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BSOL2015-023578-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Tit�t - 4 XP 0914tcv COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT Application Number: BSOL2015-0235 Property Address: 50665 SPYGLASS HILL DR APN: 770320001 Application Description: TODOROFF / SOLAR (42) 11.34KW PANELS (42) MICROINVERTERS Property Zoning: 929 N ANAHEIM BLV STE E Application Valuation: $43,609.00 Applicant: MOHR POWER SOLAR INC DBA 21ST CENTURY SO 1452 POMONA ROAD CORONA, CA 92882 0 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my License is in full force and effect. Lise Class: C4$_License No.: 661434 e: tZqlContracto . 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 any 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.). (� 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 Address: 30 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760)777-7153 Date: 1/4/2016 Owner: THEODORE TODOROFF 929 N ANAHEIM BLV STE E ANAHEIM, CA 92253 yr ! c ca � V 0 Contractor:�y+ SMOHR POWER SOLAR INC DBA 21ST r URY SO O 1452 POMONA ROAD ? L v CORONA, CA 92882 Q U (951)736-2000 ay Llc. No.: 661434 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' compensationas provided for by Section 3700 of the Labor Code, for the performance o8�07tof which this permit is issued. e and will maintain workers'compensation insurance, as required by 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: _ 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 comxpI With those provisions. Dpi I—� Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER LAWFUL, 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 e--mentionled property for inspection purposes. Dat E�l �� 1�� Signature(ApplicantorAgen AMOUNT DESCRIPTOW0, PAID DATE-- MIN BSAS SB1473 FEE 101-0000-20306 0 $2.00 $2.00 1/4/16 17. w, ......... ..... PAID" BY s4 METHOD' �t�s�..�,RECEIPT1#v13>zi4.� n, 'WM-57 %A-* E��'Nw MOHR POWER SOLAR INC DBA 21ST. CHECK R11909- 4229 SKH Total'Paid for BUILDING STAN DARDS'AD,M IN ISTRATION BSA:. -$2.00 .$2.00 DESCR 0. P-9, & AMOUNT'-`- b' qgw Rm g -41AC -%g%m _COUNT N't'i 1-�k �.R- 1,6 PV SYSTEM - ARRAY, FIRST 20 101-0000-42403 0 $24.17 $24.17 1/4/16 ui, M, "WA'. M ET. 1 4 0 D'i, -hm R. w - �.MHE K,V,`,f g m W ,N Wtt. MOHR POWER SOLAR INC'DBA 21ST CHECK R11909 SKH W-'DESCRIRTION_6 R.� C 0 R.HkR g IOUNT.. -4, N., PAID 'ZATE` �kgx 'A INE 0.i!iPAID:: 'j Y* 4,�,;FNX PV SYSTEM - ARRAY, FIRST 20 PC .101-0000-42600 0, $24.17 $24.17 1/4/16 wm:vw ; rk"METHOD -w q, - '4' W Wi! ft " 'T MOHR POWER SOLAR INC DBA 21ST CHECK R11909 4229 SKH �DESCRIPTIONK mg� v- RI'm TM r. ACCOUNT, we'sy AlAw 4 AMOUNTS �'4=2;V-9� m vg� , , , 4 m PAffbAlt" PV SYSTEM - MISC EQUIPMENT .101-0000-42403 0 $48.34 $48.34 1/4/16 5N MET HOW SH VIEWS t'€ I" 1111- -i-g N I'vW1 - I I ff9 I .. .. ECIM, MOHR POWER SOLAR INC DBA 21ST CHECK R11905 4229 SKH ggi.! 4, 'ggr .#.RNIR,%, Act ktg,'i VAN Y w w ow T AMOL 01 84 VA bAT 0 �mg- R PV SYSTEM - MISC EQUIPMENT PC 101-0000-142600 0. $48.34 $48.34 1/4/16 K,01 r PAID -g -B -011 01 ECEIPTt, R'A Of t -METH JR IN 1 1 I Nil 0 2 0021 MOHR POWER SOLAR INC DBA 21ST S CHECK - R11909 1 4229 SKH - Total Paid for ELECTRICAL, $145.02 $145.02 RIPTIOW 'i.�W -r 4- �g qm" 4.;' AMOUNT k PAID* -'�,PAIWDATE- N m j �`ACCOUNT,41', fflR-m ngg r&ROM QTY y 45 ,¢ PERMIT ISSUANCE 0 $91.85 01.85 1/4/16 k, ig. ry 5-m! METHODSEE' r5, so 1 N". At V Ifi5liBy -0504, IM�i- R MOHR POWER SOLAR INC DBA 21ST CHECK' R11909 4229 1 SKH Total. Paid for PERMIT ISSUANCE:*. $91.85, $91.85 t71 TOTALS. Description: TODOROFF / SOLAR (42) 11.34KW PANELS (42) MICROINVERTERS Type: SOLAR Subtype: Status: APPROVED Applied: 11/30/2015 SGU Approved: 12/7/2015 LUR Parcel No: 770320001 Site Address: 50665 SPYGLASS HILL DR LA QUINTA,CA 92253 Subdivision: TR 25389-3 Block: Lot: 1 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $43,609.