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BSOL2015-0166Applicant: Contractor: r SOLARCITY CORPORATION 3055 CLEARVIEW WAY 3055 CLEARVIEW WAY ATTN ZOE STEELE ATTN ZOE STEELE SAN MATEO, CA 94402 SAN MATEO, CA 94402 VOICE (760) 777-7125 788-495 CALLE TAMPICO Llc. No.: 888104 FAX (760) 777-7011 FAX LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT (760) 777-7153 BUILDING PERMIT Date: 9/14/2015 Application Number: BSOL2015-0166 Owner: Property Address: 51910 AVENIDA JUAREZ ELISA SILVA APN: 773155008 51910 AVENIDA JUAREZ Application Description: 5.3kW PV SYSTEM - (20) 270W PANELS/(1) INVERTER LA QUINTA, CA 92253 Property Zoning: Application Valuation: $13,470.00 Applicant: Contractor: SOLARCITY CORPORATION SOLARCITY CORPORATION 3055 CLEARVIEW WAY 3055 CLEARVIEW WAY ATTN ZOE STEELE ATTN ZOE STEELE SAN MATEO, CA 94402 SAN MATEO, CA 94402 (650)963-4722 Llc. No.: 888104 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 Bu ' ess and Professions Code, and my License is in full force and effect. License ss: C4 B CIO, A C20 Lice., e : 8 Da 110 Contractor: , 7 I hereby affirm under penalty of perjury that 1 am exempt from the Cor>ctor's State License Law for the following reason (Sec. 7031.5, Business and Professi s 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).: ( ) 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.). ( 11, 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 Address: 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' com ensation, as provided for by Section 3700 of the Labor Code, for the performance Wor which this permit is issued. have and will maintain workers' compensation insurance, as required by of the Labor Code, for the performance of the work for which this permit y 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 subje the workers' compensation laws of California, and agree that, if I Id beco e s bject to the workers' compensation provisions of Sectio th labor ode I shall forthwith cspl I see p�sions. Date: Applicant: 0 WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONRAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES N CIVIL FINES UP TO i ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITIO T THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370 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 per1ormed 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 abo in ormati correct. I agree to comply with all city and county ordinance nd to la relat' g t building construction, and hereby authorize representatives f this to nter u on a above• m�� pr y foipection purposes. Date: / Signature (Applicant or Age . • 1.' FINANCIAL INFORMATION Mr fr ?-'e-.'DESCRIPTION,ACCOUNT > =," QTY 'AMOUNT PAID, PAID DATE BSAS SB1473 FEE 101-0000-20306 0 $1.00 $0.00 .. PAID BY ;..: '` ' " ;,,d METHOD RECEIPT # - CHECK # CLTD BY Total Paid forBU1LDING STANDARDS ADMINISTRATION BSA $1.00 $0.00 .DESCRIPTION �, , - -"3"'„ ACCOUNT' '.QTY _'. ;AMOUNT ": c, -PAID " PAID DATE, PV SYSTEM - ARRAY, FIRST 20 101-0000-42403 0 $24.17 $0.00 .PAID BY. ;` ,; `' ,METHOD , RECEIPT # CHECK# j CLTD BY a= ,DESCRIPTION,...` i-'. ACCOUNT r.r "" -QTY.; AMOUNT.-, PAID PAID DATE PV SYSTEM - ARRAY, FIRST 20 PC 101-0000-42600 0 $24.17 $0.00 PAID BY r_* *' METHOD., 1"RECEIPT # CHECK # ` CLTD BY , Total Paid for ELECTRICAL: $48.34 $0.00 DESCRIPTION ACCOUNT QTY' • AMOUNT PAID PAID DATE PERMIT ISSUANCE 101-0000-42404 0 $91.85 $0.00 '.PAID BY METHOD„+ ,z,•• RECEIPT# -CHECK# CLTD BY, Total Paid for PERMIT ISSUANCE: $91.85 $0.00 TOTALS:• •• i Description: 5.3kW PV SYSTEM - (20) 270W PANELS/(1) INVERTER ADDITIONAL Type: SOLAR Subtype: Status: APPROVED Applied: 9/1/2015 SKH Approved: 9/14/2015 LUR Parcel No: 773155008 Site Address: 51910 AVENIDA JUAREZ LA QUINTA,CA 92253 Subdivision: SANTA CARMELITA VALE LA QUINTA Block: 32 Lot: 17 Issued: UNIT 2 ACTION DATE' ' COMPLETION DATE, Lot Scl Ft: 0 Building Sq Ft: 0 Zoning: Finaled: Valuation: $13,470.00 Occupancy Type: _ Construction Type: Expired: No. Buildings: 0 - No. Stories: 0 No. Unites: 0 PLAN CHECK SUBMITTAL STEPHANIE KHATAMI Details: 5.3kW SOLAR ARRAY - (20) 265W KYOCERA PANELS W/ (1) ABB PVI-4.2-OUTD-S-US-Z-U-AFCI INVERTER [407SF] 2013 CALIFORNIA ELECTRICAL CODE. FINANCIAL INFORMATION Printed: Monday, September 14, 2015 11:08:17 AM 1 of 2 CR I:J srs TEMs ADDITIONAL '•lei to �'. CHRONOLOGY TYPE - STAFF NAME ACTION DATE' ' COMPLETION DATE, NOTES E-MAIL LUIS URIBE 9/14/2015 9/14/2015 SENT ELENA AN EMAIL, PERMIT IS READY TO BE ISSUED PLAN CHECK SUBMITTAL STEPHANIE KHATAMI 9/1/2015 9/1/2015 RECEIVED CONDITIONS CONTACTS NAME TYPE , ' - NAME ADDRES51 -`` CITY - ,• STATE ZIP PHONE FAX EMAIL APPLICANT SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO CA 94402 ( CONTRACTOR SOLARCITY CORPORATION 3055 CLEARVIEW WAY SAN MATEO CA 94402 ( OWNER ELISA SILVA 51910 AVENIDA JUAREZ LA QUINTA CA 92253 ( FINANCIAL INFORMATION Printed: Monday, September 14, 2015 11:08:17 AM 1 of 2 CR I:J srs TEMs