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PMT14-01992 Y i City of Menifee Permit No.: PMT14-01992 '-��y, Type: Residential Electrical 29714 HAUN RD. ':XCCEL MENIFEE, CA 92586 MENIFEE Date Issued: 09/05/2014 PERMIT Site Address: 28605 BROADSTONE WAY, MENIFEE, Parcel Number: 340-111-001 CA 92584 Construction Cost: $38,400.00 Existing Use: Proposed Use: Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 32 PANELS, 32 MICRO INVERTERS, 7.680 kW Work: Owner Contractor MARY DAVIS VIVINT SOLAR DEVELOPER LLC 28605 BROADSTONE WAY 4931 N 300 W MENIFEE, CA 92584 PROVO, UT 84604 Applicant Phone: 8012346399 NICOLE POWELL License Number: 973756 VIVINT SOLAR DEVELOPER LLC 4931 N 300 W PROVO, CA 84604 Phone: 9517193795 Fee Description gyt Amount($1 Building Permit Issuance 1 27.00 GREEN FEE 1 2.00 $421.00 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA_Bldg_Permit_Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions Professions Code and my license is in full for? an ect: Code:The Contractor's License Law does not apply to an owner of a property License Class G License No. who builds or improves thereon, and who contracts for the projects with a Expires U30 I Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ I am exempt from licensure under the Contractors'State License Law for the ❑ I hereby affirm under penalty of perjury one of the following declarations: following reason: I have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that,.except for my personal residence in compensation,Issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of Section 3700 of the Labor Code, for the performance of work for which this improvements covered by this permit, cannot legally sell a structure that I have permit is issued. _ built as an owner-building If It has not been constructed In Its entirety by licensed Policy# contractors. I.understand that a copy of the applicable law, Section 7044 of the tI have and will maintain workers' compensation insurance, as required by Business and Professions Code,Is available upon request when this application is ion 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site;http;llwww.leoinfo.ca.aov/calaw.html. permit Is Issued.My workers'compensation insurance carrier and policy number are: � natIvcJ �lL Property wner or Authorized gent f"I b Carrier /// Date Expires I./� ' l�( Policy# �tQU"l J'TL �� / Name of Agent Phone# 'g1 By my Signature below, I certify to each of they following: I am the property ii66wwner or authorized to act on the property owner's behalf. I have read this (This section need not be completed if the permit Is for application and the information I have provided is correct. I agree to comply one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to enter the above- 0 1 certify that in the performance of the work for which this permit is issued, comp I identified Froperty for the inspec on purposes. shall not v any persons In any manner so9 s 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,I.shall forthwith comply with those provisions. Property Owner or Authorized Agent Date as 7 �City Business License# i Date;� Applicant; WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UNLAWFUL, AND.SHALL _ SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ' CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING ($100,000), IN ADDITION TO THE COST OF.COMPENSATION, ❑yFS OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE �///''' MIXTURE CONTAINING A HAZARDOUS 'MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES 1�I NO EQUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS I hereby affirm that under the penalty of perjury there is construction lending INFORMATION GUIDE? agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE 3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name []YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION [. FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address - \yJ I`�0 DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR OWNER BUILDER DECLARATIONS GUIDE LINES I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME: License Law for the reason(s)indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter, Improve, demolish, 0 SCHOOL? or repair any structure, prior to its issuance, also requires the applicant for the 'C 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 I HAVE READ THE HAZARDOUS MATERIAL Section 7000)of Division 3 of the Business and Professions Code)or that he or YES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from Iicensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING ❑ 1, as owner of the property, or my employees with wages as their sole' HAZARDOUS MATERIAL REPORTING. compensation, will ( ) all of or ( ) porting of the work, and the structure is PROPERTY Q�N AUT ZED AGENT not intended or offered for sale.