PMT16-03786 City of Menifee Permit No.: PMT16-03786
29714 HAUN RD. Type: Residential Electrical
<A-CCELA-> MENIFEE, CA 92586
MENIFEE Date Issued: 12105/2016
P E R M I T
Site Address: 26050 GLENHAVEN PL, MENIFEE, CA Parcel Number: 360-040-009
92584 Construction Cost: $55,590.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 34 MODULES,34 MICROINVERTERS, 11.1 18KIN,
Work: REQUIRES 200AMP PANELUPGRADE
Owner Contractor
PAUL&NINA MEDINA SEMPER SOLARIS CONSTRUCTION ING
26050 GLENHAVEN PIL 1805 JOHN TOWERS AVE
MENIFEE, CA 92584 EL CAJON, CA 92020
Applicant Phone:6197154054
ALICIA ANDREWS License Number.978152
SEMPER SOLARIS CONSTRUCTION INC
1805 JOHN TOWERS AVE
EL CAJON, CA 92020
Fee Description OtV 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 3.00
SMIP RESIDENTIAL 1 8.00
General Plan Maintenance Fee-Electrical 1 12.60
$460.10
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_Perrnft-Tem;pIate.rpt 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 oeourythat I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason;
License Class C-to License No. 9 7 By my signature below I acknowledge that,except for my personal residence
Expires /_V/7,( Z5 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 DECLARATIkN have built as an owner-builder if it has not been constructed in its entirety by
a 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 worker's 71344 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
this permit is issued. www.leginfo.ca.gov/calaw.htirl.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
o I have and will maintain worker's compensation insurance,as required by
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 a in the property
this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
number are; application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy# Expires ho h 0 enter the above identified property for inspection purposes.
X
(This section need notto 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# 0;5risV5
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwItply with th Will the applicant or future building occupant handle hazardous material or a
i �4� mixture containing a hazardous material equal to orgreater that the
Applicant Date amounts specified on the Hazardous Materials Information Guide?
WARNING'*.;-ArLURE TO SECdi-E`WORKER'S COMPENSATION COVERAGE IS ciYes *,rNo
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 TOONE 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 for guidelines
CONSTRUCTION LENDING AGENCY ci Yes iXNo
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 Ao
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements underthe State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazardous ma en.al repo ing.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ciYes
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 RdPTRTY OWN 0 @*Z_ED AGENT
issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursuantto the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING ffiRPI
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 RAP-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
a 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( I all of or( )portion of the work,and the structure is www.epa.govllead 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 Contractor's 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 thatthe 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. o No EPA Lead-Safe Certified Firm is required for this project because:
o 1,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.
7�
FIR
1!14-1
2
I 1-n a
DATE PERMIT/PLAN CHECK NUMBER
TYPE: El COMMERCIAL FZI RESIDENTIAL E]MULTI-FAMILY E]MOBILEHOME F]POOL/SPA FISIGN
SUBTYPE: E]ADDITI.ON []ALTERATION. []DEMOLITI.ON- [34�CTRICAL [2MECHIANICAL
[_]NEW []PLUMBING El RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 11-111PA 34 MPWW
/mlcfaltjwF-Te-
OJEVJ pS-,N ??AS 40GA- "ii� -TathD
PROJEcrADDRESS V 0'�-b Mk�fVMJCO T(AW
ASSESSOR'S PARCEL NUM13ER 3jjG-dqd - ()0l LOT TRACT
PROPERTY OWNER'S NAME 4
ADDRESS 2410!;'d C
PHONE EMAIL
APPLICANTNAME AUCIAANDREWS
ADDRESS 1218 SPRING ST. RIVERSIDE, CA92507
PHONE (714)457-4190 EMAIL alicie.andrews@sempersolaris.com
CONTRACTOR'S NAME SEMPERSOLARIS OWNERBUILDER? DYESZNO
BUSINESS NAME
ADDRESS 1805 JOHN TOWERS AVE. EL CAJON, CA 92020
PHONE (619)357-4142 EMAIL
CONTRACTOWS STATE LIC NUMBER 978152 LICENSE CLASSIFICATION B, C10, C46,C36
VAUJATION$ s-'10.0D SQ FT L SO FT
APPLICANT'S SIGNATURE Z:�' DATE
DEPARTMENT DISTRIBUTION )FMEUjFEjeUSI E�JZNSENUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SNP CITY C
INVOICE
AM UNT PAID AMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
PLAN COECK FEES PAIDAMOUNT
OCASH OCHFCK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED C YES 0 No DLNUMBER NOTARIZED LETTER I-- YES 0 NO
City of Menifee Building&.5oj'ety Department 2971-4 Houn Rd. f4enifee, CA 92586-951-572-6777
www.citwfinenifee.as lospection Request Line 951-246-6213
EsGil Corporation
InTartnership witfi governmentfor Buifding Safety
DATE: 11/30/2016 0 APPLICANT
YJURIS.
JURISDICTION: Menifee Q PLAN REVIEWER
0 FILE
PLAN CHECK NO.: PMT16-03786 SET: I
PROJECT ADDRESS: 26050 Glenhaven Place
PROJECT NAME: Medina 34 AC Module rooftop PV System
The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's building codes.
F-1 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.
El The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
F-1 The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
El The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
F-1 The applicant's copy of the check list has been sent to:
z Esgil Corporation staff did not advise the applicant that the plan check has been completed.
F-1 Esgil Corporation staff did advise the applicant.that the plan check has been completed.
Person contacted: Telephone #:
Date contacted: (by:�f� Fax #:
Mail Telephone Fax In Person E-mail:
F-1 REMARKS:
By: Morteza Beheshti Enclosures:
EsGil Corporation
El GA F1 EJ n PC 11/23
9320 Chesapeake Drive, Suite 208 * San Diego,Califomia92123 * (858)560-1468 * Fax(858)560-1576