PMT15-00851 City of Menifee Permit No.: PMT15-00851
29714 HAUN RD. Type: Residential Electrical
-tCCF,.L MENIFEE, CA 92586
ea�mw=n:e smu,�e MENIFEE Date Issued: 0 4/1 712 01 5
PERMIT
Site Address: 30719 LORING PARK CIR, MENIFEE, CA Parcel Number: 364-300-045
82584 Construction Cost: $6,895.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 12 PANELS 1 INVERTER, 3.12KW
Work:
Owner Contractor
MELVIN SEGURA SOLARCITY CORPORATION
30719 LORING PARK CIR 3055 CLEARVIEW WAY
MENIFEE, CA 92584 ATTN ZOE STEELE
Applicant Phone: 6509635630
BEVERLY MILLER License Number: 888104
SOLARCITY CORPORATION
3055 CLEARVIEW WAY
SAN MATEO, CA 94402
Fee Description OQt Amount is
Solar,,Resldentlal,or Srr all Comrnerclal 1, � x25200
Building Permit Issuance 1 27.00
�Addltlona�Plan Revlew:Electncal1575Q
GREEN FEE 1 1.00 SMIP
$438.50
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 C e and my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Clas ense No l/y 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 C DECLARATION
❑ I am exempt from Iicensure under the Contractors'State License Law for the '.
❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason: L..
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. improvements covered by this permit, I cannot legally sell a structure that I have
Policy# 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:h>/www leginfo ca govlcalaw htmi.
permit is issue-.M workers'compensation pSe carrier and policy number are:
Carrier -t� � N�L "'!/""J Property Owner or Authorized Agent Date
Expires Policy# q& IV&6Y!�F,�S033
Name of Agent Phone#%i:
[I 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-
❑ I certify that in the performance of the work for which this permit is issued, I identified property for the inspection purposes.
shall not emplo any persons in any manner so as to become subject to the
compensation
workers' compensation laws ofCalifornia, and agree that if should become
subject to the workers'compensation
sation provisions of Section 3700 of the Labor �
Code,I shall forthwith comply with those provision}s..� Property OwnerorAuthorizeci Agent Daley °
Date; Applicant;
�� 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 ADDITION TO THE COST OF COMPENSATION, ❑YES OCCUPANT 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 ONO 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
Lender's Address 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 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 Iicensure 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 ONO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 40 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL []MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA [—]SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION [Z]ELECTRICAL ❑MECHANICAL
❑NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME
ADDRESS �7
PHONE jj E,rlL'Qq) EMAIL
APPLICANT NAME Beverly Miller
ADDRESS 41568 Eastman Dr. Murrieta, CA 92562
PHONE (951)291-8703 EMAIL bmiller2@solarcity.com
CONTRACTOR'S NAME OWNERBUILDER? ❑YES❑NO
BUSINESS NAME Solarcity
ADDRESS 3055 Clearview Way San Mateo,CA 94402
PHONE (650)638-1028 EMAIL
CONTRACTOR'S STATE LIC NUMBER 888104 LICENSE CLASSIFICATION B,C10, C46
VALUATION$ &M SQ FT ac L SQ FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION �..A CITY OFMENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN 0 SMIP
INVOICE PAID AMOUNT
AMOUNT a '%CASH G CHECK# 'C)CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT CASH '..'CHECK# "')CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED `"'YES ' NO DL NUMBER NOTARIZED LETTER 0 YES NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.citycfinenifee.us Inspection Request Line 951 246-6213
Menifee PMT15-00851
04/13/2015
EsGil Corporation
fn Partnership with Government for Bui( ing Safety
DATE: 04/13/2015 ❑ APPLICANT
❑ JURIS.
JURISDICTION: Menifee ❑ PLAN REVIEWER
PI-AN CHECK NO.: PMT15-00851 SET: I ❑ FILE
PROJECT ADDRESS: 30719 Loring Park Cir
PROJECT NAME: Segura 3 KW 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
0 GA ❑ EJ ❑ MB ❑ PC 4/6
I
Menifee PMT15-00851
04/13/2015
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Menifee PLAN CHECK NO.: PMT15-00851
PREPARED BY: Morteza Beheshti DATE: 04/13/2015
BUILDING ADDRESS: 30719 Loring Park Cir
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING AREA Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Junsdiction Code rnhf Manual Input
Bldg, Permd Fee by Ordinance
Pan Check Fee by Ordinance T
Type of Review: ❑ Complete Review ❑ Structural Only
❑Repetitive Fee ❑ Other
Repeats E]- Hourly 1.5 Hrs. @"
Ill Fee $105.00 $157.50
* Based on hourly rate
Comments: 1 1/2 hours plan review.
Sheet 1 of 1
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