PMT14-02732 City of Menifee Permit No.: PMT14-02732
��^� 29714 HAUN RD. Type: Residential Electrical
"': 6CVA, MENIFEE, CA 92586
MENIFEE Datelssued: 1 0/1 012 0 1 4
PERMIT
Site Address: 27231 KEPLER ST, MENIFEE, CA 92586 Parcel Number: 360401-037
Construction Cost: $1,900.00
Existing Use: Proposed Use:
Description of PANEL UPGRADE TO 200A PANEL SOLAR PMT14-02734
Work:
Owner Contractor
RYAN LUBBEN HORIZON SOLAR POWER INC
27231 KEPLER ST 7100 WEST FLORIDA AVENUE
MENIFEE, CA 92586 HEMET, CA 92545
Applicant Phone: 9519261176
HORIZON SOLAR POWER INC License Number: 992053
7100 WEST FLORIDA AVENUE
HEMET, CA 92545
Fee Description Olyr Amount
S�e ' s�S�tc b�oaFd5�Gg0trol�Cente t r�� e ", � 1a'�`'�0
Building Permit Issuance _ n1 27.00.
$144.00
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifcations 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_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 Coe and my license is in full or a and effect. Code:The Contractor's License Law does not apply to an owner of a property
License who builds or improves thereon, and who contracts for the projects with a
Expires Signature - licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECL
❑ I am exempt from licensure under the Contractors'State License Law for the
❑ 1 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, I 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
❑ 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'//www leainfo ca gov/calaw html.
permit is issued.My workers'compensation insurance carrier and policy number are:
C, e Coym ('l *A a Property Owner or Authorized Agent Date
Carrier p '�IR ff �ns �
Expires ( I l 1 (� Policy# G��i�� 1
P
❑ By my Signature below, I certify to each of the following: I am the property
Name of Agent Phone# 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 aulhoriz6`representafives 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 id lfed propert�f a in n purposes.
shall not employ any persons 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 property Owner or !zed A nl Date l r l
Code, I shall forthwith comply with thos provisions.
� �� � � City Business License
Date; 1 l) I (U��� Applican
WARNING: FAILURE TO ORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWELIL, 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, OYES 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 ❑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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address ❑NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
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 OYES 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, ❑NO 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 OYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure 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($500).) CODE, SECTIOUS ON
25505RIAL t�25533IAND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole
compensation,will do( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF M1ENI F1ElE
PLCK No: P�p�it No:
29714 Haun Road r`Ns oz j5z
Menifee, CA 92586 Build Bcituilding &f Menifee Safety Dept. Date: pa/o. /o
Phone: (951)672-6777 Amount A unt
Fax:(951)679-3843 OCT 10 2014 Ck t�
# Ck#:
Building Combination Peftiteived
Legal Description:
To Be Completed By Applicant
Planning Case:
Property Address: F' L: Rt: R:
17 .3" C Asses r's Pa Number.G
Project/Tenant Name: J o
Name: ,(j Unit#: Floor#:
Property Address: Y'I yl Phone No. , F Fax No.
Owner .�� Unit Number
Email Address: zip Code
Name:
Phone No.
Applicant Address: 1 �' Unit Number 7 Fax No.
Z'
Email A dress:
Code
M C
Name:
ti PI l� Phone No.. Faz No.
Contractor Address:_ Jt� j
"l'� l " J: ' C'}' % it ('L,� CIIY .A state Zip Code
on tractor s City gu57ness Icense No.
Contractor's City State of alifomia License No.
,7 t .� Classification:
Number of Squares:
Square Footage
Description of Work:
1
Applicant's Signature t ' !^ G! /��� � � � !` Cost of Work:$ C l rya
Date:
-> .-To Be Cdfnpleted By-City StaffOnly
5 Completes sets of fully dimensioned,drawn to sale plans whichdintlutles R-Receivetl or N/A-Not Applicable
❑ TiUe Sheet 1 set of documents which include
❑ Elevations ❑ Electrical Plan El Gen❑ Plot I Site Plan ❑ Roof Plan El Mechanical Plan El Title 24cEner Is Report(on cd only)
9Y(on 8 /:x ti)
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Structural Calculations
❑ Floor Plan ❑ SINCNraI Framing Plan&Delaas g El sound
Line diagram for elec.services over 400 AMP
Class Code: ❑ Sharin Plan ElSound Report-Residential
Indicate New Construction Alteration'
Work Type: Addition Means/Methods
Repair' Retrofit'Proposed Building Use(sJ: Revision to Existing Perfnit• Required? YES No
Existing Building Use(s):
#Buildings: #Units: #Stories:
Will the Building Have a Basemen[?
Bldg. Code Occupancy Group Y of N
At Project Indicate Indicate it YES or NO Indicate all Geo-tech.Haz.Zone
Type(s):
Completion: Construction Sprinklared that apply:pp Y Coastal Zone
C of ir Required? YES or NO Noise Zone
Commis C
APPROVALS:
Listed on Historic Resources Invento
City Project Arch.Review Board ry ITV PLAN Costal NING STAFF ONLY
Fee Exempt: Landmark Comm. Planning Comm.Zoning Administrator
Elec.Vehicle Charger Landmark
Expedite Project(s): Seismic Retrofit Special case:am9.
Child Care City Project omaal mval
For Staff se Only
Green Building Landmark Affordable Housing
U
Building/Safety Permit Specialist Cit Plannin Y 9 Civil Engineering E f -
Admin Tmnspo lotion MgmL Renl Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY