PMT15-00853 City of Menifee Permit No.: PMTI5-00853
29714 HAUN RD. Type: Residential Electrical
S kCC'tm#.,f�k. MENIFEE, CA 92586
Wk., MENIFEE Date Issued: 04/17/2016
PERMIT
Site Address: 31267 MYSTIC LN, MENIFEE, CA 92584 Parcel Number: 372-271-035
Construction Cost: $14,365.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 25 PANELS 1 INVERTER, 6.5KW
Work:
Owner Contractor
SHANE WHITE SOLARCITY CORPORATION
31267 MYSTIC LN 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 O_yt Amount($1
Solar, Residential or Small Commercial 1 2 62'00
Building Permit Issuance m 1 x� 27.00
�Additionalplan Rewe Electrical e 158 157 5Q
GREEN FEE 1 1.00
SMIPRE IDEf1TIAL � s rssr� $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 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 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).
WORKERENSATION DECLARATION
❑ 1 am exempt from Iicensure 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 b this permit, cannot legally sell a structure that I have
permit is issued. P Y P 9 Y
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:http; www Ieginfo ca gcvfcalaw html.
permit is issue M workers'compensation a carrier and policy number are:
/ YL � Property Owner or Authorize gent Date
Carrier. J >
Expires /f Policy# �(t✓�D ®W(r'i ,�id�J3
T ❑ 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($10D)or less) with all applicable city and county ordinances and stale 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 inspection 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
subject to the workers'compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Prope Owne or�uthorized Agent /l Date(
City Business License# ��
Date; Applicant;
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 ❑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 ❑YES 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 ❑YES 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 ❑YES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from icensure 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
❑ 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044, Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or Improved for the
purpose of sale).
L & SAFET
LL Y PERMIT/PLAN CHECK APPLICATION
EcMen fee
DATE h5PERMIT/PLAN CHECK NUMBER 7'15- 60M 3
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION QELECTRICAL ❑MECHANICAL
❑NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
W
PROJECTADDRESS ,
ASSESSOR'S PARCEL NUMBER — -035 LOT o TRACT �v
OWNER NAME LA
ADDRESS
PHONE 9{S� ? p ®c)c EMAIL
APPLICANT NAME Beverly Miller
ADDRESS 41568 Eastman Dr. Murrieta, CA 92562
PHONE (951)291-8703 EMAIL bmiller2@solarcity.com
CONTRACTOR'S NAME OWNERBUILDER? ❑YES❑NO
BUSINESS NAME Solarcity
ADDRESS 3055 Clearview Way San Mateo, CA 94402
PHONE (650)638-1028 EMAIL
CONTRACTOR'S STATE LIC NUMBER 888104 LICENSE CLASSIFICATION B.C10,C46
VALUATION$ b� SO FT 7�,�� L SO FT
APPLICANT'S SIGNATURE DATE f0
DEPARTMENT DISTRIBUTION w OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN ( SMIP i� CITV
INVOICE 1 PAID AMOUNT
AMOUNT Q_ .CASH 'CHECK# "CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT t>'CASH 'CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED C YES 0 NO DL NUMBER NOTARIZED LETTER YES C 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 PMT15-00853
04/ 13/2015
EsGil Corporation
in Tartnersfiip witk Government for ouifding Safety
DATE: 04/13/2015 ❑ APPLICANT
❑ JURIS.
JURISDICTION: Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMTIS-00853 SET: I
PROJECT ADDRESS: 31267 Mystic Ln.
PROJECT NAME: White 6 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
❑ GA ❑ EJ ❑ MB ❑ PC 4/6
Menifee PMT15-00853
04/13/2015
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Menifee PLAN CHECK NO.: PMT15-00853
PREPARED BY: Morteza Beheshti DATE: 04/13/2015
BUILDING ADDRESS: 31267 Mystic Ln.
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING AREA Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Air Conditioning
Fire Sprinklers
TOTALVALUE
Junsdiction Code mnf Manual Input
Bldg. Permit Fee by Ordinance IV
Plan Check Fee by Ordinance
Type of Review: ❑ Complete Review ❑ Structural Only
❑Repetitive Fee [] Other
Repeats E Hour�l 1 1.5 Hrs. @
EsGil Fee $105.00 $157.50
* Based on hourly rate
Comments: 1 1/2 hours plan review.
Sheet 1 of 1
macvalue.doc+