PMT15-01167 a
a
City of Menifee Permit No.: PMT15-01167
,�-�•'' 29714 HAUN RD.
<;KCC£L/�k. MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued:
05/15/2015
PERMIT
Site Address: 32105 HEATHER LN, MENIFEE, CA Parcel Number: 372-170-011
92584 Construction cost: $65,500.00
Existing Use: Proposed Use:
Description of INSTALL GROUND MOUNTED SOLAR SYSTEM, 56 PANELS, 2INVERTERS, 14.56 kW
Work:
Owner Contractor
ARTURO CASTILLO HORIZON SOLAR POWER INC
32105 HEATHER LANE 7100 WEST FLORIDA AVENUE
MENIFEE, CA 92584 HEMET, CA 92545
Applicant Phone: 9519261176
HOLLY THOMPSON License Number: 992053
HORIZON SOLAR POWER INC
7100 WEST FLORIDA AVENUE
HEMET, CA 92545
Fee Description Qty Amount
Building Permit Issuance 1 27.00
GREEN FEE 1 3.00
NTf -
$448.50
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
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
ProfessWCdy I'cense is in full fo a Code:The Contractor's License Law does not apply to an owner of a property
icen eNo. who builds or improves thereon, and who contracts for the projects with a
Signature V licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECL
❑ 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 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 .are [list I have
permit is issued. a
Policy# built as an owner-building if it has not been construrfr' ,,,Its ei„
contractors. I understand that a cony�r dpo0rabls 'aw, Section iLa t al.
have and will maintain workers' compensation insurance, as required by Business and Professions Code m _ „pun request when this application Is
ection 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http'//www.Ieqinfo.ca.00v1caIaw html.
emiit is issssuu .My workers'compensation insurance carver and policy number are:
Carrier l7 C Property caner or Authorized gent Date
Expires Policy# '"I LJbZ� '
❑ 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 a e to comply
one-hundred dollars($100)or less) with all applicable ci and oun ordinances and state laws re ti g to building
constructio . auth n ep ese tatives of this city or county to ant r the above-
El I certify that in the performance of the work for which this permit is issued,I entifi d roperty f r the i pact n pur es.
shall not employ any persons in any manner so as to become subject or the
workers' compensation laws of California, and agre h uld b come
subject to the workers'compensation provisions o action 70 th Labor rop rty d Agent Date
Code,I shall forthwith comply with th rovisi usine e# d 5(P-779
Date; Applican
WARNING: FAILURE TO SEC ORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAW 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, ❑YES 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 IA0 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
��" 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 ❑YES 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, �0 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 r1YES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensors 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 CALIFOR IA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE, SECTIO .
5 3 NO 25534 CONCERNIN
❑ I, as owner of the property, or my employees with wages as their sole AZARDOU ATERIAL 0 �I G
compensation,will do( )all of or( ) porting of the work, and the structure is P PERT O NER O A 0 1 ED GENT
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).