PMT15-03568 City of Menifee Permit No.: PMT15-03568
29714 HAUN RD.
�A\CCEL/k? MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued:
11/25/2015
PERMIT
Site Address: 27262 EMBASSY ST, MENIFEE, CA Parcel Number: 335-333-002
92586 Construction Cost: $7,904.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 16 MODULES, 16 MICRO INVERTERS,4.16KW
Work:
Owner Contractor
MILDRED REYNOLDS VISION INSTALLATION
27262 EMBASSY STREET 5255 N EDGEWOOD DR
MENIFEE, CA 92586 PROVO, UT a4604
Applicant Phone: 8887817074
License Number:853582
Fee Description Qtv Amount($)
Solar, Residential or Small Commercial 1 252.00
Building Permit Issuance 1 27.00
Additional Plan Review Electrical 158 157.50
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 2.00
General Plan Maintenance Fee-Electrical 1 12.60
$452.10
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_Bidg_Permit_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ 1 am exempt fmm licensure under the Contractors State License Law for th
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 1
Professions Code d my license is in full force and effect. �9 which I must have resided for at least one year pdor to completion c
license Class Ucen a No. f 63 d Z improvements covered by this permit, I cannot legally sell a structure that I hay.
Expires Signatur built as an owner-building if it has not been constructed in its entirety by license
contractors. I understand that a copy of the applicable law, Section 7044 of th-
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application I
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one of the following declarations: httpJ/wwwlecinfo.ca.aov/calaw.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# ❑ By my Signature below, I certify to each of the following: I am the propert
have and will maintain workers compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read tht
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 compi.
permit is issued.My workers'compensation insurance carver and policy number are: with all applicable city and county ordinances and state laws relating to bulldinl
r' construction.I authorize representatives of this city or county to enter the above
Carrier -F'(�NV / iden'tied prone r the it spection purposes.
Policy#Qj�S�J7{)5 Expires Lc�) Cal ' �— ro e Date ( jS
Prty O er or Authorized Agent
(This section need not be completed if the permit is for City Business License# Q 9 O 7 tato
one-hundred dollars($100)or less)
HAZARDOUS MATERIAL DECLARATION
❑ 1 certify that in the performance of the work for which this permit is issued,I
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 the workers'compensation provisions of Section 3700 of the Labor amounts spe ied on the Hazardous Materials Information Guide?
4WARNIhN
rt 'h co ly with those provisions. ❑YES
FKo
e; `"L o�`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
FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMQ)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ❑YES 10
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 achool?
LABOR CODE, INTEREST,AND ATTORNEYS FEES OYES ikNO
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 Califo ealth&Safety Code,Section 25505 and 25534 concerning
3097 Civil Cade) ha pus material reporting.
OWNER BUILDER DECLARATIONS Y , D�N�610, - Date
I hereby affirm under penally of perjury that I am exempt from the Contractor's �-
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY NER 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 receivifig 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:
www.epa.gov/lead or contact the National Lead Information Center at
❑ 1, as owner of the property, or my employees with wages as their sole 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 Finn Certification No.:
purpose of sale).
❑ 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 contractors)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 Buifding Safety
DATE: 11/23/15 ❑9PPLICANT
JLIRIS.
JURISDICTION: City of Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT15-03568 SET: I
PROJECT ADDRESS: 27262 Embassy St.
PROJECT NAME: MILDRED REYNOLDS 16 tr 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 11/16
9320 Chesapeake Drive, Suite 208 ♦ San Diego, California 92123 ♦ (858)560-1468 ♦ Fax(858)560-1576
City of Menifee PMT15-03568
11/23/15
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Menifee PLAN CHECK NO.: PMT15-03568
PREPARED BY: Sergio Azuela DATE: 11/23/15
BUILDING ADDRESS: 27262 Embassy St.
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING F—KTE—A—IF Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code Imnf I Manuallnput
Bldg. Permit Fee by Ordinance
Plan Check Fee by Ordinance
Type of Review: ❑ Complete Review ❑ Structural Only
[_]Repetibve Fee ❑ Other
Repeats 1.5 Hrs.
p � °�
EsGil Fee $105.00 $157.50
Based an hourlyrate
Comments: 1 1/2 hours plan review.
Sheet 1 of 1
macvalue.doc+