PMT15-01084 City of Menifee Permit No.: PMT15-01084 I
29714 Type: Residential Electrical
GCE., MENIFEEEE,, C CA 92 92586
eax"° MENIFEE Date Issued: 05/12/2015
i
PERMIT
Site Address: 33485 WILD LILAC RD, MENIFEE, CA Parcel Number: 384-050-028
92584
Construction Cost: $43,200.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 36 PANELS, 2 INVERTERS, 9.9KW
Work:
Owner Contractor
GREG MILLAR PETERSEN-DEAN INC
33485 WILD LILAC ROAD 39300 CIVIC CENTER DRIVE
MENIFEE, CA 92584 FREMONT, CA 94538
Applicant Phone: 5103716500
JENNY ENCISO License Number: 468117
39300 CIVIC CENTER DRIVE
FREMONT, CA 94538
Fee Description - Ply Amount
Building Permit Issuance 1 27.00
GREEN FEE 1 2.00
$444.50
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 Code and y license is in full for a 1. Code:The Contractor's License Law does not apply to an owner of a property
License Cla2ss License No. who builds or improves thereon, and who contracts for the projects with a
�"
Expires r `dl_ Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION D RATION
❑ 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 1 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
II have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
tion 3700 of the Labor Cade, for the performance of the work for which this submitted or at the following Web site:�'l/www lecinfo ca covlcalaw html.
permit is issued.My workers'com sa'on insurance carrier and policy number are:
Son
Property Owner or Aut orized gent Date
Carrier J a
l Expires Policy# O I
❑ 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 ci aad-c my ordinances and state laws relating to building
constru I authori repres tatives of this city or county to enter the above-
', ❑ 1 certify that in the performance of the work for which this permit is issued,I iden'ied prope or t 1 action purposes.
shall not employ any persons in any manner so as to become subject to the
workers'compensation laws of California, and agree I should become t
subject to the workers'compensation provisions of ction 370 f the Labor Property Off n or Authorized Agent Dat
Cade,I shall forthwith comply with those provi ns. -
City Business License#
Date; Applicant;
WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
i 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, DYES 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
INFORMATION GUIDE?
I hereby affirm that under the penalty of perjury there is a construction lending
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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address ❑NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
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
l 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 I HAVE READ THE HAZARDOUS MATERIAL
provisions of the Contractor's State License Law(Chapter 9(commencing with
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 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($500).) COZDE, SECTION
E STION 25505 MATERIALFfE5533 ND 25534 CONCERNING
POkt
❑ I, as owner of the property, or my employees with wages as their sole
compensation, will do ( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
1
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE PERMIT/PLAN CHECK NUMBER _ 0 Q
TYPE: COMMERCIAL W ESIDENTIAL 0 MULTI-FAMILY C:% MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: f;ADDITION 0 ALTERATION 0 DEMOLITION 0 ELECTRICAL 0 MECHANICAL
'? NEW Ct PLUMBING "D RE-ROOF
APPLICATION NAME i I by
DESCRIPTION OF WORK
PROJECT ADDRESS gWild LilaqZ$Y9
ASSESSOR'S PARCEL NUMBER U.S f9 - (�)�T 1 TRACT
OWNER NAME Gym v
ADDRESS I WO W. nit m
PHONE EMAIL City Of
I
APPLICANT NAME T Ing Safety Dept.
ADDRESS lJ R 2 8 2015
PHONE" EMAIL Rpnigil
ved
CONTRACTOR'S NAME menocanOWNER BUILDER? 0 YES ' O
BUSINESS NAME
ADDRESS o a 6
PHONE1j9)n2_2- ab EMAILi2 row
CONTRACTOR'S STATE LIC NUMBER i(J�' LICENSE CLASSIFICATION
VALUATION $ 2 v ® FT /// L SO FT
APPLICANT'S SIGNATURE DATE
.,I ITY STAFF US
DEPARTMENT DISTRIBUTION // CITY OF MENIFEE BUSINESS LICENSE NUMBER
PLANNING ENGINEERING FIRE SMIP GREEN � Z Q G
INVOICE µ9 PAID AMOUNT cP
AMOUNT � p 2 7 OCASH C.:'CHECKq
G ci CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT C+ CASH %CHECK# 1;CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 'YES =' NO LICENSE NUMBER NOTARIZED LETTER YES 0 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
EsGil Corporation
In(Partnership with Government far Bui(ding Safety
DATE: 05/06/2015 ❑ APPLICANT
❑ JURIS.
JURISDICTION: City of Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT15-01084 SET: I
PROJECT ADDRESS: 33485 Wilds Lilac Rd.
i
PROJECT NAME: Millar (4+5)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 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 4/29
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax(858) 560-1576
City of Menifee PMT15-01084
05/06/2015
k
[DO NOT PAY- THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Menifee PLAN CHECK NO.: PMT15-01084
PREPARED BY: Morteza Beheshti DATE: 05/06/2015
BUILDING ADDRESS: 33485 Wilds Lilac Rd.
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING AREA Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Judsdiotlon Code rnn( Manual Input
Bldg. Permit Fee by Ordinance �►
Plan Check Fee by Ordinance T
Type of Review: ❑ Complete Review ❑ Structural Only
❑Repetitive Fee ❑ Other
Repeats Hourly 1 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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