PMT15-01774 i
,I
City of Menifee Permit No.: PMT15-01774
29714 HAUN RD,
} MENIFEE, CA 92586 Type: Residential Electrical f
enere�ma warns" MENIFEE Date Issued: 06/26/2015
I
1
PERMIT
Site Address: 30472 BUCKBOARD LN, MENIFEE, CA Parcel Number: 358-450-001
92584 Construction Cost: $7,600.00
Existing Use: Proposed Use:
Description of SOLAR 14 PANELS 3.64 KW
Work: MPC#PT12-1605
LOT 8
Owner Contractor
BROOKFIELD HOMES SOLARCITY CORPORATION
3090 BRISTOL ST#110 3055 CLEARVIEW WAY
COSTA MESA, CA 92626 ATTN ZOE STEELE
Applicant Phone:6509635630
CRYSTAL MORRIS License Number: 888104
SOLARCITY CORPORATION
3055 CLEARVIEW WAY
SAN MATEO, CA 94402
Phone: 7142747895
Fee Description ,Qtv Amount($1
sdential=oKr5 all�Com,A_r;t-1' 252 00
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 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
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 CQ�� n my license is in fu1 force and a act. Code:The Contractor's License Law does not apply to an owner of a property
License Clas�.,`1 l License No. who builds or improves thereon, and who contracts for the projects with a
Expires.il I(CZ 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:
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 iss/ue,,d/,,
Policy# �{Ly s a(0?/fI�CTZ`'� built as an owner-building if a has not been constructed in its entirety 0 licensed
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 fallowing Web site:htto//www.leciinfo.ca.gov/calaw.htmi.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier Lt4w��A a,� Property Owner or Authors dAgent Date
Expires Oq Policy# II 7� ''//2 G�
Name of Agent i�V��Phone# L_J& /"1 .J�ns� � ❑ 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
constr coon.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 kientifi d property for the inspection purposes.
shall not emolov 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 �P caner thorized Agent / Date
Code,I shall forthwith comply with those pro isions. Q „
City Business License# G�•
Date; Applicant;
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 A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES 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
Lender's Address `,,,0 FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
B DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS LI 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 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, -Q 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 ors 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
El I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation,will do( )all of or( ) porting of the work, and the structure is PROPERTY 0== HORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code; �
The Contractor's State License Law does not apply to an owner of a property X \�
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF M]ENIFEE
PLCK No: P
29714 Haun Road FT -Ibo5
Date: Date: .
Menifee, CA 92586
Phone: (951)672-6777 Amount: Amount:
Fax:(951)679-3843 Ck#: t
Building Combination Permit 7771
G ( 5-1
PTiZ— tb To Be Completed By Applicant P 5
Legal Description: Planning Case: F: L: Rt: R:
Property Address_ -j,�:v )�Z OC 0 Assessors Parcel Number. LOB
Pro ectlTenanl Name: rj(� B�� �V�t E MV RPH"{ r-^T- CFI Unit#: Floor#:
Name: P Phopi`� , 7 _7QO4'S Fax No.
gP-ovl�Ft�tro Flores ``
Properly Address: Unit Number Z Code
Owner _ IP
Email Address: (o
Name: ,S PHeV'_. z Fax No.
Applicant Address: Unit Number Zip Code
Email Address: -
_ r;
Name: a No.
SOLiht��('r P7/ 27 - 7 �� F
Contractor Address: City State I Zip Code
1799 - 6 towA A<i/—i-• HI�Cr-�(C� C-'A 2Sd-J
Contractor's y ustnesa cense o. Contractor's��Cityyl State of alifomla License No. Classification:
03rs"2b Tp�81b C10
Number or Squares;
Square Facings
Description o1 Work: - �W F-00 t` NIOVIJT FV SNSTEh1 Cost of Work:$
Applicant's Stgnature — .Jy� _
Date: Z
10 Be Completed By Clty Staff Only
Indicate As R-Revived or N/A-Not Applicable
5 Completes sets of fully dimensioned,drawn to sale plans which include: 1 set ordocuments which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Solls Report(on ad only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Tula 24 Energy(on S'/a x 11)
Foundation Plan ❑ Structural Calculations
❑ ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plana Details ❑ Sharing Plan ❑ Sound Report-Residential
Class Code: Indicate New Constntellon Alteration' Addition' Means/Methads
Work Type: Repair" Retrofit' Revlslon to Existing Petmle Required? YES NO
Proposed Building Use(s): Existing Building Use(s9 ):
#Buildings: #Units: It Stories; Will the Building Have a Basement?
Y of N
Bldg. Code Occupancy Group indicate Indicate it Indicate all Gso•lech.Haz.Zone
At Project Sprinkle prinklere d YES or NO that
Completion: Cotruction apply: Coastal Zone
Type(s): C or 0 YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board I I Landmark Comm. IPlanning Comm.Zoning Administrator
Fee Exempt: City Project Else.Vehicle Charger Landmark seismic Retrofit special Case:aft1q.
olfkla[Appmvsl
Expedite Project(s): Child Cam City Project Green Building I Landmark I Affordable Housing
For Staff Use Only
Buildingl5alely Permit Specialist City Planning I Civil Engineering EPWM-Admin I Transportation Mgmt. Ronl Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY