PMT15-01133 3
City of Menifee Permit No.: PMT15-01133 !
_ 29714 HAUN RD. Type: Residential Electrical {
1 MENIFEE, CA 92588
MENIFEE Date Issued: 05/13/2016
PERMIT
Site Address: 31917 ANTHONY CT, MENIFEE, CA Parcel Number: 372-222-042
92584 Construction Cost: $8,619.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 15 PANELS 1 INVERTER 3.9KW
Work:
Owner Contractor
VAAIVA TUFELE SOLARCITY CORPORATION
31917 ANTHONY CT 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 Qtv Amount l$1
Building Permit Issuance 1 27.00
dti I`ora�la,iol'an�e ieW �Ctr"a;: �, S ;,
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 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 (I` 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).
WORKERS'C PENSATION DECLARATION
❑ I am exempt from licensure 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 by this permit, 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
❑ 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:httv://www.leginfo,ca.govicalaw.html.
permit is issue M workers'compensation insurV4Ge carrier and policy number are:
Carrier /V"/ �7 / � 2 Property Owner orAuthorize gent Date
Expires Policy# /&Co/d'i'47 .so3)
❑ By my Signature below, I certify to each of the following: I am the property
Name of Agent Phone# owner or authorized to act an 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-
El I 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 O - or uthorized Agent , �y A Date'
Date; Applicant; City Business License# 3552("A
�-� _/
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 ❑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 AYES 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 hem(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 Stale 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 AYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do ( ) all of or( ) porting of the work, and the structure is PROPERTY OWNER ORAUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If, however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
k
Menifee
DATE 0 4/0 812 0 1 5 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL []MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA [I]SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑✓ ELECTRICAL ❑MECHANICAL
[]NEW [:]PLUMBING El RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK residential roof mount 15 panels 1 inverter 3.9 KW
PROJECTADDRESS 31917AnthonyCt.
ASSESSOR'S PARCEL NUMBER :J,a.-p�-� '�- LOT �-lO TRACT 11014
OWNERNAME VaaivaTufele
ADDRESS same
PHONE (619)606-2344 EMAIL
APPLICANT NAME Beverly Miller
ADDRESS 41568 Eastman Dr. Murrieta, CA 92562
PHONE (951)291-8703 EMAIL bmiller2@solarcity.com
CONTRACTOR'S NAME OWNERBUILDER? ❑YES❑NO
BUSINESS NAME Solarcity
ADDRESS 3055 Clearview Way San Mateo,CA 94402
PHONE (650)638-1028 EMAIL
CONTRACTOR'S STATE LIC NUMBER 888104 LICENSE CLASSIFICATION B,C10, C46
VALUATION$ $8,619.00 SO FT 271 L SO FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION �ro CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN 1 SMIP
INVOICE e PAID AMOUNT
AMOUNT D CASH C%CHECK# -CREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT CASH ''CHECK# "`CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED "YES C NO DLNUMBER NOTARIZED LETTER O 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