PMT15-00584 City of Menifee Permit No.: PMT16-00684
29714 HAUN RD.
5lCCEL MENIFEE, CA 92586 Type: Residential Electrical
c uWh.' MENIFEE Date Issued: 0 312 712 01 6
i
p
w
i
PERMIT
Site Address: 28928 TULITA LN, MENIFEE, CA 92584 Parcel Number: 388-053-018
Construction Cost: $45,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 44 MODULES 2 INVERTERS 11.44KW
Work:
Owner Contractor
ALICE SMITH VERENGO INC
28928 TULITA LN 20285 S WESTERN AVENUE STE 200
MENIFEE, CA 92584 TORRANCE, CA 90501
Applicant Phone: 3108039053
STEVEN FARACLAS License Number: 935263
20285 S WESTERN AVENUE STE 200
TORRANCE, CA 90501
Fee Description Oft Amount is
rswmnza*-m^�^ 1'4:..b ""TMr`-?- cxrx 'y''#K exsgro
olar, Resldentla or Small Commercial s_,._ 220
Building Permit Issuance � -� ��27.00
'NAddlfionalPlanRevlewElectrcal, ,", � �,y` �' � 158 '' �'��'"�5750
GREEN FEE 1 2.00
`SMIPCtESIDENTIAL '' + _. .� '� � 600
$444.60
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_eldg_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 Cod a� nd my license is in full orce td Tit. Code:The Contractor's License Law does not apply to an owner of a property
License ClalggIsG"t_� License No. 3/S �f who builds or improves thereon, and who contracts for the projects with a
Expires_�'I3(J] Signature licensed contractor(s)pursuant to the Contractors State License Law).
1 T,
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, 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:htto'1/www.IeigInfo.ca.gov/ca1awntml.
permit is issued.My workers'compensation insurance carrier and policy number are:
S.["({ llvo Fln"Lllj� Property caner or uthorized Agent Date
Carrier q
Expires / Policy# I oG'n 4 a` 1
❑ By my Signature below, I certify to each of the following: I am the properly
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-
El I certify that in the performance of the work for which this permit is issued, I identified property for the i spection purposes
shall not emclov any persons in any manner so as to become subject to the 7 Z„ . g
workers' compensation laws of California, and agree that if I should become J
subject to the workers'compensation provisions of Section 3700 of the Labor rope ty Owner or Authoriz Age D to
Code, I shall forthwith comply with those provisions.
City Business License#
Date; Zk ( , Applicant;
WARNING: FAILURE TO SECURE WOR RS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND ALL
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 HANDLEA HAZARDOUS MATERIAL ORA
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 ONO 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 items)(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 I HAVE READ THE HAZARDOUS MATERIAL
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 OYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensors 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 ($500).) CODE
SECDOUS SECTION
MATE 505fAL �E5533,AND 25534 CONCERNING
El I, as owner of the property, or my employees with wages as their sole
compensation,will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER ORAUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
�o me-kc-,�- IL rho c
3 1 0 --( -7 S S Gi o-7
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
y1Menifee
DATE ,-, PERMIT/PLAN CHECK NUMBER M 6I*— DD5911
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK l?.�ol` MounT SpFA2 44 h�oAJ cS 2 ENJC2z {
l 1 .�-(,{ Ilcw
PROIECTADDRESS Z�q2� pT�l (�T62� �reJl
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME C_\C.0 -1-L
ADDRESS Z 2 L . C h C/\1 O L Tj L i t "4-
PHONE `ZS ( `(AEU (l`�S EMAIL
APPLICANT NAME EJ-EsJ t-A4>4Lt.--
ADDRESS 7AA-10C �� CotuTQJtCTC,4.—
PHONE CQ�) 222'E'Sgg'L EMAIL �'FCxfc�c\0.S bier¢ agc,\..r . .-u✓�
CONTRACTOR'S NAME LIB OWNER BUILDER? O YES #NO
BUSINESS NAME
ADDRESS
222-0'1 � S, LJt&-T'%zl" Alc � • To�2 UH `� 6l
PHONE(y \t�) 'I '7 EMAIL 22
CONTRACTOR'S STATE LIC NUMBER 3�Z�� LICENSE CLASSIFICATION
VALUATION$ -(S, OCQO SQ FT L SQ FT
APPLICANT'S SIGNATURE `�s— DATE IS
OTYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN c� I SMIP
INVOICE ^7r��' 00 PAID AMOUNT
AMOUNT I OCASH OCHECK# QCREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH QCHECK# QCREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES Q NO DL NUMBER NOTARIZED LETTER Q 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(Buirding Safety
DATE: 03/23/2015 ❑ APPLICANT
❑ JURIS.
JURISDICTION: Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT15-00584 SET: I
PROJECT ADDRESS: 28928 Tulita Ln
PROJECT NAME: Smith 2x3.8KW 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:
By: Morteza Beheshti Enclosures:
EsGil Corporation
❑ GA ❑ EJ ❑ MB ❑ PC 3/13
Menifee PMT15-00584
03/23/2015
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Menifee PLAN CHECK NO.: PMT15-00584
PREPARED BY: Morteza Beheshti DATE: 03/23/2015
BUILDING ADDRESS: 28928 Tulita Ln
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING AREA Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod,
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code mnf Manual Input
Bldg, Permit Fee by Ordinance
Plan Check Fee by Ordinance
Type of Review: ❑ Complete Review ❑ Structural Only
❑Repetitive Fee ❑ Other
Repeats o- Hours 1 1.5 Hrs. @
EsG1l Fee $105.00 $157.50
" Based on hourly rate
Comments: 1.5 hour plan review.
Sheet 1 of 1
macvalue.doc+