BSOL2019-000578-495 CALVE TAMPICO TO � 4"i VOICE (760) 777-7125 LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Permit Type/Subtype: SOLAR/RESIDENTIAL LESS THAN 1OKW Owner:
Application Number: BSOL2019-0005 OLESOVSKY PETRA
Property Address: 52855 AVENIDA DIAZ 52855 AVENIDA DIAZ
APN: 773311028 LA QUINTA, CA 92253
Application Description: OLESOVSKY / 6.0kW PV SYSTEM - (20) 30OW PANELS+OPT/(1) INV
Property Zoning:
Application Valuation: $29,800.00
Applicant:/ Contractor:
ANTHONY CARPENTER D LLrr �"� MCCORMICK'S ELECTRICAL
22642 LAMBERT DR 32441 SHADOW CANYON TRAIL
LAKE FOREST, CA 92630 APR 2 5 2019 WILDOMAR, CA 92595
CITY OF LAQUINTA (858)344-6048
DESIGN & DEVELOPMENT DEPARTMENT Llc. No.: 1018522
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
(commencing with Section 70001 of Division 3 of the Business and Professions de, and
my License is in full force and effect.
License Class: CCS License No.:
L S CoAtriietor:
OWNS ILDER 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).:
(_) 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 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 Add
Date: 4/25/2019
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 k for which this permit is issued.
711 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: STAT�_C_OMPENSATICN INSURANCE FUND Policy Number: 9211701
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 th or Code, I shall forthwith
comply with those provisions.
mss' A:YEeRTO
t:
WARNING: FAILURE TO SECURICERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMP 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 ent upon thea e -
mentioned property for inspection purposes.
5e (Applicant or Agen
Application Number:
Property Address:
APN:
Application Description:
Property Zoning:
Application Valuation:
Applicant:
ANTHONY CARPENTER
22642 LAMBERT DR
LAKE FOREST, CA 92630
BSOL2019-0005
52855 AVENIDA DIAZ
773311028
OLESOVSKY / 6.0kW PV SYSTEM - (20) 30OW PANELS+OPT/(1) INV
$29,800.00
Owner:
OLESOVSKY PETRA
52855 AVENIDA DIAZ
LA QUINTA, CA 92253
Contractor:
MCCORMICK'S ELECTRICAL
32441 SHADOW CANYON TRAIL
WILDOMAR, CA 92595
(858)344-6048
I.Ic, No.: 1018522
D4q: 4/Z5/2019
Detail: 6.0kW SOLAR ARRAY - (20) HYUNDAI 30OW MODULES+ P320 SOLAR EDGE. OPTIMIZERS W/ (1) SOLAREDGE 5E-5000HUS 240V INVERTER. 2016
CALIFORNIA ELECTRICAL CODE
FINANCIAL INFORMATION
DESCRIPTION ACCOUNT QTY AMOUNT
BSAS SB1473 FEE 101-0000-20306 0 $2.00
Total Paid for BUILDING STANDARDS ADMINISTRATION BSA: $2.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PV SYSTEM LESS THAN 10KW
101-0000-42403
0
$26.68
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PV SYSTEM LESS THAN 10KW PC
101-0000-42600
0
$26.68
Total Paid for ELECTRICAL: $53.36
DESCRIPTION
ACCOUNT
CITY
AMOUNT
PERMIT ISSUANCE
101-0000-42404
0
$101.40
Total Paid for PERMIT ISSUANCE: $101.40
DESCRIPTION
ACCOUNT
CITY
AMOUNT
RECORDS MANAGEMENT FEE
101-0000-42416
0
$10.00
Total Paid for RECORDS MANAGEMENT FEE: $10.00
DESCRIPTION
ACCOUNT
CITY
AMOUNT I
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE: $5.00
ta 0aigrau
CAI 117ORNIA --
PERMIT # �/
PLAN LOCATION:
Project Address• 52&�b -IqVrNjD,6- biAa
Project Description:
APN#:
2CC L by tJ�)
Patio/Porch SF
Email;
Applicant Name:�.s�
State Lic: City Bus Lic:
Address: WZ LA"&t—L— 1 z
0, �1/V
City, ST, Zip:
Telephone:
Email: AYOE
v-,:�7
Valuation of Project $
Contractor Name: j / -
New SFD Construction:
Address: '�)2 o,J ,,,T�
Conditioned Space SF
City, St, Zip W L-jr-� (�4
Garage SF
Telephone: (6%)3`+� _ �oo
Patio/Porch SF
Email;
Fire Sprinklers SF
State Lic: City Bus Lic:
C- 1,0
Architect/ Engineer Name: siANISy CTV,4,
Construction Occupancy:
Address: 1,sZ3 t_d
Grading:
City, St, Zipr��r.1rA�403
Construction Type: Occupancy:
Telephone(213)3-)3 -�
Bedrooms:
Stories:
# Units:
Email: CVA,N�J� �� Ccs
State Lic:Co-Ts- City Bus Lic:
Property Owner's Name: ()
New Commercial / Tenant Improvements:
Address: 2� .�yu�}
Total Building SF
City, ST, Zip V'►�S
Construction Type: Occupancy:
Telephone: �-
Email:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
OFFICE USE ONLY
#
Submittal
Required
Received
Plan Sets
_.._............ ... w.........
Structural Calcs
Truss Calcs
Title 24 Calcs
CVWD Fire Flow Letter
Soils Report
Grading Plan (PM10)
Landscape Plan
Subcontractor List
Grant Deed
HOA Approval
School Fees
Burrtec Debris Plan
Planning approval
Public Works approval
Fire approval
City Business License
MCCORMICK"S CSLB Lic# 1018522
,LEMUC L 858-344-6048
Letter of Authorization to
Assign Agent(s)
1, the undersigned licensed contractor, authorize my employee(s) named below to act on
my behalf on the performance of the actions listed below:
Fu I I Name of Authorized Agent(s)
Brittany Delaplane
Matthew Smith
Jason Smith
Approved Actions
Relationship
-Office Manager - -
Field Supervisor
Administrative Assistant
Act on my behalf on the following actions in matters and dealings with the Building and Safety Departments in
all Southern California Counties:
Submitting Plan Checks
Applying for Permits
Obtaining a business license
Terminating permits
Other
SEE ATTACHED
Certificate of
ACKNOWLEDGEMENT
For questions concerning this Authorization, please contact the License Holder at
phone number ( SLR_).344-6048 or e-mail address iohn@mccormickselectrical.com
mccormickselectrical.com
1 understand that this letter of authorization will expire in one year from the date signed.
igh u e o Contras v License Holder — to
Printed Name of Contractors License Holder T License # and Class
McCormick's Electrical C-10 Electrical & Solar Contractor mccormickselectrical.com