(Section 7044, Business and Professions Code; The Contractor's Stale License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the Improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale), CITY OF ME IFEE PLCK No: Permit No: 29714 Haun Road City of Menifee a Menifee, CA 92586 Building & Safety Del l 3 Date, Phone: (951)672-6777 JUL 3 1 2014 Amount' Amount: eo Fax:(951)679-3843 Ck#: Ck#: Building Combination PermV it� �l�� To Be Completed By Applicant Legal Description: Planning Case: F: L: Rt: R Property Address:28605 Broadstone Way Menifee CA 92584 Assessor's Parcel Number. ProjectfTenant Name: Unit#: Floor#: Name: Mary C.Davis Phone No-951-723-1318 Fax No. Property Address: Unit Number Zip Code Owner 28605 Broadstone Way Menifee CA p 92584 Email Address: mdcorp@verizon.net Name: Nicole Powell Phone No.951-719-3795 Fax No. Applicant Address: 27449 Colt Court Temecula CA Unit Number Zip Code 92584 Email Address: nicole.powell@vivintsolar.com Name:Vivint Solar Developer LLC Phone No.951-719-3795 Fax No. Contractor Address: 27449 Colt Court City State ZipCoda Temecula CA 92590 Contractor's Ity37308 Business License o. Contractor's City State of California License No. Classification: C�6 U 973756 Number of Squares: Square Footage Description of Work:solar roof mount,7.680 kw dc,32 modules/inverters Cost of Work:$ 38,400 Applicant's Signature Date: 7 o' mpleted By City Staff Only - Indicate As R-Received or N/A-Not Applicable 5 Completes sets of fully dimensioned,drawn to sale plans which include: i set of documents which include ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Gen Tech/Soils Report(on cd only) ❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 81A x 11) ❑ Foundation Plan ❑ Structural Calculations ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP ❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan ❑ Sound Report-Residential Class Code: Indicate New Construction Alteration* Addition* Means/Methods Work Type: Repair" Ld Retrofit` Revision to Existing Permit' Required? YES NO Proposed Building Use(s): Existing Building Use(s): #Buildings: #Units: #Stories: Will the Building Have a Basement? Y of N Bldg.Code Occupancy Group Indicate Indicate if YES or NO Indicate all Geo-tech.Haz.Zone At Project Construction Sprinklered that apply: Coastal Zone Completion: Type(s): C Of O Noise Zone Required? YES or NO Listed on Historic Resources Inventory CITY PLANNING STAFF ONLY APPROVALS: Costal Commiss Aron.Review Board Landmark Comm. Planning Comm.Zoning Administrator Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit spacial Case:BI g. Official Approval Expedite Project(s): Child Care City Project Green Building Landmark Anordable Housing For Staff Use Only Building/Safety I Permit Specialist I City Planning I Civil Engineenng EPWM-Admin I Transportation Mgml. I Rent Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY EsGil Corporation j In(Partnership with Government for ouitding Safety j DATE: 08/29/2014 APPLICANT iJURIS. JURISDICTION: Menifee ❑ PLAN REVIEWER ❑ FILE PLAN CHECK NO.: pmt14-01992 SET: II PROJECT ADDRESS: 28605 Broadstone Way PROJECT NAME: Davis 32@215 Watt micro inverter Solar Photovoltaic System ❑ The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes. ❑ The plans transmitted herewith will substantially comply with the jurisdiction's codes when minor deficiencies identified below are resolved and checked by building department staff. ❑ The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck. ❑ The check list transmitted herewith is for your information. The plans are being held at Esgil Corporation until corrected plans are submitted for recheck. ❑ The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person. ❑ The applicant's copy of the check list has been sent to: ❑ Esgil Corporation staff did not advise the applicant that the plan check has been completed. ❑ Esgil Corporation staff did advise the applicant that the plan check has been completed. Person contacted: Telephone #: Date contacted: (by: ) Fax #: Mail Telephone Fax In Person E-mail: ❑ REMARKS: By: John Le Vey Enclosures: EsGil Corporation ❑ GA ❑ EJ ❑ PC 08/22/2014 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858)560-1468 ♦ Pax(858) 560-1576