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 11.3kW SOLAR ARRAY - (42) 260W CELLS BLK-G3-260-275 MODULE W/ (42) ENPHASE M250-60-2LL-S22 MICRO INVERTER [630SF]. MAIN PANEL UPGRADE 225 AMP, 125 AMP LOAD CENTER. 2013 CALIFORNIA ELECTRICAL CODE. ADDITIONAL SITES Applied to Approved CHRONOLOGY TYPE STAFF NAME ACTION DATE CHRONOLOGY COMPLETION DATE NOTES PLAN CHECK SUBMITTAL STEPHANIE GUMPERT 11/30/2015 11/30/2015 RECEIVED ' TELEPHONE CALL LUIS URIBE 12/7/2015 12/7/2015 LEFT FRANK A MESSAGE, PERMIT IS APPROVED AND READY TO BE ISSUED. CONDITIONS CONTACTS NAME TYPE NAME ADDRESSI CITY STATE ' ZIP PHONE FAX EMAIL APPLICANT MOHR POWER SOLAR INCbBA 21ST 1452 POMONA ROAD CORONA CA 92882 FRANK@MOHRPOWER CENTURY SO COM CONTRACTOR MOHR POWER SOLAR INC DBA 21ST 1452 POMONA ROAD 'CORONA CA 92882 FRANK@MOHRPOWER CENTURY SO COM OWNER THEODORE TODOROFF 929 N ANAHEIM BLV ANAHEIM CA 92253 STE E I Printed: Monday, January 04, 2016 12:02:22 PM 1 of 3 SYSTF. HIS INSPECTIONS PARENT PROJECTS BOND INFORMATION 7 Printed: Monday, January 04, 2016 12:02:22 PM 2 of 3 V SYST[nAS FINANCIAL DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD BY BSAS SB1473 FEE 101-0000-20306 0 $2.00 $2.00 1/4/16 R11909 4229 CHECK MOHR POWER SOLAR SKH INC DBA 21ST Total Paid for BUILDING STANDARDS ADMINISTRATION. $2,00 $2.00 BSA: PV SYSTEM - ARRAY, 101-0000-42403 0 $24.17 $24.17 1/4/16 R11909 4229 CHECK MOHR POWER SOLAR SKH FIRST 20 INC DBA 21ST PV SYSTEM - ARRAY, 101-0000-42600 0 $24.17 $24.17 1/4/16 R11909 4229 CHECK MOHR POWER SOLAR SKH FIRST 20 PC INC DBA 21ST PV SYSTEM -MISC 101-0000-42403 0 $48.34 $48.34 1/4/16 R11909 4229 CHECK MOHR POWER SOLAR SKH EQUIPMENT INC DBA 21ST PV SYSTEM - MISC 101-0000-42600 0 $48.34 $48.34 1/4/16 R11909 4229 CHECK MOHR POWER SOLAR SKH EQUIPMENT PC INC DBA 21ST Total Paid for ELECTRICAL: $145.02 $145.02 PERMIT ISSUANCE 101-0000-42404 0 $91.85 $91.85 1/4/16 R11909 4229 CHECK MOHR POWER SOLAR SKH INC DBA 21ST. Total Paid for PERMIT ISSUANCE: $91.85 $91.85 TOTALS:, $23$,87 $73RiR7 INSPECTIONS PARENT PROJECTS BOND INFORMATION 7 Printed: Monday, January 04, 2016 12:02:22 PM 2 of 3 V SYST[nAS ATTACHMENTS Printed: Monday, January 04, 2016 12:02:22 PM 3 of 3 SYSTBiNS Bin # Qty of La Q Olin to Building a Safety Division Permit # _ 78-495 Calle Tampico S6L ZOi �23� La Quinta, CA 92253 - (760) 777-7012 l.�' Building Permit Application and Tracking Sheet Project Address: r Owner's Name: A. P. Number: Address: ay liS S Q Legal Description: City, ST, Zip: Contractor: 1A1 �0 P SULK}. Telephone: 77- Lip%?%::rffi :-, Address: ) tf S� y,"e 1t4 J?4- Project Description: I�+t SUC.lrl to City, ST, Zip: �� L__A Telephone: j { 7 _ �� `r. State Lic. # 6 City Lie. #.: G L,/ � �,1 Gl� l�►vt~�t G�C� Arch., Engr., Designer: Address: City, ST, Zip: Telephone: State Lic. #: Construction Type: Occupancy: Project type (circle one): New Add'n Alter Repair Demo Name of Contact Person: M1j�� Sq. Ft.: # Stories: # Units: Telephone # of Contact Person: �' S (�� — t j Estimated Value of Project: L12 APPLICANT: DO NOT WRITE BELOW THIS LINE # Submittal Req'd Reed TRACKING PERMIT FEES Plan Sets Plan Check submitted Item Amount Structural Calcs. Reviewed, ready for corrections Plan Check Deposit Truss Calcs. Called Contact Person Plan Check Balance Title 24 Calcs. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2"" Review, ready for corrections/issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted Grading IN ROUSE:- 'r0 Review, ready for corrections/issue Developer Impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue School Fees, Total Permit Fees