PMT15-00942 City of Menifee Permit No.: PMT16-00942
29714 HAUN RD.q9kXtEL—A> MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 06/15/2015
3
4
i
PERMIT
Site Address: 29697 WILLIAMETTE WAY, MENIFEE, Parcel Number: 338-320-003
CA 92586 Construction Cost: $20,000.00
a
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 20 MODULES, 1 INVERTER 5.5KW
Work:
Owner Contractor
JOHNNY SANDERS KILLION ENERGY INC
29697 WILLIAMETTE WAY 15261 CONNECTOR LANE
MENIFEE, CA 92586 HUNTINGTON BEACH, CA 92649
Applicant Phone: 7143738544
DALLAS FERGUSON License Number: 971660
KILLION ENERGY INC
15261 CONNECTOR LANE
HUNTINGTON BEACH, CA 92649
Fee Description Qyt Amount
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
0
$440.50
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 Blog_Permit_Templale.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 Code and my license is in full force n O effect. Code:The Contractor's License Law does not apply to an owner of a property
License ffss Class /a Licens No.�> who builds or improves thereon, and who contracts for the projects with a
Expires� b Signatur licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors'State License Law for the
❑ 1 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 by this permit, I cannot legally sell a structure that I have
permit is issued. built as an owner-building if it has not been constructed in its entirety by licensed
Policy# 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 requestwhen 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:htto'//www leoinfo.m.goy/calaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
..qq Carrier Property Owner or Authorized Agent Date
��G , ,
Expires, y/�P / Policy# ?092C 4{V Z
Cs�f( ! /e7 y`��,0�� ❑ By my Signature below, I certify to each of the following: 1 am the property
Name of Ageni_�'f'n Y ,n Phone# b/ O 7 , O 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
it 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 property�yr the inspection purposes,
shall not emolov 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 CCp2 2 Date
Code,I shall forthwith comply with those provisions.
`>' City Business License#
� � J
Date; � Applicant; —
WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
F 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 _.prNCT 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
- FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
,.,�
Lender's Address �u DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
I hereby affirm under penally 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, O 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 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 licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS
�"O
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to 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 I�EPOR�ING.
compensation,will do( )all of or( )porting of the work, and the structure is PROP�TY22 W 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
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).
EsGil Corporation
in(Partnership with Government for Building Safety
DATE: 05/7/2015 ❑ APPLICANT
❑ JURIS.
JURISDICTION: City of Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT15-00942 SET: II
PROJECT ADDRESS: 29697 Willimette Way
PROJECT NAME: Habbard 2x3,000 Watts 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 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: Morteza Beheshti Enclosures:
EsGil Corporation
❑ GA ❑ EJ ❑ PC 4/30
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858)560-1468 ♦ Fax(858)560-1576