PMT16-01709 City of Menifee Permit No.: PMT16-01709
29714 HAUN RD.
"/ACCEL/? MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued:
06I20/2016
PERMIT
Site Address: 27012 BOTTLEBRUSH LN, MENIFEE, CA Parcel Number: 335-363-027
92585 Construction Cost: $14,364.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 28 PANELS, 28 MICROINVERTERS,7.56KW,
Work: REQUIRES 200AMP PANEL UPGRADE
Owner Contractor
ANN YOUNG VISION INSTALLATION
27012 BOTTLEBRUSH UN 5255 N EDGEWOOD DR_125
MENIFEE, CA 92586 PROVO, UT 84604
Applicant Phone:8887817074
KELLY BAKER License Number: 853582
VISION INSTALLATION
5255 N EDGEWOOD DR_125
PROVO, CA 84604
Fee Description Qtv Amount l$I
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
$462.10
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_Pennit_Templatesirt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or Improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from Iicensure under the Contractors State License Law for
Professions Cod/e�and my license is in full force and effect. the following reason:
License Class l 1� z L!cepse No. By my signature below I acknowledge that,except for my personal residence
Expires 5 Signature in which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARAYI improvements covered by this permit.I cannot Iegallysell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
o I 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.IegInfcrcaxoy/calaw.htm1.permit is issued.
Policy# Date
\I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which o 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 authorized to act on the property owners behalf.1 have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier I with all applicable city and county ordinances and state laws relating to
//a1 yy..�r��-- building construction.I authorize representatives of this city or county to
Policy# "f l:.157T1 IIS Expires 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 emolov 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,isbaitfofth ithc reply with th provisions. Will the applicant or future building occupant handle hazardous material ora
Applicant s Date l ' mixture containing a hazardous material equal to or greater that the
ll�� amounts specified on the Hazardous Materials Information Guide?
WARNING FAIL tE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes \No
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(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY 0Yes \No
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 Ti,No
OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 s
Business and Professions Code).Any city or county that requires a permit to Date
construct,after,improve,demolish or repair any structure,prior to its PROP NER OR AUTHORIZED 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 IRRPI
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 Iicensure 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
D I,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.ei3a.gov/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).
Code;The Contractors State License Law does not apply to an owner of a o 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. u No EPA Lead-Safe Certified Firm is required for this project because:
01,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's 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 for Building Safety
DATE: 06/09/16 ❑ APPLICANT
❑ JURIS.
JURISDICTION: City of Menifee ❑ PLAN REVIEWER
❑ FILE
PLAN CHECK NO.: PMT16-01709 SET: I
PROJECT ADDRESS: 27012 Buttlebrush Ln.
PROJECT NAME: ANN YOUNG 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 06/06
9320 Chesapeake Drive, Suite 208 ♦ San Diego,California 92123 ♦ (858)560-1468 ♦ Fax(858)560-1576
City of Menifee PMT16-01709
06/09/16
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: City of Menifee PLAN CHECK NO.: PMT16-01709
PREPARED BY: Sergio Azuela DATE: 06/09/16
BUILDING ADDRESS: 27012 Buttlebrush 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
Plan Check Fee by Ordinance �J
Type of Review: ❑ Complete Review ❑ Structural Only
❑Repetitive Fee ❑ Other
Repeats Hourl 1.5 Hrs.
$1 EsGil Fee 05.00 $157.50
Based on hourly rate
Comments: 1 1/2 hours plan review.
Sheet 1 of 1
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