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BSOL2017-002878-495 CALLE TAMPICO LA QUINTA, CALIFORNIA'92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: SOLAR/THERMAL BSOL2017-0028 52400 AVENIDA VALLEJO 773263008 aaw DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT PACIFIC GREEN HOMES / POOL THERMAL SYSTEM $7,000.00 Applicant: REVCO SOLAR ENGINEERING INC 2663 CABOT RD STE B LAGUNA HILLS, CA 92653 JAN 0 8 2018 CITY OF LA QUINTA COMMUNITY 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 Leffect. ision 3 of the Business and Professions Code, and my License is in full force anLicense Class: B. C46. C10 No.: 38 Date: r:>� 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).: (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.). (1 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 arri 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 /Date: 1/8/2018 Owner: PACIFIC GREEN HOMES 52400 AVENIDA VALLEJO LA QUINTA, CA 92253 Contractor: REVCO SOLAR ENGINEERING INC 2663 CABOT RD STE B LAGUNA HILLS, CA 92653 (949)367-0740 Llc. No.: 387219 -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 0 ork for which this permit is issued. :;-4 I -have and will maintain workers' compensation insurance, as required by Sectiohc3700 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 COMPENSATION INSURANCE FUND Policy Number: 9003164 _ 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 shall forthwith comply with t[h➢ose provisions. )I e WARNING: FAILURE TO SECURE WORKERS' COMPENSAT (�) <0VERAGE 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 ey�r upon abovR- mentioned property for inspection purposes. , / /j/ Date �Signatuce.(APPlicantor,Age Date: _ 1/.8/2018.. Application Number: BSOL2017-0028 Owner: Property Address:' < "' :32400 AVENIDA VALLEJO PACIFIC GREEN HOMES APN: 773263008 52400 AVENIDA VALLEJO Application Description: PACIFIC GREEN HOMES / POOL THERMAL SYSTEM LA QUINTA, CA 92253. Property Zoning: Application Valuation:,- $7,000.00 Applicant: Contractor: REVCO SOLAR ENGINEERING INC REVCO SOLAR ENGINEERING INC 2663 CABOT RD STE B. 2663 CABOT RD STE B LAGUNA HILLS, CA 92653 LAGUNA HILLS, CA 92653 (949)367-0740 - --- -------- -------._--=--=---------------------- '- Llc. No.: 387219. - - -- ------ - - - -- Detail: SOLAR POOL WATER HEATING SYSTEM - 280SF COLLECTOR, ELECTRICAL CONTROL AND PIPING TO EXISTING POOL PLOMBING. THIS PERMIT DOES NOT INCLUDE ADDITIONAL.OR ALTERATION TO EXISTING POOL PUMP/EQUIPMENT. 2016 CALIFORNIA BUILDING CODES. FINANCIAL INFORMATION DESCRIPTION ACCOUNT QTY AMOUNT. \ BSAS SB1473 FEE 101-0000-20306 0 $1.00 J Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00. DESCRIPTION ACCOUNT QTY AMOUNT APPLIANCES, RES 101-0000-42403 0 $13.00 DESCRIPTION ACCOUNT QTY AMOUNT ' APPLIANCES, RES PC 101-0000-42600 0 $13.00 Total Paid for ELECTRICAL: $26:00 DESCRIPTION ACCOUNT QTY AMOUNT PERMIT ISSUANCE 101-0000-42404 0 $98.83 • 'Total Paid for PERMIT ISSUANCE: $98.83 DESCRIPTION ACCOUNT QTY AMOUNT SOLAR THERMAL 101-0000-42401 0 $26.01 DESCRIPTION ACCOUNT QTY AMOUNT SOLAR THERMAL PC 101-0000-42600 0 $26.01 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT/REP 101-0000-42401 0 $13.00 DESCRIPTION ACCOUNT QTY AMOUNT WATER SYSTEM INST/ALT%REP PC 101-0000-42600 " 0, $13.00 Total Paid for PLUMBING FEES: $78.02 DESCRIPTION ACCOUNT QTY AMOUNT RECORDS MANAGEMENT FEE 101-0000-42416 0 $10.00 Total Paid for RECORDS MANAGEMENT FEE: $10.00 DESCRIPTION ACCOUNT QTY AMOUNT TECHNOLOGY ENHANCEMENT FEE 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00