BSOL2016-010478-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: .
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
SCOTT MUSICH
1488 BOND ST SUITE 100
tlt.PERVILL, IL 60563•
T4tv, 4 4 Q91A i
DESIGN & DEVELOPMENT DEPARTMENT
BSOL2016-0104
78601 HIGHWAY 111
643220007
ALDI / 71.3kW PV SYSTEM - (230)
$67,450.00
IINGG-PER
SSP 1
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: C10 license No.: 996078
D� ate: ~_ Contractor.
'J
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).:
(_J 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.).
( ) 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 Address:
TIM
VOICE (760) 777-7125
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 9/13/2016
Owner:
ACM LA QUINTA IV B
216 1800 AVE OF THE STARS 105
A.SUB LOS ANGELES, CA 92253
Contractor:
ASGARD ELECTRICAL AND LIGHTING
PO BOX 832
CRESTI-INE; CA 9232-5-4,
(909)589-2060
Llc. No.: 996078
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: STATE FARM GENERAL INSURANCE COMPANY Policy Number:
92ECV4980
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
comply with those pr vi``si��ons.
Date: ' c0 • 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 upo
above-mennttiio d pro erJrty for inspection purposes.
Date: / ✓ `fsignature (Applicant or Agent):
r -
i
Date: '9/13/2016
Application Number: BSOL2016-0104
Owner:
Property Address: 78601 HIGHWAY 111
ACM LA QUINTA IV B '
APN: 643220007
1800 AVE OF THE STARS 105
Application Description: ALDI / 71.3kW PV SYSTEM - (230) 31OW PANELS/(3) INV/125A SUB
LOS ANGELES, CA 92253
Property Zoning:
Application Valuation: $67,450.00
Applicant:
Contractor:
SCOTT MUSICH
ASGARD ELECTRICAL AND LIGHTING
1488 BOND ST SUITE 100
PO BOX 832
NAPERVILL, IL 60563
CRESTLINE, CA 92325
(909)589-2060
LIc. No.: 996078
'Deta4:`7'1:3kW SOLAR ARRAY -.(230) 31GW CSUN PANELS W/(:,) SIviA SUNNYBOY T RIPOWER 20006TL lrSVe-111" RS, (1) 75kVA TRANSFORMER AND (1) 125A
SUB PANEL [4,140SF] LOAD SIDE CONNECTION INTO EXISTING 1,200A SERVICE ALL EXISTING AND PROPOSED
EQUIPMENT SHALL MAINTAIN AND BE
INSTALLED PER PRODUCT LISTING. 2013 CALIFORNIA ELECTRICAL CODE.
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i
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE
101-0000-20306 0 $3.00
Total.Paid for BUILDING STANDARDS ADMINISTRATION BSA: $3.00
DESCRIPTION
ACCOUNT
QTY
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
$48.34
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PV SYSTEM- MISC EQUIPMHITi PC
101-0000-42600
J Total Paid for ELECTRICAL: $145.02
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$91.85
J
t
Total Paid for PERMIT ISSUANCE: $91.85
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City of La Quanta
Bu"w s Safety Dlvw6n
P.O. Box 1504,'78-49S Calk Tames
LG.W4 CA 91233 - (760) 777-7012
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Stats Lie. #: - rd 41 Project type (circle one): New Add'a Repair Demo
Name of Coatekx Person LO U S i \ Sq. FL: ti Stories: # Unitx
Tdephoae # of Coahet Person: Estimated Valk of Projoct i
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—r dTm kr .FAQ -co wtLob T
parson Engineering, Inc.
1488 Bond Street, Suite 100
Naperville, IL 60563-6503
630.357.0540 Fax: 630.357.0164
www.Iarsonengr.com
Larson
March 9, 2016
Mr. Quency P. Fahlgren
QPatrick Engineering Design Resources
7308 SE 66" Avenue
Portland, OR 97206
Re: Aldi Inc. Store No. 68
78-601 Highway 111
Solar Array Roof Framing Analysis
La Quinta, CA
LEI Project No: 21160076.004
Dear Mr. Fahlgren:
Pursuant to your request, Larson Engineering, Inc. (LEI) has evaluated the existing roof framing
design drawings for the above referenced project to determine whether the existing,roof structure
can support the proposed roof mounted solar array system.
Our review is based on the following drawings: existing roof structure per sheet S-111 prepared
by B & B Associates and dated 8/7/2015; the proposed racking layout drawings, sheet PC -2
prepared by PanelClaw, Inc. and dated 3/3/2016; and technical information provided by
PanelClaw, Inc. for the PolarBear III I OD racking system.
Larson Engineering based their determination of the loads on the California Building Code 2013,
and SEAOC PV -1 and PV -2, as well as the drawings noted above. Per the calculations performed
by LEI, we have determined that the existing roof structure is adequate to support the proposed
roof mounted solar array system.
If you have any further questions regarding this matter, please feel free to contact our office.
Sincerely,
Larson Engineering, Inc.
Matthew J. Kan
Engineer I — Structural
mkan@larsonengr.com
MK:jlb
B.
Joseph Tinder 2y g� Nps c2
a. .
Mar 9 2016 4: �i R
si C 71837
Joseph B. Tinder, P.E.
Regional Managercfj9� CIVIL
jtinder@larsonengr.com Ol` ret\F
1 of 1 21160076.004:-160309,MK-.LI
heck .A License - License Detail
Contractor's License Detail for License # 996078
Page 1 of
)ISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this
nformation, you should be,aware of the following limitations.
CSLB complaint disclosure is restricted by law (B&P 7124.6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the
link or button to obtain complaint and/or legal action information.
Per B&P 7071:17 , only construction related civil judgments reported to the CSLB are disclosed.
Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration.
Due to workload, there may be relevant information that has not yet been entered onto the Board's license database.
Business Information
ASGARD ELECTRICAL AND LIGHTING
PO BOX 832
CRESTLINE, CA 92325
Business Phone Number:(909) 589-2060
Entity Sole Ownership
Issue Date 08/25/2014
Expire Date 08/31/2018
. - License Status
'his license is current and active.
II information below should be reviewed.
Additional Status
The license may be suspended on 10/06/2016 if the workers' compensation insurance policy is not filed with the CSLB.
Classifications.
10 - ELECTRICAL
Bonding Information
Contractor's Bond
his license filed a Contractor's Bond with HUDSON INSURANCE COMPANY.
ond`Number:30011074
and Amount: $15,000
ffective Date: 05/21/2016
ontractor's Bond History
Workers' Compensation
his license has workers compensation insurance with the STATE FARM GENERAL INSURANCE COMPANY
olicy Number:92ECV4980
ffective'Date:08/01/2015
kpire Date: 09/01/2016 .
/orkers' Compensation History
tps://www2.cslb.ca.gov/OnlineServices%CheckLicenseII/LicenseDetail.aspx?LicNum=996078 9/13/201