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PMT15-00787 City of Menifee Permit No.: PMT15-00787 29714 HAUN RD. Type: Residential Electrical 1 MENIFEE, CA 92586 MENIFEE Date Issued: 0412 312 01 6 PERMIT Site Address: 31944 RUXTON ST, MENIFEE,CA 92584 Parcel Number: 360-580-006 Construction Cost: $53,550.00 Existing Use: Proposed Use: Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 20 PANELS, 20 MICROINVERTERS, 5.1 kW Work: Owner Contractor JAMES BLOW VIVINT SOLAR DEVELOPER LLC 31944 RUXTON STREET 3301 N THANKSGIVING WAY MENIFEE, CA 92584 STE 500 Applicant Phone: 8558772974 ROBYN YOUNG License Number: 973756 VIVINT SOLAR DEVELOPER LLC 27449 COLT COURT TEMECULA, CA 92590 Phone: 9517193795 Fee Description Qttv Amount f$1 Solar Res�ential o`r Small Commercial ' �' � `w''Pt " '`�� 2 OOn Building Permit Issuance 1 27.00 tAtlditional`PlanReviewElecfrlcal � ,. ,_� ygA,4 ,,_ �158� �,,. � ��t15T50- GREEN FEE 1 3.00 SMIP.RESIDENTIAL 1= �00 $446.60 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 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 'I LICENSED DECLARATION 1 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 7944, Business and Professions Professions Codeyap my license is in fu{ fia ce. cf effect. Code:The Contractor's License Law does not apply to an owner of a property License Class 1.��p License No. "` JyC• 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 DECLARATION ❑ 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 I acknowledge that, except for my personal residence in compensation,issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of work for which this which I must have resided for at least, one year prior to completion of permit is issued, /' f Improvements covered by this permit, I cannot legally sell a structure that I have Policy# �J �,jlil l.) built as an owner-building if it has not been constructed in its entirety by licensed contractors..I runderstand 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:hfto'//www.leginfo.ca,gov/calaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: Carrier E.VGm l-on Property Owner or Authorize Agent Date (' Expires .I 1 ) Policy# 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- ❑ 1 certify that in the performance of the work for which this permit is issued, I idengfisd prdperty'f r the inspeetton-p ri7 poses:" 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 u v I ' 3-IS subject to the workers'compensation provisions of Section 3700 of the Labor Property Owner rAuthorized A Code, I shall forthwith comply with those. ro�/isions. P Y gent Date L) _�3 —+If City Business License# Date; 11 Applicant;Y& 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 ADDITION TO THE COST OF COMPENSATION, ❑YES 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 1 ❑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 r 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 EYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address I/ FROM THE SOUTH COAST AIR QUALITY MANAGEMENT ,�(NO 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 reasons)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, F�,yw 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 , , 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING ❑ 1, as owner of the property, or my employees with wages as their sole HAZARD US M�RIAL REPORTING. compensation, will do ( ) all of or ( ) porting of the work, and the structure is PROPER Y OWNER R AUTHORIZED AGENT not intended or offered for sale.(Section 7044, Business and Professions Code; The Contractor's Stale License Law does not apply to an owner of a property X �- who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). u1�5 APPLICATION& SAFETY PERM IT/PLAN CHECK V. :5 ` Menifee DATE I PERMIT/PLAN CHECK NUMBER �5 TYPE: COMMERCIAL RESIDENTIAL --'. MULTI-FAMILY t=) MOBILE HOME POOL/SPA C). SIGN SUBTYPE: <;-ADDITION O ALTERATION O DEMOLITION C.1 ELECTRICAL MECHANICAL -E% NEW C PLUMBING C% RE-ROOF-NUMBER OF SQUARES SOIAR DESCRIPTION OF WORK Solar roof mount, 5.1 kW DC, 20 Invert/Modules, No Panel Upgrade PROJECTADDRESS 31944 Ruxton Street City 01 Menifee y ASSESSOR'S PARCEL NUMBER 3tp- roo-60(D LOT TRACT OWNER NAME James Blow ADDRESS 31944 Ruxton Street, Menifee, CA 92584-471- Received PHONE 951-205-5725 EMAIL jimmyjake350@yahoo.com APPLICANT NAME Vivint Solar Developer LLC ADDRESS 27449 Colt Court , Temecula, CA 92590 PHONE 951-719-3795 EMAIL Gail.schaefer@vivintsolar.com CONTRACTOR'S NAME Gail Schaefer OWNER BUILDER? '%YES `XNO BUSINESS NAME Vivint Solar Developer LLC ADDRESS 27449 Colt Court, Temecula, CA 92590 PHONE 951-719-3795 EMAIL Gail.Schaefer@vivintsolar.com CONTRACTOR'S STATE LIC NUMBER 973756 LICENSE CLASSIFICATION C46 VALUATION$ 53,550.00 SO FT L SQ FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN ' SMIP INVOICE PAID AMOUNT AMOUNT ID CASH "CHECK# =.-CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT c, CASH "CHECK# '`�-CREDIT CARD VISA/MC OWNER BUILDER VERIFIED YES ' NO DL NUMBER NOTARIZED LETTER <% YES '_3 NO City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92585 951-572-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 EsGil Corporation In Partnership with Government for Buifding Safety DATE April 21, 2015 ❑ PLICANT JURIS. JURISDICTION: Menifee ❑ PLAN REVIEWER ❑ FILE PLAN CHECK NO.: PMT15-00787 SET: II PROJECT ADDRESS: 31944 Ruxton Street PROJECT NAME: Blow 3800 Watt 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: Applicant to review red lined Note on sheet E-1 prior to permit issuance. By: Eric Jensen Enclosures: EsGil Corporation ❑ GA ❑ EJ ❑ PC 04/14 9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858)560-1468 ♦ Fax(858)560-1576