PMT15-01250 City of Menifee Permit No.: PMT16-01260
29714 HAUN RD. Type: Residential Electrical
CCELlr MENIFEE, CA92586
s�smMs° MENIFEE Date Issued: 05/13/2016
PERMIT
Site Address: 28125 ASPENWOOD WAY, MENIFEE, Parcel Number: 372-026-013
CA 92584 Construction Cost: $2,500.00
Existing Use: Proposed Use:
Description of ELECTRICAL PANEL UPGRADE 200 AMP FOR SOLAR
Work:
Owner Contractor
KIMBERLY KREMLING VIVINT SOLAR DEVELOPER LLC
28125 ASPENWOOD WAY 3301 N THANKSGIVING WAY
MENIFEE, CA 92584 STE 500
Applicant Phone: 8558772974
ROBYN YOUNG License Number: 973756
VIVINT SOLAR DEVELOPER LLC
3301 N THANKSGIVING WAY
STE 500
LEHI, CA 84043
Fee Description Ca Amount
Building Permit Issuance 1 27.00
$144.00
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 staled,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
1 hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the properly 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 o 4 ¢ffect. Code:The Contractor's License Law does not apply to an owner of a property
License Class L � License No. , V who builds or improves thereon, and who contracts for the projects with a
Expires _�f)._LV Signatures licensed contractor(s)pursuant to the Contractors State License Law),
WORKERS'COMPENSATION DECLARATION
❑ lam exempt from licensure under the Contractors'State License Law for the
hahereby affirm under penalty of perjury one of the following declarations: following reason:
ve 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 is�s�u�d� i D built as an owner-building if it has not been constructed in its entirety by licensed
Policy# \y V V, JS'r'i V t./ 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 ofessions Code,is avail le-upon request when this application is
section 3700 of the Labor Code, for the performance of the work for which this sula Itted . a .htt //www.le info.ca. ov cola tml.
permit is issued.My workers'
compensation insurance carrier and policy number are:
Carrier LV o t Prop rty 0t t a following Web si zp er or Authorize gent Date
Expires N! I I J Policy#
❑ By my Signature below, I certify to each of the following: I am the grope,.,
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 ordinanc rrd state laws relating to building
construction.I authorize representative this city or county to enter the above-
❑ I certify that in the performance of the work for which this permit is issued,I identi'ed prope for the inspection rposes. \
shall not employ any persons in any manner so as to become subject the l3 I)
workers' compensation laws of California, and agree that if I sh Wd'6ecome '
subject to the workers'compensation Date; _ p viisons of Section 3 of the Labor propert w or Authorized gent Date
Code,I shall forthwith comply with th e p '
�_ I
(1� tI5 City Business License#
- _ Applicant
WARNING: FAILURE TO SE URE 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, ❑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 0 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
OWNER BUILDER DECLARATIONS GUIDE LINES
1 hereby affirm under penally 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 AYES 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, 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 ❑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
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($500).) CODE, SECTION 25505 25533 AND 2553 -GON ERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL DEPORTING.
compensation,will do ( )all of or( ) porting of the work, and the structure is PROPE\Yi0 NER OR AU RIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
_I'
r;.
Menifee
DATE PERMIT/PLAN CHECK NUMBER M 16- bias's
TYPE: i COMMERCIAL G RESIDENTIAL ", MULTI-FAMILY '% MOBILE HOME tr POOL/SPA SIGN
SUBTYPE: 0 ADDITION •C'ALTERATION DEMOLITION 0 ELECTRICAL MECHANICAL
- NEW , , PLUMBING <: RE-ROOF-NUMBER OF SQUARES SOLAR
DESCRIPTION OF WORK electrical upgrade 200 amp
PROJECTADDRESS 28125 aspenwood,.�waay 2 �j
ASSESSOR'S PARCEL NUMBER :j'j -k - O!Pf LOT _ TRACT
OWNER NAME Kimberly Kremling
ADDRESS 28125 aspenwood way. menifee ca 92584
PHONE 951-264-3363 EMAIL
APPLICANT NAME Vivint Solar Developer LLC
ADDRESS 27449 Colt Court , Temecula, CA 92590
PHONE 951-719-3795 EMAIL robyn.young@vivintsolar.com
CONTRACTOR'S NAME Rob n Young OWNER BUILDER? 0 YES XNO
BUSINESS NAME Vivint Solar Developer LLC
ADDRESS 27449 Colt Court, Temecula, CA 92590
PHONE 951-719-3795 EMAIL robyn.young@vivintsolar.com
CONTRACTOR'S STATE LIC NUMBER 973756 LICENSE CLASSIFICATION C46
VALUATION$ 2,500.00 SQ FT LSo FT
APPLICANT'S SIGNATURE DATE"C �_ I
OTY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY DIE MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE
AMOUNT 14 ` PAID AMOUNT
�� CASH %CHECK# -`%CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT -CASH ::::CHECK# ':3 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED i%YES ?:' NO DLNUMBER NOTARIZED LETTER YES _ 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