PMT15-01773 City of Menifee Permit No.: PMT16-01773
29714 HAUN RD. Type: Residential Electrical
iCCF.t..l . MENIFEE, CA 92586
MENIFEE Date Issued: 06/26/2016
l
PERMIT
Site Address: 30448 STAGE COACH RD, MENIFEE, CA Parcel Number: 358-442-006
92584 Construction Cost: $7,600.00
Existing Use: Proposed Use:
Description of SOLAR 14 PANELS 3.64 KW
Work: MPC#12-1605
LOT 6
Owner Contractor
BROOKFIELD HOMES SOLARCITY CORPORATION
3090 BRISTOL ST#110 3055 CLEARVIEW WAY
COSTA MESA, CA 92626 ATTN ZOE STEELE
Applicant Phone: 6509635630
CA License Number: 888104
Fee Description Otv Amount
Building Permit Issuance 1 27.00
SMIP RESIDENTIAL 1 1.00
$281.00
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 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
i
City Of Menifee
I
LICENSED DECLARATION
I hereby affirm under penally or perjury that I am licensed under provisions of ❑ 1, 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 Cg(jg n y license is in ful f rce and a act. 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
❑ I hereby affirm under penalty of perjury one of the following declarations: following reason:
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// �
Policy# lY. P7(,.Pej L `'( built as an owner-building if it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
❑ I 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:ht1w//www leginfo ca gov/calaw html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carri er�,l YG�i�� ( y1v Property caner orAuthorized Agent Date '..
Expires C)G(h 1 S Policy#
Name of Agen {IBC,v) -Phone# LI��'�"t �5� ❑ By 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 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
construlction. I authorize representatives of this city or county to enter the above-
❑ I certify that in the performance of the work for which this permit Is issued,I identiFl d 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 pro 'sions. P_ropefly"der dr�`iuthorized Age��ngpt Date
___� City Business License# 0
Date;Cp�(l CPS Applicant;
4 '
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, pYES 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 '�,�J0 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 FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
0 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 pYES 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, -Q0 SCHOOL?
or repair any structure, prior to its issuance, also requires the applicant for the r
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 ❑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 ( ) all of or ( ) porting of the work, and the structure is PROPERT RARAUTHORIZED.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
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).
CITY OF MENIFEE
FT
29714 Haun Road Date:ate: 605 Data,-
Menifee, CA92586 �j [-
Phone: (951)672-6777 ou^ u gI cV
Fax:(951)679-3843 Ck . k
Building Combination Permit 6 5"
PT•f z-- [tics TO Be Corn leted By Appikmint {_ , , r -7
Legal Desc p an: Plunrung Case: F: R
Property Address_ =30 & `, L r (�A gssessors Parcel Number. LO*
Pre ecf/Tenant Name: -(/ �J Unit W. Floor#:
K(a ski a Avm(* Mv(z�HN RArJ�H
Name: P�s 6 Fax No.
P-ooKF W-- . ores Z 7 7 _
OwneProperty Address: � p -�f it mbar Zip Coda
EmalAddress: cos TA ri/l'WC�✓i,4 �/g zb lz6 7p
Names P� -- Z 7 /O�.� Fax No.
Applicant tl ress: Unit Number ZIP Code
Email Address: �mo✓�
/Y1
Name: E
No.
Cardiactor Address: City StaleZI Code
I7rssr- 6 Dwv. IV1�• �/0°'Te-i'!b'E C^ 2507
on ors y u ness tense o. Confractor's CI State of aafomla License No.
029rI& gid Cleasification: C10 G�fb
Numcer of squares;
Square Footage
Description of Work: - Cost of Wodc q
'fiFp Icanl's Signature
L<W F,70r- Movr.1T rV s4s r�rn oat / —
�+r
Tp Be Completed By City Staff only -
Indlem,As R-Recehmd m NIA-Not Applicable
S Completes sets of July dimanalonad,dmwn to sale plans which include: t act of documents which mdude
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Solis Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ TTlle 24 Energy(on S K x 11)
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Structural Calculations
❑ Single Line diagram for also.services over 400 AMP
❑ Floor Plan ❑ ShicturalFlaming Plan&Deleils ❑ Sharing Plan ❑ Sound Report-Realdantiai
Class Code: Indicate LJNaw Construction Agerstian• Addition• MeansMolhods
Work Type. ]Repair- Retrofit' Reunion 10 12*111gFOrrW Requlred? YES NO
Pmposed Building Use(s): Existing Building Uae(s):
#Buildings: #Unds: #Stodes: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate M
Indicate all Geo-tech.Haz Zone
At Protect ma YES or NOCompletion: Conatmctlon that apply: Coastal ZaneType(s): yES or NONoise Zone
tl7 Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch-Review Board I I Landmark Comm. 1111anning Comm.Zoning Administrator
Fee Exempt: City Projeol Else.Vehicle Charger Landmark Seismic Retrofit pea m: da.
ORdsl must
Expadlte Projee[(s): Child Cara city Project Green BuiWhng Landmark AgordaMe Housing
For Stag Use Only
aulldi. /safety Parnh Specla sl City Planning I Civil Engineerng I
EVVInVi-
In I Tansporkillon Mgmt. Rant onlrol
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY