PMT14-03361 City of Menifee Permit No.: PMT14-03361
29714 HAUN RD. Type: Residential Electrical
` MENIFEE, CA 92586
MENIFEE Date Issued: 01/07/2016
PERMIT
Site Address: 29069 OVERBOARD DR, MENIFEE, CA Parcel Number: 333-333-012
92586 Construction Cost: $15,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 16 PANELS, 16 MICROINVERTERS, 3.62 kW
Work:
Owner Contractor
CHRISTOPHER GRIMM VERENGO INC
29069 OVERBOARD DRIVE 20285 S WESTERN AVENUE STE 200
MENIFEE, CA 92586 TORRANCE, CA 90501
Applicant Phone: 3108039053
STEVEN FARACLAS License Number: 935263
VERENGOINC
20285 S WESTERN AVENUE STE 200
TORRANCE, CA 90501
Pee Description Q�t Amount is)
olS.,r,:ce' 8 0l C<_> o mttl - aErm
Building Permit Issuance 1 27.00
ddltlona .a�T rveview lerica .,4 .mom � "'
GREEN FEE 1 1.00
$439.60
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 Cc a and mv,license is in full for and. ffect. Code:The Contractor's License Law does not apply to an owner of a property
License CI ss G�� Licens/e,No '- > �� I who builds or improves thereon, and who contracts for the projects with a
Expires 3 f f r' Signature V v 1T licensed contractor(s)pursuant to the Contractors State License Law),
WORKERS'COMPENSATION DECLARATI
❑ 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.
Poll y# built as an owner-building if it has not been constructed in its entirety by licensed
/g contractors. I understand that a copy of the applicable law, Section 7044 of the
PJ 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:htto/Iwww leuinfo ca gov/calaw html.
permit is issued.My workkers'wmpensation insurance carrier and policy number are:
Carrier `NfIM',,!i / Property Owner or Authorized Agent Date
Expires b-r Policy# I0000CILY
D/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 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 nspection 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 1/ �\ /
subject to the workers'compensation provisions of Section 3700 of the Labor pr perty Owner orAuthoriz d Age Da
Code,I she I forthwith comply with those provisions. M
�L City Business License
Date; ( 7 ( f Applicant;
WARNING: FAILURE TO SECURE ORKERS' HAZARDOUS MATERIAL DECLARATION
- COMPENSATION COVERAGE IS UNLAWFUL, NO 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 CCUPANT 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 0 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 ❑YES/A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
/ FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address O 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 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, MM 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 (Chapter9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or n�`EES 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL 14tEPORTING.
compensation,will do( )all of or( )porting of the work, and the structure is PRO ER OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X V
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
F ,`Menifee
DATE 1"L 2z ly PERMIT/PLAN CHECK NUMBER —
TYPE: O COMMERCIAL )!Q2ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK (1coI� ^ -T Suu421 1
3-GZI?s�
PROJECTADDRESS 2-9� 61 C"(Ea-
ASSESSOR'S PARCEL NUMBER � -5 - DAD, LOT TRACT
6
OWNERNAME CH iZ15 GQ-i r-t Building & Safety Bpt.
ADDRESS Z�iC q 0V C—aZa- 9--Q CL DEC 2 2 20 4
PHONE "(5 f `f`IS 275 EMAIL „p
APPLICANT NAME c� iE^j A•�
ADDRESS Z54,A-oe cc,.3-r�JtCTaLL
PHONE CC(G�(, 221'ggg2. EMAIL �'�clfc�c�4S \f.zr¢ cS+ter ,
CONTRACTOR'S NAME OWNER BUILDER? O YES Af NO
BUSINESS NAME
ADDRESS
22o� �, �CSTc(I�) I'LyJ� To(2.¢AhlLt c�� 9u�c, j
PHONE C3 l�1 �( � - -7 (o EMAIL
CONTRACTOR'S STATE LIC NUMBER 9 3�2�3 LICENSE CLASSIFICATION
VALUATION$ SO FT L SQ FT J
APPLICANT'SSIGNATURE'�� DATE I Z-/ 2Z-
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION _ CITY OF MEN ICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT � a O CASH 0 CHECK ff 0 CREDIT CARD VISAiMC
PLAN CHECK FEES PAIDAMOUNT IS? 0CPSH J HECK4 aU'}3 OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
EsGil Corporation
In partnership with Government for Building Safety
DATE: 12/31/2014 ❑ APPLICANT
❑ JURIS.
JURISDICTION: City of Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT14-03361 SET: I
PROJECT ADDRESS: 29069 Overboard Dr.
PROJECT NAME: CHRISTOPHER GRIMM 16 @ 215 Watts Micro-inverters 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 building 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 (SA) Enclosures:
EsGil Corporation
❑ GA ❑ EJ ❑ PC 12/22/2014
9320 Chesapeake Drive,Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax(858) 560-1576
City of Menifee PMT14-03361
12/31/2014
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Menifee PLAN CHECK NO.: PMT14-03361
PREPARED BY: John Le Vey (SA) DATE: 12/31/2014
BUILDING ADDRESS: 29069 Overboard Dr.
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING F—WIRTE—A-7 Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Junsd fiction Code mnf iManuallniput
Bldg, Permit Fee by Ordinance W If
Plan Check Fee by Ordinance
Type of Review: ❑ Complete Review ❑ Structural Only
❑Repetitive Fee ❑ Other
Repeats H�ourl 1 1.5 Hrs. @`
ESGII Fee 1 $105.00 $157.50
" Based on hourly rate
Comments: 1 1/2 hours plan review.
Sheet 1 of 1
macvalue.doc+