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BSOL2015-00787 n. 78-495 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 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING PERMIT BSOL2015-0078 53725 AVENIDA CORTEZ 774101016 DANIELS/6.89kW PV SYSTEM - (26) 265W PANELS/(1) INV+200A MSP $15,226.90 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 Divis&ofeness and Professions Code, and my License i in full force and effect. License Cla s: B C10 A C20 Li4 40 r Da 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 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, as owner of the property, or my employees with wages as their3ole 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: VOICE (760) 777-7125 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: SANDRA PETERSON 54565 OAKHILL LA QUINTA, CA 92253 Contractor: SOLARCITY CORPORATION 3055 CLEARVIEW WAY ATTN ZOE STEELE, SAN MATEO, CA 94402 (650)963-5630. Llc. No.: 888104 Date: 9/9/2015 o c z �" (J7 m o � . -p D C r C> T o� � Cfl m o tV C� Z D O y Ul z U WORKER'S COMPENSAT+ON DECLARATION I hereby affirm under penalty of perjury one ofthe following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 370Uof the Labor Code, for the performance rk for which this permit is issued. I have and will maintain workers' co••npensation insurance, as required by Section 700 of the Labor Code, for the perfornance 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 3x00 aJLaCode, I shall forthwith comply wit thos provisions. Daw " ' Applican WARNING: FAILURE TO SECURE WORKERS' CONI PEN5ATION C VERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000M. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR N SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. APPLICANT ACKNOMLEDGEMENT IMPORTANT: Application is hereby made to the 3uilding Official for a permit subject to the conditions and restrictions set forth on this application. 1. Each person upon whose behalf this application is made, each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this application , the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the Cty of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of is: uance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and staL- that the above information is correct. I agree to comply with all city and county ordinances and state Flaelti,n o buildingconstruction, and hereby authorize representati-es of thi up n t e above mentioned rop y for inspection purposes. Date v Signature (Applicant oo Agent):f �"�.y„S”` !F"Y�>�,.(Sv� .=S�i.;,:.,µ>�xw>b>i(. :r<.. �?'%"3�:�;. %�F.,�..v=_i...--.i "�::$>b«X.Pf.. 3<:F.��9�.. .sF56.i, C>€. .�'kM,Y�. A..d:FY+«�T.W"W.N :.< x.�SW:F'. CS'Y.!<,:E Af. ..-.a,r�.uAR-:}+?:.: `$-'✓ ��++'F 6.�A-Tv:.i>... CYT. �.-.FiFo C.w•�... `BSAS SB1473 FEE 101-0000-20306 0 $100 $0.00: '...j$ i BYz METIOD� i �:" 4 3 _i.Hi� v:t !y ht 'a�+ ,., rl:r "ka*A" : �tj. S'e`-' ,l.,s .xx✓. �i� Y a!r. ::t '>: xx ''•i t f4 g ? k:^ RECEIPT # i CHECK FPAID s� z ,i, �5 3az.�a.aai-+"k r, -mac � x i Al a y ," "�a ,a `�.4 �,%VX x., W vaNl a ,*ar,so.A°' >tOP r. Total Paid for B U I LD I N G STAN DAR DS ADMINISTRATION BSA 1.00r $0.00 v .s4. .9�T -0ESCRI?TION &'...% 'C S+,a;j�"Sffi _ "�i� ACCOUNT ' T - TtY y ER>o.:3tSE =,'N:IAIVIO NU T �;ih'y, � `s PAID t: PAID DATEx €? k ,9r .. i ",e < -�u :s'?'t:...:.:.t:.:.h :L .. zm'. .,. *:. ,, ,; gi`.,;,s :.< ,: � ,,.==,ri,`,c r. N<E i,a s:s€3 ; • '::e .:�t ... `F q :p C :: _.:», ?,�1 "- '�`,$`at .:......f3t ..,Rsi.: _ J E Y '3'x�Ye�s's: Zxa' .:: P.I S z` PV SYSTEM- ARRAY; FIRST 20 101-0000-42403 0 $24.17 $0.00 PAIQ BYE Y METHODS4 ECEIPT#�� CHECK # E I CL D BY n �<�. .£'*)a: . s", :.>;dY :,'. >}.-'Y uS"- .�+.a[ .:=t.'.�{Z'e .'f':?r•.'X' .., a,.:.- 3:.�i3`S'»N'£Y_�3 :4� 'e:;% �'`DESGRIPTIONr '.. W 'S�i'. %;`et,k'Y., x:=`=Y ASR'•>Yy<.. :;'e +0 3 :,TKA' - TY!�AMOUNT` ✓:."F"{i$°t' v SFFi.', 4t � ,5,"4...,,'x...". ',k€x11 '. E°ACCOUNT + E`Ki°.s',.piS'E ,X. 4. ,� Miami '�_d"Y n.><.�l ,.�>.y. < `ae,�wra.. r. gPAID F,{..:.2; '>�(a k,aRH�G' .SiKr : �. PAID DATES E k i..4• a vh<,-'Y^„z,x -xt_ PV SYSTEM -ARRAY, FIRST 20 PC 101-0000-42600 0 $24.17. $0.00 PAIDzBY gE€ ' ,t 'METHO.D `����. xn..'�: ;_# ;; k>"9. � i•Y.">lcq ��'f a®.4,,.YahR4 b`k�': ^5,;, ,4 hsn'{�ti�V' °t4 F 4i DESCRIPTION �� �.E•:�� `,"i f.�ie 'FI 44'-k'�4 �}� A000UNT:1'-, � i� $! "•. F>.v ,� t..:e 'xSP t..TSg' iii AMOUNT fi S�" ,�a•x+!,�^f.: >iy ' ' },,� i, S -. . 45xi�' _..✓ �a>' m :i: rS `%.,-, e✓t-.'S;'-� ',�P .:'cA x4::'�i.c.x::e�}3i`'ia,. ;,:y<�Y� £..'Y<i.:n d vis,;YL`f{xg2��:r'imr:.#X:F,$-F..�..k':-a>.-ey. x ... Tt Ftk PQID� Y �� 5,�, 3 n<`f'.S>.. U,...,. 3M PAIDfYDATE` PV.SYaSTEM - MISC EQUIPMENT 101.0000-42403 0 $24.17''' $0.00 ' PAID BY M; r..'hb.,,b: kJ �-- i W: iY L ""`t.n,43s^<d...,.,: t3YF •! RECEIPT #y _ e „ h CHECK<# . CCTD�BYF,y; x, ,,�•� � � � d� r� � �� -11AETHOD s 'g � �,. , , ,�� A. t � ��0. .:... a.Fv ACCOUNT " r �S QTY .a.v 5. v� rrrar®5-?..>.'2 AMOUNT;, ` i� '> -.' F`,�N t'.r�..^s 45PAID;DATE yt.K.'c '?E . .w a�..,. :.�a..<�.F.S.. !<:.r: ,..sP PV SYSTEM.- MISC EQUIPMENT PC, 101-0000-42600 0 $24.17' $0.00 -1fx fir"^.;,,^ -r'. ;..�.-::.'^,+.: ..,'"•:+: si5? :4 z-,$ir. ,$T.. aMETIOD� X.•:a'i.a ,"c RECEIPT#3' E'er ,r. Y',:a ..;>"S't... <.CHECK:# 5,PAIU"BY ; y Sk '2^ fjRie9.�.:.v..:t:.�..:�w a�T`: aw .v' e,s5..t.'vca:>yIf,'<..�..csz `3x°vt,s':i,_>t..`"':::ii.+> LTD xt' Total Paid for ELECTRICAL: $96.68 ':ryvi3 x.€' ✓ , a,... xzr .>;r< A,r F v4 ..:S Via -DESCRIPTION; �a ,rr.„ icy n F; :Z„ ti<: ACCOUNTS a.y°`.'Lets ':,Q TY AMOUNT x$0.00 PAID PAID°DATE` ,,v= z rk•:s.a'.':s�.eNxn.,.'x�b??�t„F:zt'-f3[..;,,.x=?Sx,4,'E.zFa�<�i..c:...,€Ys4„r'xu;�i<..`.''-F�:.re ;z k.,, 5t'':Y,.yi'>,e>�?i4.. �a r ,> tkc+:N',:,:•rar.,-'.�xR?'.,.;5'�,-��W,�` c-1:.§fR. 'ri*.gtt'z'x, PERMIT ISSUANCE 101-0000-42404 '' 0 $91.85 $0.00 " Rei.: � " �> x?' : t7.y> `:S� '°^€, s ,�-.x��,�... 3Q�' T`�.r-:E�a x;r"CHECK # 6 CLTD BYi" ,1i„; `ra9:.a4_a ,�<<-r .• s Ex._. x. s..F .�'..� , z z°�.i,h?. 4,4.METFIO.D.RECEIPT# Total Paid forPERMIT'ISSUANCE: $91.85 $0.00 . ' Permit Details PERMIT�NUMBER ' :-: BSOEZ01{5=007$ City of Ea Quanta r .k Description: DANIELS/6.89kW PV SYSTEM - (26) 265W PANELS/(1) INV+200A MSP Type: SOLAR Subtype: Status: APPROVED Applied: 6/12/2015 AZA Approved: 8/25/2015 JFU Parcel No: 774101016 Site Address: 53725 AVENIDA CORTEZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA AT VALE LA QUINTA Block: 195 Lot: 10 Issued: UNIT 19 Lot Sq Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $15,226.90 Occupancy Type: Construction Type: Expired: No. Buildings: 0 No. Stories: 0 No. Unites: 0 Details: 6.89 kW SOLAR ARRAY- (26) 265W KYOCERA KU2656ZPA PANELS W/ (1) SOLAREDGE SE5000A-US-ZB-U-AFCI INVERTER + MAIN SERVICE PANEL UPGRADE TO 200A [468SF] 2013 CALIFORNIA ELECTRICAL CODE. Printed: Wednesday, September 09, 2015 1:24:53 PM 1 of 3 SYSTEMS ADDITIONAL CHRONOLOGY: CHRONOLOGY TYPE ; . " STAFF NAME ACTIO PItDATE`,- _ _. >-COMPLETION DATE `- °.:NOTES NOTIFIED ELENA W/ SOLAR CITY THAT REVIEW WAS E-MAIL JAKE FUSON 6/23/2015 6/23/2015 COMPLETE AND REVISIONS WERE REQUIRED. NOTIFIED ELENA W/ SOLAR CITY THAT PLANS WERE E-MAIL JAKE FUSON. 8/25/2015 8/25/2015 APPROVED AND PERMIT WAS READY TO ISSUE. PLAN CHECK SUBMITTAL ED VASQUEZ 8/14/2015 8/14/2015 2ND PLAN CHECK SUBMITTAL RECEIVED RECEIVED CONDITIONS CONTACTS NAME TYPE NAME` - ADDRESSI CITY 'STATE 21P° `' PHONE; FAX EMAIL APPLICANT SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO CA 94402 mplasse@solarcity.com CONTRACTOR SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO CA 94402 mplasse@solarcity.com OWNER SANDRA PETERSON 54565 OAKHILL LA QUINTA CA 92253 Printed: Wednesday, September 09, 2015 1:24:53 PM 1 of 3 SYSTEMS