PMT15-00625 fi
City of Menifee Permit No.: PMTIS-00626 I
29714 HAUN RD.
ham.' MENIFEE, CA 92586 Type: Residential Electrical
sce sa� � 6
MENIFEE Date Issued: 04/01/2015
PERMIT
Site Address: 31380 WILLOWOOD WAY, MENIFEE, CA Parcel Number: 372-031-008
92584 Construction Cost: $21,675.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 17 PANELS, 17 MICROINVERTERS, 4.335 kW
Work:
Owner Contractor
FLORENCE PEURIFOY VIVINT SOLAR DEVELOPER LLC
31380 WILLOWOOD WAY 3301 N THANKSGIVING WAY
MENIFEE, CA 92584 STE 500
Applicant Phone: 8558772974
GAIL SCHAEFER License Number: 973756
VIVINT SOLAR DEVELOPER LLC
3301 N THANKSGIVING WAY
STE 500
LEHI, CA 84043
Phone: 9517193795
Fee Description ON Amount l$1
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GREEN FEE 1 1.00
$440.50
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_Permil_Template,rpt Page 1 of 1
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I
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 1n full"effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class iicars o. who builds or improves thereon, and who contracts for the,projects with a
Expires "f Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
[I I am exempt from licensure under the Contractors'Stale 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 must have resided for at least one year prior to completion of
permit is issued.Section 3 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
ssueG 2
Policy# WE I O c](P Q l J O() 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 law, Section 7044 of the
❑ 1 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://www leainfo ca gov/calaw htmi.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier von -,In ll�(UYa YICk COYN �otrtq Property Owner orAuthorized Agent Date
Expires Policy#Ncsoquol 506
Name of Agent Phone# ❑ By my Signature below, I certify to each of the following: I am the property
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 inspection purposes.
shall not emoloy 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 Authorized Agent Code,I(sshall forthwith comply with those provisions. P Y 9 Date
Date; I -I I J Applicant; .ten,_,. L City Business License#
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 ADDITIOtTTO THE COST OF COMPENSATION, - DYES 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 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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
*RO 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 constmct, alter, Improve, demolish, 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 S 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 REPORI�ING,
compensation, will do ( ) all of or( ) porting of the work, and the structure is PROP 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 said 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).
APPLICATION& SAFETY PERMIT/PLAN CHECK
®' Menifee
DATE In 115 PERMIT/PLAN CHECK NUMBER VW 115-00
TYPE: COMMERCIAL eAMESIDENTIAL 0 MULTI-FAMILY MOBILE HOME -' POOL/SPA C, SIGN
SUBTYPE: is ADDITION 'J%ALTERATION "DEMOLITION VCLECTRICAL MECHANICAL
NEW PLUMBING C RE-ROOF-NUMBER OFSQUARES SOLAR
DESCRIPTION OF WORK Solar roof mount, 4.335 kW DC, 17 invert/Modules
PROJECT ADDRESS 31380 willowood way
City of Menifee
ASSESSOR'S PARCEL NUMBER 3'l'0l-[�3\-off- LOT Sun&M & Safety Dept.
OWNER NAME Florence Peurifoy
ADDRESS 31380 Willowood way Menifee CA 92584
PHONE 951-970-0310 EMAIL ReceNve
APPLICANT NAME Vivint Solar Developer LLC
ADDRESS 27449 Colt Court , Temecula, CA 92590
PHONE 951-719-3795 EMAIL Gail.schaefer@vivintsolar.com
CONTRACTOR'S NAME Gail Schaefer OWNER BUILDER? '7 YES -XINO
BUSINESS NAME Vivint Solar Developer LLC
ADDRESS 27449 Colt Court, Temecula, CA 92590
PHONE 951-719-3795 EMAIL Gail.Schaefer@vivintsoiar.com
CONTRACTOR'S STATE LIC NUMBER 973756 LICENSE CLASSIFICATION C46
VALUATION S 21,675.00 SO FT L So FT
APPLICANT'S SIGNATURE DATE
OTY STAFF USE ONLY -.
IL-
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN ' SMIP 3'-
INVOICE PAIDAMOUNT r'
AMOUNT _15 %CASH C;t CHECK# CCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT _'•CASH '.CHECK# €i CREDITCARD VISA/MC
OWNER BUILDER VERIFIED '.'YES NO DL NUMBER NOTARIZED LETTER C= YES ': NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
Menifee PMT15-00625
3/25/2015
EsGil Corporation
In Partnership with Government for Buif6ing Safety
DATE: 3/25/2015 ❑ APPLICANT
❑ JURIS.
JURISDICTION: Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT15-00625 SET: I
PROJECT ADDRESS: 31380 Willowood Way
PROJECT NAME: Peurifoy 3.8KW 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 3/18
Menifee PMT15-00625
3/25/2015
[DO NOT PAY- THIS IS NOT AN INVOICE]
a
VALUATION AND PLAN CHECK FEE
JURISDICTION: Menifee PLAN CHECK NO.: PMT15-00625
PREPARED BY: Morteza Beheshti DATE: 3/25/2015
BUILDING ADDRESS: 31380 Willowood Way
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_0rdinance
Type of Review: ❑ Complete Review ❑ Structural Only
ElRepetitive Fee El Other
—W Repeats ❑ Hourly 1.5 Hrs. @
- _ EsGil Fee $105.00 $157.50
* Based on hourly rate
Comments: 1.5 hour plan review.
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