PMT15-03013 City of Menifee Permit No.: PMT15-03013
29714 HAUN RD.
9 CCEL. MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 10/13/2015
PERMIT
Site Address: 23762 CASA BONITA AVE, MENIFEE, CA Parcel Number: 351-081-001
92587 Construction Cost: $28.000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 28 PANELS,28 MICROINVERTERS,7.00 kW
Work:
Owner Contractor
JUDITH KASSENS VERENGO INC
23762 CASA BONITA AVE 20285 SOUTH WESTERN AVENUE 200
MENIFEE, CA 92587 TORRANCE, CA 90501
Applicant Phone:3108039053
PATRICIA GARCIA License Number: 935263
VERENGO INC
20285 SOUTH WESTERN AVENUE 200
TORRANCE, CA 90501
Phone:3103573801
Fee Description QtV Amount f5l
Solar, Residential or Small Commercial 1,Building Permit Issuance 1 27.00
Additional Plan Review Electrical 158 :- 157.50
GREEN FEE 1 2.00
——--- - - - - - --
SMIP—RESIDENTIAL -
_ _ _ _ 1 _ _ _ _ 4.00
General Plan Maintenance Fee-Electrical 1 12.60
$455.10
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.rpl Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ I am exempt from licensure under the Contractors'State License Law for the
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 1 acknowledge that, except for my personal residence in
Professions Cod apd my license is in full force and effect. which I must have resided for at least one year prior to completion of
License Class I c(i_License no.o. — improvements covered by this permit, I cannot legally sell a structure that I have
Expires Signature �kkp4fi�Ebuilt 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
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 the following federations: hftplANww.leninfo.m.gov/calaw.htmi.
I have and will maintain a certificate of consentt 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# XBy my Signature below, I certify to each of the following: I am the property
I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
section 3700 of the Labor Code, 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 carder and policy number are: with all applicable city and county ordinances and state laws relating to building
Sfarr r nisi! constructs n.I authorize representatives of this city or county to enter the above.
Cartier / roperf r the inspection purposes. yy��
Policy#I ILSg Expires 16-1- f � Date
Property Owner orAuthorizeddAgent
(This section need not be completed if the permit is for City Business License# D 1--7
one-hundred dollars($100)or less)
ccc���
yu'I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
)shall 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 thew ers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide?
Code,I shall for wit mply with those provisions. ❑YES kNO
Applican• Date; ��•�J' 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/t NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed 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 ❑YES A NO
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 conceming
3097 Civil Code) hazardous material reporting.
OWNER BUILDER DECLARATIONS ❑ NO '^
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date({J'�3•�s^
License Law for the reason(s)Indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable item(s)(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
El I, as owner of the roe www.epa.gov/lead or contact the National Lead Information Center at
p p rfy, or my employees with wages as their sole 1-800424-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 Finn 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 purpose of sale). Firm Certification No.:
❑ I, as owner of the property an exclusively contracting with licensed ❑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.
EsGil Corporation
In Partnership with Government for Buirding Safety
DATE: 10/07/15 ❑ PIPPLICANT
JURIS.
JURISDICTION: City of Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT15-03013 SET: I
PROJECT ADDRESS: 23762 Casa Bonita Ave.
PROJECT NAME: JUDITH KASSENS 28 @ 215 Watts Micro-inverters Solar Photovoltaic
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: Sergio Azuela Enclosures:
EsGil Corporation
❑ GA ❑ EJ ❑ PC 09/30
9320 Chesapeake Drive, Suite 208 ♦ San Diego,Califomia 92123 ♦ (858)560-1468 ♦ Fax(858)560-1576
City of Menifee PMT15-03013
10/07/15
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Menifee PLAN CHECK NO.: PMT15-03013
PREPARED BY: Sergio Azuela DATE: 10/07/15
BUILDING ADDRESS: 23762 Casa Bonita Ave.
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING F—TffE—A—1 Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Judsdiction Code mnf Manual input
Bldg. Permit Fee by Ordinance
Plan Check Fee by Ordinance
Type of Review: ❑ Complete Review ❑ Structural Only
❑Repetitive Fee El Other �
Repeats Hourl 1 1.51 Hrs. @
EsGil Fee 1 $105.00 $157.50
' Based on hourly rate
Comments: 1 1/2 hours plan review.
Sheet 1 of 1
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