PMT14-02562 i
City of Menifee Permit No.: PMT14-02662
'I
29714 HAUN RD. Type: Residential Electrical ICI
d IIELR- MENIFEE, CA 92586
MENIFEE Date Issued: 11/06/2014
PERMIT
Site Address: 28950 TULITA LN, MENIFEE, CA 92584 Parcel Number: 388-053-019
Construction Cost: $18,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 18 PANELS, 18 MICROINVERTERS,4.5 kW
Work:
Owner Contractor
DEBRA SMITH VERENGO INC
28950 TULITA LANE 20285 S WESTERN AVENUE STE 200
MENIFEE, CA 92584 TORRANCE, CA 90501
Applicant Phone: 3108039053
KHOI NGUYEN License Number: 935263
VERENGOINC
20285 S WESTERN AVENUE STE 200
TORRANCE, CA90501
Fee Description Oily Amount l$1
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
I
$388.00
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 building 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_Templatesiot 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 Cod to
my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License CI ss t O License No. > >2 who builds or improves thereon, and who contracts for the projects with a
Expires' I l S Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARA ION
❑ 1 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 acknowledge that, except for my personal residence in
compensation, issued by the Director of Industrial Relations as provided for by which must have resided for at least one year prior to completion in Section 3ssu of the Labor Code, for the performance of work for which this im improvements covered b this permit, I cannot legally sell a structure that I have
of
permit is issued. P Y P 9 Y
Policy# built as an owner-building if it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable taw, Section 7044 of the
f5 I have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http://wwwlectinfocaoov/calawhtml.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier Date
Expires/ /r /(1— Policy# j0o°Li ° yZ S�J
i r
Name of Agent AN,4 Phone#31b' � ❑ BY my Signature below, I certify to each of the following: I am the properly
owner 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,I identified property for the inspection purposes. _
shall not employ any persons in any manner so as to become subject to the i
workers' compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor Property Owner or Authori e Agent 1
Code,I shall fort with comply with those provisions. P Y 9 nt Dale
/1 `v City Business License#
Date; � � 6 �' Applicant; v v`
WARNING: FAILURE TO SECUR RKERS' 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, DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE // MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES p-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 a 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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address d.'N/O FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
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 EYES 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, �g O SCHOOL?
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 I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or WES NFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any EHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to N UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL F EPORI'Il
compensation, will do ( ) all of or ( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X �--
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF M]ENI FE E
,)t Menthe Dept, PLCK No: Permit No:
29714 Haun Road,-'-,,t9 8' sorely _ a
Date: Date:
Menifee, CA 92586 sp 23 2014 9I 05
Phone: (951)672-6777 Amount: Amount:
Fax:(951)679-3843 a9i3
Received Ck#: Ck#:
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R:
Property Address:
L 1 sp U T- LANE Assessor's Parcel Number. TF
B �l R3ProjecUrenant Name: Unit#: Floor#:
Name: � i Phone No. No.Property Y�-�Iz-A SM. I t FF � - 0 - S-Zr�Address: Unit NumberOwner z8`tso u\- t A LPtttF odey25e
Email Address:
Name: I Phone No.
•}-o �1/� J CtJ Fax No.
y( 10 - 9�-5 S o
Address: _ W Zip Code
Applicant Unit Number
F15 S• 12rJ AU:. 2oD a �0
Email Address: AQ C ci ✓e2rn/y oJa` C_ carL
Name:
V E f?�N y a .Sv L. (� Pone No. Fax No.
o- �3 • gS 3
Contracto Address: j tyr�LCZ-F\-f✓La S�tg Zi�C0&d-dI
RM c ,ftL F l°L ICfFT'� l o C./�
Contractor s City Business icense o. Contractor s iity Staatte of California License No. Classification: _ i
Number of Squares:
Square Footage
Description of Work: RODT A N% IZ7✓ J9 ✓ o 1(f q. 5— Cost of Work:$ 10 O
Applicant's Signature ^f _/
oBe Completed By Clty Staff Only
Indicate As R-Received or N/A-Not Applicable
5 Completes sets of fully dimensioned.drawn to sale plans which include: '1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8'/x 11)
Foundation Plan ❑ Plumbing Plan ❑ Structural Calculations
❑ ❑ Cross Section
❑ 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" Retrofit' Revision to Existing Permit' Required? YES NO
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units: it Stories: Will the Building Have a Basement?
Y of N
- Bldg. Code Occupancy Group Indicate Indicate if Indicate all Geo-tech.Haz.Zane -
At Project Sprinklered YES or NO
Completion: Construction that apply: Coastal Zone
Type(s): C Of o YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch. Review Board Landmark Comm. Planning Comm. Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retroft special Case:Bldg.
Ofiicial Approval
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safety Permit Specialist I City Planning I Civil Fngineering EPWM-Admin Transportation Mgml. I Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
EsGil Corporation
In(Partnership with Government for ouirding safety
DATE: 10/27/2014 ❑ APPLICANT
❑ JURIS.
JURISDICTION: Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT14-02562 SET: REV-I
PROJECT ADDRESS: 28950 Tulita Lane
PROJECT NAME: Smith 18 microinverter rooftop PV 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: ) Email: Fax #:
Mail Telephone Fax In Person
❑ REMARKS: Revision is to routed PV circuits to building specific panelboard.
By: Eric Jensen Enclosures:
EsGil Corporation
❑ GA ❑ EJ ❑ MB ❑ PC 10/21
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858)560-1468 ♦ Fax(858) 560-1576
i
Menifee PMT14-02562
10/27/2014
(DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Menifee PLAN CHECK NO.: PMT14-02562
PREPARED BY: Eric Jensen DATE: 10/27/2014
BUILDING ADDRESS: 28950 Tulita Lane
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING AREA Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code Imnf Imanual Input
Bldg. Permit Fee by Ordinance
Plan Check Fee by Ordinance
Type of Review: ❑ Complete Review ❑ Structural Only
❑ Other
❑Repetitive Fee
Repeats �r Hourly 1 jHr. @
EsGil Fee $105.00 $105.00
. Based on hourly rate
Comments: 1 hour plan review.
Sheet 1 of 1
macvalue.doc+