PMT16-01039 City of Menifee Permit No.: PMT16-01039
29714 HAUN RD.
�AACCEL/�. MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued:
04118/2016
PERMIT
Site Address: 27224 RIO VISTA DR, MENIFEE, CA Parcel Number: 336-290-005
92586 Construction Cost: $15,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 30 PANELS, 1 INVERTER 8.1 KW
Work:
Owner Contractor
RALPH KELLER DERIVER CONSTRUCTION
27224 RIO VISTA DR 26225 PALMERI WAY
MENIFEE, CA 92584 LAKE ELSINORE,CA 92532
Applicant Phone:9512444341
MICHAEL PAYMENT License Number:507334
26225 PALMERI WAY
LAKE ELSINORE, CA 92532
Fee Description DIN, Amount ISI
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_Bldg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or Improves thereon,and who contracts for the projects
/hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
���I Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class G Jb C 31 License No. -5',0 3' By my signature below I acknowledge that,except for my personal residence
Expires Signature /ike-rir,.,,PGY7 r-rLLi( in which l must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
oI hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which www.leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
V.Mave and will maintain workers compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below l certify to each of the following:I am the property
this permit is issued.My workers compensation Insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number are: ,� application and the information I have provided is correct.I agree to comply
Carrier 6r' /PIG -r�u�!/ with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# 949/ Expires C2 '7�r�_ enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o I 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 CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwio comply with se provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant d ° Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
' WARNING;FAILURE TO SECURE RKER'S COMPENSATION COVERAGE IS O Yes arf o
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAOMD)7 See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidetinee
CONSTRUCTION LENDING AGENCY ❑Yes cs�-IQo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be Within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) o Yes I04fo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements underthe5tate of
I hereby affirm under penalty of perjury that 1 am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the haz3rdous material reportin .
checkmark(s)I have placed next to the applicable item(s)(Section 70315 Oro O q
Business and Professions Code).Any city or county that requires a permit to �,7/,. ,� r Date 4 Ile,
construct,alter,improve,demolish or repair any structure,prior to its I AdPERTY OWNER ORA ORIZED AGENT
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 Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
oi,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Cade;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
❑1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State license Law does not apply to an owner of a if your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE PERMIT/PLAN CHECK NUMBER t�j OVA
TYPE: O COMMERCIAL RESIDENTIAL C MULTI-FAMILY C MOBILE HOME C POOL/SPA O SIGN
SUBTYPE: O ADDITION C ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING C RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK L t- Y L Yd
PROJECTADDRESS 7--7 2?-4 a viS-F 0�L
ASSESSOR'S PARCEL NUMBER 45r�kQ216'WS LOT Ito_ TRACT1:1 Z,
OWNER NAME Z 1- PP
ADDRESS 277i2- 0 Vj`Jrl�-
PHONE EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME 1 G p}'Lr 1 OWNER BUILDER? QS'ES O NO
BUSINESS NAME E�21(/I eA G 7- //C'/o 1
ADDRESS 7 6 Z 2 € / 4XLe F�e,S/ D-L C-A Z.�77i
PHONE S'.�I 378-? i3,� EMAIL U� _•� /
CONTRACTOR'S STATE LIC NUMBER 5-07 -73; LICENSE CLASSIFICATION C-16 -(�
VALUATION$ / VVP. &*'o SQ FT L SO FT
[
APPLICANT'S SIGNATURE / DATE
r -
- -
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE I ;;�J 0 PAID AMOUNT AMOUNT 0CASH 0CHECK# Ci CREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED C YES 0 NO DL NUMBER NOTARIZED LETTER O YES 0 NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee,us Inspection Request Line 951-246-6213
EsGil Corporation
In Partnership with government for Bui(ding Safety
DATE: 4/14/2016 ❑ APPLICANT
Q_J:rRIS.
JURISDICTION: Menifee ❑ PLAN REVIEWER
Cl FILE
PLAN CHECK NO.: PMT16-01039 SET: I
PROJECT ADDRESS: 27224 Rio Vista Dr.
PROJECT NAME: Keller 7,600 watt 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: (b. Fax #:
Mail Telephone Fax In Person E-mail:
❑ REMARKS:
By: Morteza Beheshti Enclosures:
EsGil Corporation
❑ GA ❑ EJ ❑ PC 4/6
9320 Chesapeake Drive, Suite 208 ♦ San Diego,California 92123 ♦ (858) 560-1468 ♦ Fax(858)560-1576
Vlenifee PMT16-01039
4/14/2016
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Menifee PLAN CHECK NO.: PMT16-01039
PREPARED BY: Morteza Beheshti DATE: 4/14/2016
BUILDING ADDRESS: 27224 Rio Vista Dr.
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
Plan Check Fee by Ordinance W
Type of Review: ❑ Complete Review ❑ Structural Only
❑Repetitive Fee ❑ Other
Repeats [D-� 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+