PMT15-00923 City of Menifee Permit No.: PMT15-00923
29714 HAUN RD.f" MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 0 610 4/2 01 5
PERMIT
Site Address: 27677 ALMONT WAY, MENIFEE, CA Parcel Number: 333-311-011
92585 Construction Cost: $10,342.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 18 PANELS, 1 INVERTER 4.68KW
Work:
Owner Contractor
CHAD BARKER SOLARCITY CORPORATION
27677 ALMONT WAY 3055 CLEARVIEW WAY
MENIFEE, CA 92585 ATTN ZOE STEELE
Applicant Phone: 6509635630
BEVERLY MILLER License Number: 888104
SOLARCITY CORPORATION
3055 CLEARVIEW WAY
SAN MATEO, CA 94402
Fee Description Q yt Amount f$1
I I #
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
$439.50
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 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
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
ProfessW
cense Is in fullfore and act. Code:The Contractor's License Law does not apply to an owner of a property
License4License No. who builds or improves thereon, and who contracts for the`projects with a
Expiresature licensed contractors)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensors 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. 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
❑ 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:http7lwwvv Iepinf0 ca govlcalaw hand,
permit is issu d y wor,+k-er's'compensation/iJ, J rance carrier and policy number are:
Carrier eie"( �, t-c-•i✓ Property Owner or Authorized Agent
r��t ,,,J— ff pp / ��11 2xx Date
Expires "1 Policy# ~T sPW �Q�bd� GJ-J
❑ 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($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 1 certify that in the performance of the work for which this permit Is issued, I identified prop t)'rt e inspection purposes,
shall not amble 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 shall forthwith comply with those provisiogs. / P y 9 nt Date
Date; Applicant; City Business License# 6�5 a 4
WARNING: FAILLIF SECURE WORKERS' HAZARDOUS MATERIAL DE
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL CLARATION
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, EIYES 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 LINO 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 THC-
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name AYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
[I 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 EIYES 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 DYES 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do ( ) all of or ( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044, Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X _
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not Intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not butter improved for the
purpose of sale).
SAFETYBUILDING & PERMIT/PLAN CHECK APPLICATION
sy'Menifee
DATE 04/13/2015 PERMIT/PLAN CHECK NUMBER '[ 5-QOaa3
TYPE: ❑COMMERCIAL Q RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: [—]ADDITION ❑ALTERATION ❑DEMOLITION QELECTRICAL ❑MECHANICAL
[:]NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK residential roof mount 18 panels 1 inverters 4.68 KW
PROJECTADDRESS 27677 Almont Way �,1 G
ASSESSOR'S PARCEL NUMBER ;�`1 LOT I Ja TRACT
OWNER NAME Chad Barker
ADDRESS same
PHONE (858)245-0225 EMAIL
APPLICANT NAME Beverly Miller
ADDRESS 41568 Eastman Dr. Murrieta, CA 92562
PHONE (951)291-8703 EMAIL bmiller2@solarcity.com
CONTRACTOR'S NAME OWNER BUILDER? ❑YES❑NO
BUSINESS NAME Solarcity
ADDRESS 3055 Clearview Way San Mateo, CA 94402
PHONE (650)638-1028 EMAIL
CONTRACTOR'S STATE LIC NUMBER 888104 LICENSE CLASSIFICATION B, C10, C46
VALUATION$ $ 10,342.00 SO FT 325 L SO FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN ' SMIP
INVOICE ^Q7iO PAID AMOUNT
AMOUNT dC7� "CASH (CHECK# L%CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT `:GASH %CHECK# '"CREDITCARD VISA/MC
OWNER BUILDER VERIFIED "YES " NO DLNUMBER NOTARIZED LETTER C) YES 01 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213