 VILLETA DR GOLDBERG, REN APN: 60,4174015 44375 VILLETA" DR Application Description: 'GOLDBERG / 7.4kw PV SYSTEM - (29) 255W PANELS/(1) INVERTER LA QUINTA, CA 92253 Property Zoning: Application Valuation: $16,342.95 Applicant: Contractor: SOLARCITY CORPORATION SOLARCITY-CORPORATION _ 3055 CLEARVIEW WAY 3055 CLEARVIEW WAY SAN MATEO, CA 94402 SAN MATEO, CA 94402 (650)963-4722 Llc. No.: 888104 Detail: 7.4kW SOLAR ARRAY - (29) 255W KYOCERA PANELS W/(1) ABB PVI-6000-OUTD-US-Z-A INVERTER AND.(1) 125 AMP SUBPANEL [522SF] 2013 CALIFORNIA ELECTRICAL CODE. t r DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ` ACCOUNT QTY AMOUNT Credit Card Fee 101-0000-43505 0 $4.17'. Total Paid for Credit Card Fee:. $4.17 DESCRIPTION ACCOUNT QTY r AMOUNT PV SYSTEM - ARRAY, FIRST 20 101-0000-42403 0 $24.17 DESCRIPTION ACCOUNT QTY AMOUNT PV SYSTEM -ARRAY, FIRST 20 PC 101-0000-42600 0 $24.17 DESCRIPTION ACCOUNT, QTY AMOUNT PV SYSTEM - MISC EQUIPMENT 101-0000-42403 0 $24.17 DESCRIPTION ACCOUNT QTY AMOUNT PV SYSTEM - MISC EQUIPMENT PC 101-0000-426.00 0 $24.17 Total Paid for ELECTRICAL: $96.68 DESCRIPTION ACCOUNT QTY AMOUNT. - PERMIT ISSUANCE 101-0000-42404 0 $91.85 , i ' Description: GOLDBERG / 7.4kW PV SYSTEM - (29) 255W PANELS/(1) INVERTER Type: SOLAR (WEB) Subtype: RESIDENTIAL LESS THAN Status: ISSUED Applied: 7/18/2016 ECON 1OKW Approved: 7/19/2016 AOR Parcel No: 604174015 Site Address: 44375 VILLETA DR LA QUINTA,CA 92253 Subdivision: TR 23269 Block: Lot: 180 Issued: 7/20/2016 ECON Lot Scl Ft: 0 Building Scl Ft: 0 Zoning: Finaled: Valuation: $16,342.95 Occupancy Type: Construction Type: Expired: 1/16/2017 ECON No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 1.4kW SOLAR ARRAY - (29) 255W KYOCERA PANELS W/(1) ABB PVI-6000-OUTD-US-Z-A INVERTER AND (1) 125 AMP SUBPANEL [522SF] 2013 CALIFORNIA ELECTRICAL CODE. I. CONDITIC►NS FINANCIAL •INFORMATION .• ...... . Printed: Tuesday, August 02, 2016 7:42:36 AM 1 of 3 SYSTEMS INSPECTIC :)ARFNT PRO �Q 'N 77 -4- "k- 'I ZW CLT D PAID'DATE#� !`RECEIPT,#t: H Eb # �WETHOD,4r,��, A1U:BY` m .4 VNIA7 A 11V 'I 201607201 BSAS SB1473 FEE 101-0000-20306 0 $1.00 $1.00 7/20/16 WEB9181 521492113 CREDIT ELENA L LOYA ECON, 7 Total Paid for BUILDING STANDARDS ADMINISTRATION. $1.00. $1. 00 BSA: . 201607201 Credit Card Fee 101-0000-43505 0 . $4.17 $4.17 7/20/16 WEB918 52140113 CREDIT ELENA L LOYA ECON 7 Total Paid for Credit Card Fee: $4.17 $4.17 201607201 PV SYSTEM -ARRAY, 101-0000-42403 0 $24.17 $24.17 7/20/16 WEB918 521492113 CREDIT ELENA L LOYA ECON FIRST 20 201607201 PV SYSTEM - ARRAY, 101-0000-42600 0 $24.17 1$24.17 7/20/16' WEB918 521492113 -CREDIT ELENA' . L LOYA. ECON. FIRST 20 PC 7 4 201607201 PV SYSTEM - MISC. 101-0000-42403 $24.17 $24.17 7/20/16 WEB918 521491413 CREDIT ELENA L LOYA E . CON EQUIPMENT .0 201607201. PV SYSTEM - MISC 101-000042600 0 $24.17 $24.17 7/20/16 WEB918 521492113 CREDIT ELENA L LOYA ECON EQUIPMENT PC Total Paid for ELECTRICAL: $96.68 $96.68 101607201 PERMIT ISSUANCE 101-0000-42404 c� $,91.85 $91.85 7/20/16 WEB918 '521492113 CREDIT ELENA L LOYA ECON 7:- Totalft.icl for PERMIT ISSUANCE: $91.85 $91.85 . . ........ ......... ..... ... . ........... TOTALS. $IOJ6� ......... 1,11 1-1. 1 MIN INSPECTIC :)ARFNT PRO L .... BOND INFORMATION Printed: Tuesday, August 02, 2016 7:42:36 AM 3 of 3 SYSTEMS