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BSOL2015-010578-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: SOLARCITY CORPORATION 3055 CLEARVIEW WAY ATTN ZOE STEELE SAN MATEO,CA 94402 T"ty' °F'4Qwxfw COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BSOL2015-0105 45325 BIRCHCREST CIR 604303002 REIINA/8.215kW PV SYSTEM - (31) 265W PANELS/(2) INV+125A SUB $18,155.00 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 th Business and Professions Code, and my Lic se is in full force and effect. LicRX2 A C20 Lic se 8 04 DaUnt—ract6r': OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the ntractor'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.). (_) 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 VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: AVINANTE REI iNA 45325 BIRCHC2EST CIRCLE LA QUINTA, Cf 92253 Contractor: SOLARCITY CORPORATION 3055 CLEARVIEW WAY ATTN ZOE STEELE SAN MATEO, Ca 94402 (650)963-5630 Llc. No.: 888104 Date: 9/23/2015 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury onE of the following declarations: I have and will maintain a certifiote of consent to self -insure for workers' aeption, as provided for by Section 3:00 of the Labor Code, for the performance k for which this permit is issued. I have and will maintain workers' compensation insurance, as required by 00 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: _ _ I certify that in the performance -of the work for which this permit is issued, I shall not employ any person in any manner _o as to become subject to the workers' compensation laws of California, and agree fiat ' I should become subject to the workers' compensation provisions of Sec ' 00 &thbor de, I shall forthwith compl i h o provisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATIOVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE ND 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 -he Building Official for a permit subject to the conditions and restrictions set forth on t1 is application. 1. Each person upon whose behalf this appication 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 owr er, 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 or 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 nate that the above information is correct. I agree to comply with all city and county ordinances and stat ws re ing to building conte- nd reby authorize representatives of this cit to nter u n the abope r inspection purposes. DatSignature (Applicaric or Agen o to �I J I QO C, WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury onE of the following declarations: I have and will maintain a certifiote of consent to self -insure for workers' aeption, as provided for by Section 3:00 of the Labor Code, for the performance k for which this permit is issued. I have and will maintain workers' compensation insurance, as required by 00 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: _ _ I certify that in the performance -of the work for which this permit is issued, I shall not employ any person in any manner _o as to become subject to the workers' compensation laws of California, and agree fiat ' I should become subject to the workers' compensation provisions of Sec ' 00 &thbor de, I shall forthwith compl i h o provisions. Date: Applicant: WARNING: FAILURE TO SECURE WORKERS' COMPENSATIOVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE ND 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 -he Building Official for a permit subject to the conditions and restrictions set forth on t1 is application. 1. Each person upon whose behalf this appication 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 owr er, 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 or 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 nate that the above information is correct. I agree to comply with all city and county ordinances and stat ws re ing to building conte- nd reby authorize representatives of this cit to nter u n the abope r inspection purposes. DatSignature (Applicaric or Agen I FINANCIAL • • � " 'QTY A- M'PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 a„ ,PAID BY �' ' 'a ; : ,' . ` METHOD `:".' RECEIPT # CHECK # _, CLTD BY, , Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 $0.00 'DESCRIPTION _ ' , :, _`7ACCOUNT ` QTY, f AMOUNT '- ? : ' r ^PAID .PAID DATE" PV SYSTEM - ARRAY, FIRST 20 101-0000-42403 0 $24.17 $0.00 :- PAID BY �'`' +° ' METHOD, " RECEIPT # `, i" CHECK # r' ; . CLTD BY, _ DESCRIPTION' a ':: r; ',ACCOUNT + QTY „ AMOUNT = PAID PAID DATE PV SYSTEM - ARRAY, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 X. .PAID BY a °' METHOD ,, w RECEIPT,# "CHECK C' . CLTD-BY Total Paid for ELECTRICAL: $48.34 $0.00 F». - DESCRIPTION <ACCOUNT , -:AMOUNT" PAID DATE. PERMIT ISSUANCE 101-0000-42404 _ 0 $91.85 $0.00 PAID BY, , -; METHOD, •3 `'.',; ,, „RECEIPT# s CHECK# 3 > CLTD BY_ : Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:00 I rLqv M, r ij�or•r+� r,�•, _ a �, ,,, G= �_�."''±�^s�^. �.a+-'?3�e�'r.'x eco __ ,., a.._"„"''� au+. Description: REIINA/8.215kW PV SYSTEM - (31) 265W PANELS/(2) INV+125A SUB Type: SOLAR Subtype: Status: APPROVED Applied: 7/16/2015 PJU Approved: 9/22/2015 JFU Parcel No: 604303002 Site Address: 45325 BIRCHCREST CIR LA QUINTA,CA 92253 Subdivision: TR 23995-2 Block: Lot: 27 Issued: Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $18,155.00 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 4�4t4,H ,C .. , i+i;..; ... 'A. �..•t-a.Yr, Details: 8.215 kW SOLAR ARRAY - (31) 265W KYOCERA KU2656ZPA PANELS W/ (1) ABB PVI-3.6-OUTD-US-Z-A INVERTER & (1) ABB PVI-3.0- OUTD-US-Z-A INVERTER + 125A SUBPANEL [558SF] 2013 CALIFORNIA ELECTRICAL CODE. ` :[•3.ti..r ” _•- -�y-a..,.. : ".`, as. :`. ..._ . ta:. y# 4`C.;..,.: -,^, �' ya,,k`:t�` Srr .s" 5 3 - ':i_..:-..-u�y"+a ADDITIO a� : =r+'.t:. ,.�.��,�, NALS 5_.i �4'!., ,. r.,.`_. �.. "4y Yff R'wO, VOr LOGY'ityk?S .�_Z AT_1,.�:,..,,_.:s...�+.:J�.✓. .0410.1 _: .._:. "F `4. 4�4t4,H ,C .. , i+i;..; ... 'A. �..•t-a.Yr, �A. ; IE�' DATE COMPLETION DATENOTES NOTIFIED ELENA W/ SOLAR CITY THAT PLAN REVIEW WAS � r r COMPLETE AND REVISIONS WERE REQUIRED. SUBMITTALPLAN CHECK r r RECEIVED r�-�;�.,a��er� -•�,p��?;,..�... '��R4�.�� ,�. m;��.,f .fir 4:..,.r �.:,: rs rb,��CONDITIONS =:;; �•,zr �.�, ;� ...,� Ago"" •.' �.r :r ...®®® r� r r. • SOLARCITY CORPORATIONr r(415)272-8957 mplasse@solarcity.co CORPORATIONCONTRACTOR SOLARCITY r ®®(41S)272 -89S7 mplasse@so.larcity.co �® CIRCLE Printed: Wednesday, September 23, 2015 3:07:23 PM 1 of 3 CR SYSTEMS