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BSOL2017-002378-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type/Subtype: Application Number: Property Address: APN: Application Description Property Zoning: Application Valuation: Applicant: ECOLIVING INC 42575 MELANIE PL STE S PALM DESERT, CA 92211 DESIGN & DEVELOPMENT DEPARTMENT BUILDING PERMIT SOLAR/RESIDENTIAL LESS THAN 1OKW BSOL2017-0023 81945 VIA LA SERENA 767660038 O'MEARA / 6.OkW PV SYSTEM - (20) 30OW PANELS+IQ6 MICRO INV $21,000.00 VOICE (760) 777-7125 1. FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: KATHERINA O:MEARA 81945 VIA LA.iERENA LA QUINTA, CA 92253 f ` ® Contractor: ECOLIVING INC I' 42575 MELANtE.PL STE S m®v 1 b Z F7 j� PALM DESERT, CA 92211 it t (760)671-2440 CITY OF I- u'' ' �' Llc. No.: 918267 oESIGN AND DEVELCV .',; l ) o".2 I Y ENT 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 Business and Professions Code, and my License is in full force and effect. License Class: C10, A License No.: 918267 Dater //( ?C'64tractor: OWNER -BUILDER DECLARATION 1 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).: (_J 1, 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. lf, 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 Contractots' 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: Date: 11/15/2017 WORKER'S COMPENSATION DECLARATION hereby affirm under penalty of perjury oneof 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 aft w rk for which this permit is issued. I have and will maintain workers' =ompensation insurance, as required by ion 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: STATE COMPENSATION INSURANCEIFUND Policy Number: 9214620 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 Sectior 3700 of the Labor Code, 1 shat forthwith comply with those prov' ions. y G'Applicant: Date: �� / ��, WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 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 _he Building Official for a permit subject to the conditions and restrictions set forth on tiis 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, an4 the applicant, each agrees to, and shall defend, indemnify and hold harmless the Citi of La Quinta, its officers, agents, and employees for any act or omission related tothe 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 issiance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and :;tate that the above information is correct. I agree to comply with all city and county oranances and state laws relating to building construction, and hereby authorize represen-atives of this city to enter upon the ab—.v mentioned propertyforinspection purposes- p� Date: /t i l / Signature (Applicant or Agentt)!�K/// Date: 11/15/2017 Application Number: BSOL2017-0023 Owner: 4 Propert7ldd�ess °'?: '` 7`81945 VIA�LA SERENA KATHERINA O'MEARA APN: 767660038 81945 VIA LA SERENA Application Description: O'MEARA / 6.OkW PV SYSTEM - (20) 30OW PANELS+IQ6 MICRO INV LA QUINTA, U. 92253 Property Zoning: Application Valuation: $21,000.00 Applicant: Contractor: ECOLIVING INC ECOLIVING INC 42575 MELANIE PL STE S 42575 MELAN E PL STE S PALM DESERT, CA 92211 PALM DESERT, CA 92211 (760)671-244C --------------------------------------------------------------------------------------- Llc. No.: 9182E7 Detail: 6.0kW SOLAR ARRAY - (10) 30OW CANADIAN SOLAR PANELS+EN PHASE IQ6-60 MICROINVERIBRS W/(1) 60 AMP AC COMBINERBOX [360SF] 2016 CALIFORNIA ELECTRICAL CODE. FINANCIAL INFORMATION J. DESCRIPTION ACCOUNT QTY AMOUNT BSAS SB1473 FEE 101-0000-20306 0 $1.00 Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $1.00 DESCRIPTION ACCOUNT QTY AMOUNT Credit Card Fee 101-0000-43505 0 $3.00 Total Paid for Credit Card Fee: $3.00 Total Paid for ELECTRICAL: $52.02 . ACCOUNT QTY AMOUNT 101-0000-42404 0 $98.83 Total Paid for PERMIT. ISSUANCE: $98.83 ACCOUNT QTY AMOUNT •101-0000-42416 • 0 $10.00. Total Paid for RECORDS MANAGEM=NT.FEE: $10.00. ACCOUNT QTY AMOUNT 502-0000-43611 0 $5.00 Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00 �TOTALS: $169.85 1 DESCRIPTION TECHNOLOGY ENHANCEMENT FEE s ■