PMT15-02777 i
City of Menifee Permit No.: PMT15-02777
29714 HAUN RD. Type: Residential Electrical
'W- cL MENIFEE, CA 92586
emsn" MENIFEE Date Issued:
09/21/2015 �
M E P pp ® p� I T 3
fit 1
Site Address: 25296 ROBINSON CREEK LN, MENIFEE, Parcel Number: 339-382-013
CA 92584 Construction Cost: $25,000.00
Existing Use: Proposed Use:
I
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 31 MODULES, 2 INVERTERS 7.75KW
Work:
Owner _ - Contractor
TANA SIMMONS T A K ELECTRIC INC
25296 ROBINSON CREEK LN 1654ILLINOIS AVENUE STE 18
MENIFEE, CA 92584 PERRIS, CA 92571
Applicant Phone: 9519703150
NADIA CONTRERAS License Number: 947912
T A K ELECTRIC INC
1654ILLINOIS AVENUE STE 18
PERRIS, CA 92571
Fee Description Qtv Amount'($)
Building Permit Issuance 1 27.00
��
dal Q'Mw ' 1 EV12mV�SE eGt..ric.2'ra`',":Fa s5 z-Szei+�, u � a'` �ct,£n... ."�^1. m5�,
GREEN FEE 1 1.00
General Plan Maintenance Fee-Electrical 1 12.60
$464.10
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 am exempt from licensors under the Contractors'State License Law for the
I hereby affirm under penalty or perjury that I am licensed under provisions of following reason:
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in
Professions Code and my license is in full force and effect. which I must have resided for at least one year prior to completion of
License Class O License No. G 91Z improvements covered by this permit, I cannot legally sell a structure that I have
Expires Signature built as an owner-building if it has not been constructed in its entirety by licensed
e contractors. I understand that a copy of the applicable law, Section 7044 of the
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one of the following declarations: htt :l/www.le info.ca. ovlcalaw.html.
I have and will maintain a certificate of consent of self-insure for workers'
compensation,issued by the Director of Industrial Relations as provided for by Date
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. Property Owner or Authorized Agent
Policy# d By my Signature below, I certify to each of the following: I am the property
have and will maintain workers' compensation insurance, as required by caner or authorized to act on the property owner's behalf. I have read this
section 3700 of the Labor Cade, for the performance of the work for which this application and the information I have provided Is correct. I agree to comply
permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to building
/�tw r construction. authorize representatives of this city or county to enter the above-
Carrier ,,,,..II !A�/!I .r,��/N identified for e inspection purposes. /s
Policy#C VvL 15d7J IQ 5 icpires /�G -s• Date
Property Owner or Authorized Agent
(This section need not be completed if the permit is for City Business License#
one-hundred dollars($100)or less)
HAZARDOUS MATERIAL DECLARATION
certify that in the performance of the work for which this permit is issued, I
s all not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers' compensation laws of California, and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide?
Code,I shall forthwith comply with those provisions. OYES /t NO
ApplicanG,g%"�,,�, / Jr Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ❑YES NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the reposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES El YES KNO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous material reporting.
OWNER BUILDER DECLARATIONS YES ❑N cy
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's �tf.- Date/ 'Z�'/5
_ License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable items)(Section 7031.5. Business and Professions Code:
Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION REPAIR AND PAINTING (RRP)
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 The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law (Chapter 9 (commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees. For more information about EPA's Renovation Program visit:
❑ I, as owner of the property, or m employees with wa es as their sole www.epa.gov/lead or contact the National Lead Information Center at
p P Y Y9 1-800-424-LEAD(5323).
compensation, will do( )all of or( ) porting of the work, and the structure is
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 ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however, Certified Firm Name:
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 Firm Certification No.:
purpose of sale).
❑ I, as owner of the property an exclusively contracting with licensed El No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044, Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
APPLICATION& SAFETY PERMIT/PLAN CHECK
J:
Menifee
DATE •1' 5 PERMIT/PLAN CHECK NUMBER 5' OA1 ! /
TYPE: - COMMERCIAL . , RESIDENTIAL CD MULTI-FAMILY - MOBILE HOME ' POOL/SPA 'SIGN
SUBTYPE: C;ADDITION G ALTERATION C DEMOLITION C' ELECTRICAL 0, MECHANICAL
ONEW CPLUMBING ORE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK V 7�J 3 2 _5
M� 77�
PROJECTADDRESS 4JZ 1 C
ASSESSOR'S PARCEL NUMBER 331'3ga-O i3 LOT 40 TRACT a��TSy-
OWNER NAME C.. tS1\rA p. gyp'
ADDRESS �� ��j1 14 ✓0"' �1� 5
PHONE 5� - ( 52�) EMAIL
APPLICANT NAME f, !�L
ADDRESS 5 IrI �5 A/6 r'1 ZL5;�-PHONE 5I EMAIL 1 (• • 60A
CONTRACTOR'S NAME OWNER BUILDER? 0 YEXNO
BUSINESS NAME
ADDRESS
PHONEICA- 2 5 EMAIL
CONTRACTOR'S STATE LIC NUMBER 912 LICENSE CLASSIFICATION
VALUATION$ 5 X 6 SO FT L SO FT c}
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION y� CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP
INVOICE O PAIDAMOUNT
AMOUNTaeg • %'CASH -CHECK# CCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH -CHECK# C%CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED ("YES NO DL NUMBER NOTARIZED LETTER YES "D NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenilee.us Inspection Request Line 951-246-6213
i
i
EsGil Corporation j
In Bartnership with Government for Buifding Safety
I
DATE: 09/15/2015 ❑ APWCANT j
9, dORIS.
JURISDICTION: City of Menifee <3 PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT15-02777 SET: I
PROJECT ADDRESS: 25296 Robinson Creek Ln.
PROJECT NAME: Simmons (3.0+3.8)KW 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 building 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: ) Fax #:
Mail Telephone Fax In Person E-mail:
❑ REMARKS:
By: Morteza Beheshti Enclosures:
EsGil Corporation
❑ GA ❑ EJ ❑ PC 9/10
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858) 560-1468 ♦ Fax(858)560-1576
1
City of Menifee PMT15-02777
09/15/2015
`DO NOT PAY- THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Menifee PLAN CHECK NO.: PMT15-02777
PREPARED BY: Morteza Beheshti DATE: 09/15/2015
BUILDING ADDRESS: 25296 Robinson Creek Ln.
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING AREA Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code mnf Manual Input
Bldg. Permit Fee by Ordinance T
Plan Check Fee by Ordinance T
Type of Review: ❑ Complete Review ❑ Structural Only
❑Repetitive Fee ❑ Other
T
RepeatsHourly 1.5 Hrs. @"
EsGil Fee $105.00 $157.50
" Based on hourly rate
Comments: 1 1/2 hours plan review.
Sheet 1 of 1
macvalue.doc+