BSOL2016-013078-495 CALLE TAMPICO D VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN &DEVELOPMENT DEPARTMENT FAX
(760) 777-7153
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
BUILDI PERMIT
D® Date: 5/30/2017
BSOL2016-0130 wner:
48615 CALLE ESPERANZA MONA DAVIDSON MURRAY
646121008 MAY 3 0 2017 48615 CALLE ESPERANZA .
DAVIDSON / SOLAR THERMALER HEATING SYSTEM LA QUINTA, CA 92253
$8,500.00
Applicant:
CALIFORNIA SOLAR THERMAL INC
16486 BERNARDO CENTER DR
STE 318
SAN DIEGO, CA 92128
CITY OF LA QUINTA
DESIGN AND DEVELOPMENT DEPARTMENT
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 he Business and Professions Code,
and my License is in full force and effect.
LicenseClss: C46 License No.: 963230
�Da e Y! 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
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 J
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.).
(_) 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 a owner of property who builds or improves
thereon, and who contracts for the p jects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
(_) I am exempt under Sec. P.C. for this rea
;DI l
v
CONSTRUCTION L NDING 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 Ad
Contractor:
CALIFORNIA SOLAR THERMAL INC
16486 BERNARDO CENTER DR
STE 318
SAN DIEGO, CA 92128
(858)336-4602
Llc. No.: 963230
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: CALIFORNIA INSURANCE COMPANY Policy Number: 4674220901
I certify that in the performSnce of the work for which this permit is issued, I
shall not employ any person in any manner so s to become subject to the workers'
compensation laws of California, and agree tha if I should become subject to the
workers' compensation provisions of Section 3 of the La , I shall forthwith
comply with those provisions.
Date: _ 5 3tt f Applica t:'
WARNING: FAILURE TO SECURE WORKERS' COMPESATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL IINALTIES 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 tk above information is correct.
I agree to comply with all city and county ordinances an tate laws relating to building
construction, and hereby authorize representatives of this t
' o enter upo e
above -me tioned property for inspection purposes.
Date Signature (Applicant or Agent):
Date: 5/30/2017
Application Number: BSOL2016=0130
Owner:
Property Address: 48615 CALLE ESPERANZA
MONA DAVIDSON MURRAY '
APN: 646121008
48615 CALLE ESPERANZA
Application Description: DAVIDSON / SOLAR THERMAL WATER HEATING SYSTEM
LA QUINTA, CA 92253
Property Zoning:
Application Valuation: . $8,500.00
Applicant:
Contractor:
CALIFORNIA SOLAR THERMAL INC
CALIFORNIA SOLAR THERMAL INC'
16486 BERNARDO CENTER DR
16486 BERNARDO CENTER DR
STE 318
STE 318
SAN DIEGO, CA 92128
SAN DIEGO, CA 92128
(858)336-4602
------------------ -.-------------------------------- ----------------------------------------=--
Llc. No.: 963230
Detail: SOLAR THERMAL DOMESTIC WATER HEATING SYSTEM [26SF) THIS PERMIT DOES NOT INCLUDE SUPPLEMENTAL PUMPS OR ELECTRICAL
INSTALLATIONS. 2013 CALIFORNIA BUILDING CODES.
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT CITY AMOUNT
BSAS SB1473 FEE. 101-0000-20306 0 $1.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$96.27
Total Paid for PERMIT ISSUANCE: $96.27
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SOLAR THERMAL
101-0000-42401
0
$25.33
DESCRIPTION
ACCOUNT
CITY
AMOUNT
SOLAR THERMAL PC
101-0000-42600
0 e
$25.33
Total Paid for PLUMBING FEES: $50.66
TOTALS: $147.9-21
r