PMT15-00918 i
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City of Menifee Permit No.: PMT15-00918
29714 HAUN RD. Type: Residential Electrical
<;kCCE1--A`. MENIFEE, CA 92586
MENIFEE Date Issued: 04/2312015
PERMIT
Site Address: 26190 MOONBEAM CIR, MENIFEE, CA Parcel Number: 338-192-007
92586 Construction Cost: $28,050.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 22 MODULES, 22 INVERTERS 5.610KW-BR
Work:
Owner Contractor
GLEN BOOTH VIVINT SOLAR DEVELOPER LLC
26190 MOONBEAM CIR 3301 N THANKSGIVING WAY
MENIFEE, CA 92586 STE 500
Applicant Phone: 8558772974
GLEN BOOTH License Number: 973756
VIVINT SOLAR DEVELOPER LLC
3301 N THANKSGIVING WAY
STE 500
LEHI, CA 84043
Fee Description Qtv Amount is
Solar, Residential or Small Commerolal m tµx 1 a
f �252 b0
Building Permit Issuance " 1 27.00
AddltlonalPlanRevieW'.Electncal �`b k 15& l : v;157:50�
GREEN FEE 1 2.00
&SMIPRESIDENTIAL ,r. wi r y 1 < x y400
$442.50
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 building operations being carried on thereunderwhen in violation of the Building Code or of any other
ordinance of City of Marries. Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,orwhere 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
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 7g44, Business and Professions
Professions Code fan my license is in ful}, cre��rJ effect. Code:The Contractor's License Law does not apply to an owner of a property
License (C�la��sps��"�1�,�(fl License.No. "� JCl who builds or improves thereon, and who contracts for the projects with a
Expires W ]tr f(0 Signatures licensed contractor(s)pursuant to the Contractors State License Law),
WORKERS'COMPENSATION DECLARATION
❑ I 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' gy my signature below 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 issu dC /n� �r"� ?Z ff th� improvements covered by this permit, I cannot legally sell a structure that I have
Policy# W t S o vt &0 I✓0V built as an owner-building if it has not been constructed in Its entirety by licensed
contractorsA 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'Orofessions 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:// w lecinfo ca aovlcalaw html,
permit is Issued.My workers'compensation insurance carrier and policy number are:
Carrier_ L.���`rd'Ll+��� Property Owner or Aul orized At Date
Expires 1 1'I ' S Policy#
Name of Agent Phone# IT 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-
0 I certify that in the performance of the work for which this permit is issued,I !den'fie pr�peflgY rthinspeetio urpo'ses..—
shall not ample v any persons in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become !/ S
subject to the workers'compensation provisions of Section 3700 of the Labor Property Owner rAuthorizedA Code, I shall forthwith comply with those roe isions. P Y gent Date
Date; I'l-n _'5 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, AYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ` ❑NCO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY u l 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
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 construct, alter, improve, demolish, �INb 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 Eg 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 ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than ($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARD US MATERIAL ffEPOR�ING. _
compensation, will do ( )all of or( ) porting of the work, and the structure is PROPER Y O NER R AUTHORIZED AGENT
not intended or offered for sale.(Section 7044, Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X \
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale. If,however,
the bullding or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
APPLICATION& SAFETY PERMIT/PLAN CHECK
Y t
-tb • Menifee
City Of MeneW Dept. A/ C�
DATE PERMIT/PLAN CHECK NUMBER '"I ✓—TYPE: COMMERCIAL RESIDENTIAL C1 MULTI-FAMILY Ci MOBILE HOME C` POOL/SPA SIGN
Re di%ADDITION t"ALTERATION '-'DEMOLITION i3 ELECTRICAL 13 MECHANICAL
G NEW PLUMBING RE-ROOF-NUMBER OF SQUARES SOAR
DESCRIPTION OF WORK solar roof mount 5.610 kW DC 22 module panels - 2 Ir\jj(t6j,%
PROJECT ADDRESS 26190 moonbeam cir
ASSESSOR'S PARCEL NUMBER 359_ I- `Dl-00 LOT 10-7 TRACT o(O ISI
OWNER NAME Glen Booth
ADDRESS 26190 Moonbeam cir Sun City 92586
PHONE 951-679-6530 EMAIL hemi1017@yahoo.com
APPLICANT NAME Vivint Solar Developer LLC.
ADDRESS 27449 Colt Court , Temecula, CA 92590
PHONE 951-326-6783 EMAIL robyn.young@vivintsolar.com
CONTRACTOR'S NAME Robyn Young OWNER BUILDER? O YES +jCNO
BUSINESS NAME Vivint Solar Developer LLC
ADDRESS 27449 Colt Court, Temecula, CA 92590
PHONE 951-719-3795 EMAIL robyn.young@vivintsolar.com
CONTRACTOR'S STATE LIC NUMBER 973756 LICENSE CLASSIFICATION C46
VALUATION$ 28,050 0 SQ FT L SQ FT Z
APPLICANT'S SIGNATURE DATE
CITYSTAFF USE O
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT -CASH C.'CHECK# >CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT -]CASH '-''CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED C'YES v NO DL NUMBER NOTARIZED LETTER '_� YES 0 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
EsGil Corporation
In(Partnership with Government for BuiGfing Safety
DATE: 04/21/2015 ❑'�,RPLICANT
JURIS.
JURISDICTION: City of Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT15-00918 SET: I
PROJECT ADDRESS: 26190 Moonbeam Cir.
PROJECT NAME: BOOTH 22 @ 215 Watts Micro-inverters 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:
By: Eric Jensen (SA) Enclosures:
EsGil Corporation
❑ GA ❑ EJ ❑ PC 04/14/2015
9320 Chesapeake Drive, Suite 208 ♦ Sao Diego, California 92123 ♦ (858)560-1468 ♦ Fax(858)560-1576
i
City of Menifee PMT15-00918
04/21/2015
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Menifee PLAN CHECK NO.: PMT15-00918
PREPARED BY: Eric Jensen (SA) DATE: 04/21/2015
BUILDING ADDRESS: 26190 Moonbeam Cir.
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING F-7k—EA-7 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 ❑�_Hourl 1.5 Hrs. @*
EsGill Fee $105.00 $157.50
* Based on hourly rate
Comments: 1 1/2 hours plan review.
Sheet 1 of 1
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