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PMT15-01532 I City of Menifee Permit No.: PMT15-01532 29714 HAUN RD. MENIFEE, CA 92586 Type: Residential Electrical { MENIFEE Date Issued: 0 7/1 612 01 5 �l 1 PERMIT Site Address: 30460 TEAL BROOK DR, MENIFEE, CA Parcel Number: 364-151-005 92584 Construction Cost: $10,800.00 i Existing Use: Proposed Use: Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 21 PANELS, 21 MICROINVERTERS, 5.67KW Work: Owner Contractor JASON COVINGTON COMPLETE SOLAR SOLUTION OF CALIFORNIA INC 30460 TEAL BROOK DR 1065 EAST HILLSDALE BLVD#308 MENIFEE, CA 92584 FOSTER CITY, CA 94404 Applicant Phone:6502411481 KEVIN CONKLIN License Number: 961988 COMPLETE SOLAR SOLUTION OF CALIFORNIA INC 1065 EAST HILLSDALE BLVD#308 FOSTER CITY, CA 94404 - Fee Description ptz Amountis Building Permit Issuance 1 27.00 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 Code 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 Class License No. 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'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 sNI 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 Code, for the performance of the work for which this submitted or at the following Web site:http�l/www.le(3info.ca.clov/calaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: Carrier 71�Iz�LC, (, - e / Property Owner or Authorize Agent Date � G, Expires �-M, Policy# �y� f �S �� Name of Agent Phone# ElBy my Signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this (This section need not be co feted 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- 0 1 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 Property Owner or Authorized Agent Date Code, I shall forthwith comply with those provisions. City Business License# Date; L � � Applicant;/��9'/�, y 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, DYES 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 El 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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address ❑NO FROM THE SOUTH COAST AIR QUALITY MANAGEMENT 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 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, ❑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 DYES 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 ❑ 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL AEPOR1 ING. compensation,will do ( )all of or( ) porting of the work, and the structure is PROP TY OWNER OR THORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; 0 The Contractor's State License Law does not apply to an owner of a property X�� �f ^— 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). Menifee PMT15-01532 6/24/2015 EsGil Corporation In(Partnership with Government for(Bui[ding Safety DATE: 6/24/2015 ❑ APPLICANT ❑ JURIS. JURISDICTION: Menifee ❑ PLAN REVIEWER ❑ FILE PLAN CHECK NO.: PMT15-01532 SET: II PROJECT ADDRESS: 30460 Teal Brook Dr PROJECT NAME: Covington 21 microinverter 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 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: ) Email: Fax #: Mail Telephone Fax In Person ❑ REMARKS: By: Morteza Beheshti Enclosures: EsGil Corporation ❑ GA ❑ EJ ❑ MB 7 PC 6/18