PMT16-01656 City of Menifee Permit No.: PMT16-01656
29714 HAUN RD. Type: Residential Electrical
�CCEL/_> MENIFEE, CA 92586
MENIFEE Date Issued: 0 6/1 412 01 6
PERMIT
Site Address: 28750 AVENIDA MARBELLA, MENIFEE, Parcel Number: 364-111-020
CA 92584 Construction Cost: $34,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM,29 PANELS,29 MICROINVERTERS, 8.12 kW
Work:
Owner Contractor
MARIANO CORTEZ PETERSEN-DEAN INC
28750 AVENIDA MARBELLA 39300 CIVIC CENTER DRIVE
MENIFEE, CA 92584 FREMONT, CA 94538
Applicant Phone:5103716500
DALLAS PEREZ License Number:468117
PETERSEN-DEAN INC
39300 CIVIC CENTER DRIVE
FREMONT,CA 94538
Phone: 9095220799
Fee Description Qtv Amount(SI
Solar, Residential or Small Commercial 1 252.00
Building Permit Issuance 1 27.00
Additional Plan Review Electrical 158 157.50
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 5.00
General Plan Maintenance Fee-Electrical 1 12.60
$456.10
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_Bklg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuantto the Contractors State License Law).
I hereby affirm under penalty of perjurythat I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑1 am exempt from licensure underthe Contractors State License Law for
Professions Code and y license ism full force and effect. y the following reason:
License Class License No. / By my signature below I acknowledge that,except for my personal residence
Expires Signature in which I 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 DECLARATI have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under penalty of perjury o e of a 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.Ieginfo.ca.gov/caIaw.htmL permit is issued.
po # °°°ddd Date
1 have and will maintain workers compensation insurance,as required by PRyIPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which . By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or a horized to act on the property owners behalf.I have read this
number a applicatio and the information I have provided is correct.I agree to comply
Carrier t\ L/Qbos with a p licable ci county ordinances and state laws relating to
-f �'L'-f1 bu' ingt stru n.iau ortze representatives of this city or county to
Policy kO / Expire ��� ter theca ove dentifie property for Inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less P 7Y0 NERD ED AGENT
o I certify that in the perfor ce of the work forwhich this permit is issued,
I shall not employ any per n any manner so as to become subject to the CITY BUSINESS LICENSE g
workers compensation la of Calif aa,a agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker mpen ion pr sions of Section 3700 of the Labor
Code,I shall fort h to ply ith th a provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts sp}}��ified on the Hazardous Materials Information Guide?
WARNING: ILUR TO ECURE COMPENSATION OVERAGE IS ❑Yes QMo
UNLAWFUL,ANDS AL SUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP NE 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(SCAQMD)?See permitting checklist
IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelt s
CONSTRUCTION LENDING AGENCY ❑Yes Xu
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 boun of a school?
(Section 3097 Civil Code) in Yes 0
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I ndersta y requirements under the State of
California Health& e de,Se ion 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous�rfiater' ep ing.
checkmark(s)I have placed next to the applicable items)(Section 7031.5 oYes N
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its p ERN 0 R R AU ENT
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 ENOV ON 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
❑1,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.epa.aov/lead or contact the National Lead Information Center at
not intended or offered forsale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;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 forthis project because:
❑I,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.
EsGil Corporation
In Partnership with Government forBuiffing Safety
DATE: 06/06/16 ❑ APPLICANT
.dJURIS.
JURISDICTION: City of Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT16-01656 SET: I
PROJECT ADDRESS: 28750 Ave Marbella
PROJECT NAME: MARIANO CORTEZ 29 @ 250 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 05/31
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Menifee PLAN CHECK NO.: PMT16-01656
PREPARED BY: Sergio Azuela DATE: 06/06/16
BUILDING ADDRESS: 28750 Ave Marbella
BUILDING OCCUPANCY: TYPE OF CONSTRUCTION:
BUILDING AREA Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code mnf IlManual Input
Bldg. Permit Fee by Ordinance +
Plan Check Fee by Ordinance +
Type of Review: ❑ Complete Review ❑ Structural Only
Re tibve Fee ❑ Other
❑+ Repeats � 1.5 Hrs. @
EsGill Fee $105.00 $157.50
Based on hourly rate
Comments: 1 1/2 hours plan review.
Sheet 1 of 1
macvalue.doc+