PMT16-04125 City of Menifee Permit No.: PMT16-04125
29714 HAUN RD. Type: Residential Electrical
<A-CCF-LA—> MENIFEE, CA 92686
MENIFEE Date Issued: 01/0412017
P E R M I T
Site Address: 26310 ADELINA DR, MENIFEE,CA 92584 Parcel Number: 360-600-005
Construction Cost: $27,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 14 PANELS, 1 INVERTER,3.99 kW
Work:
Owner Contractor
ANDRE CUTHBERTSON AMERICAN ENERGY CONSULTANTS INC
26310 ADELINA DRIVE P 0 BOX 882353
MENIFEE,CA 92584 SAN DIEGO,CA 92168
Applicant Phone:7604455386
MATT LEBRUN License Number: 1011427
AMERICAN ENERGY CONSULTANTS INC
P 0 BOX 882353
SAN DIEGO, CA 92168
Fee Description city Amount($
Solar, Residential or Small Commercial 1 252.00
Building Permit Issuance 1 27.00
Additional Plan Review Electrical 158 157.50
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Electrical 1 12.60
$455.10
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builicling operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA,_Bldg_Pemit Template.rpt Page 1 of 1
CITY OF MENIFEE
/CCENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm u nder penalty of perjury that I�'J unnior provisions of with a licensed contraictor(s)pursuant to th e Contractors State License Law).
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Chapter9(commencing wit section 70100) slo 3 of the Business and o I am exempt from licensure under the Contractoes State License Law for
Professions Code and my license is in full fo e hd effect. the following mason:
License Cla$s C —110 Li as N By my signature below I acknowledge that except for my personal residence
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Exon Signature in which I in ust have resided for at least one year prior to completion of
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improvements covered by this permit.I cannot legally sell a structure that I
:/OR'K'E R'S COMPENSATION DECLA have built as an owner-builder if it has not been constructed in its entirety by
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 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 welisite:
by Section 3700 of the Labor Code,for the performance of work for which
this permit is issued. www.Iminfo.ca.Rov&plaw.html.
Policy# lAwc, 6 (7o Date
o I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the'performance of the work for which a By my signature below[certify to each of the following:I am 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
numberare: 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 Nc`V-6`A?-0 building construction.I authorize representatives of this city or county to
Policy# M A W C-6 0 C) K-4 Expires enter the above identified property for inspection purposes.
(This section need not to be camp'sted Is the permit Is for one-h undred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
ci I certify that in the performance of the work for which this permit is issued, -Mtrll� 0'341
I shall not employ any persom in any manner so as to become subject to the CITY BUSINESS LICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
s subecttot ewo er's cop-pensation provisions of Section 3700 of the Labor
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ad I shall forthwith complywilh those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
u cified on the Hazardous Materials Information Guide?
Ap icant T te,
Date amounts so
OWARNING:FAILURE TO SECURE4ORKER'S COMPENSATION COVERAGE IS a Yes "a
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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 UPTO 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 for guidelines
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CONSTRUCrION LENDING AGENCY Dyes 0
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 ary of a school?
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(Section 3097 Civil Code) ci Yes Vo
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OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the 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 rdous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 e o No
Business and Professions Code).Any city or county that requires a permitto )4 11� 66wd, Date
OF
construct,alter,improve,demolish or repair any structure,prior to its 0 ERTYCINNERORAUTHOR!;tDAGFNT
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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRP)
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 11censure 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 perm it 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
o 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 I all of or I )portion of the work,and the structure is www.epa.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 Contractor's State License Law does not apply to an owner of a in An EPA Lead-Safe Cerfified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or Improvesthe
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. 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 dam 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 10/11/2016 PERMIT/PLAN CHECK NUMBERPme-exAlgE
TYPE: 0 COMMERCIAL %05 RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: OADDITION OALTERATION ODEMOLITION %0ELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 3'99KW Rooftop PV Solar System using 14 modules connected to I Inverter and connected to
existing 200AM P main breaker with 225A buss end fed MSP
PROJECTADDRESS 2631OAdelinaDrMenifee,CA92584
ASSESSOR'S PARCEL NUMBER LOT - TRACT CltyofManifee
PROPERTY OWNER'S NAME Andre Cuthbertson Bullaing & Safety Dept.
ADDRESS 2631OAdelinaDrMenifee, CA92584 DEC 15 2016
PHONE 484-300-0710 EMAIL Received
APPLICANT NAME American Energy
ADDRES'S 2305 Historic Decatur Rd Ste 100 San D[ego CA 92106
PHONE 619-930-5617 EMAIL ted@aenergyc.com
CONTRACTOWS NAME Matt LeBrun OWNERBUILDER? OYESANO
BUSINESS NAME American Energy
ADDRESS 2305 Historic Decatur Rd Ste 100 San Diego CA 92106
PHONE 619-930-5617 EMAIL ted@aenergyc.com
CONTRACTOR'S STATE LIC NUMBER 1011427 LICENSE CLASSIFICATION C-10
VALUATION$ 27000 4�t SO FT L SQ FT
APPLICANVS SIGNATURE lr7�P� DATE
DEPARTMENT DISTRIBUTION SMIP CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN
INVOICE �..W I PAIDAMOUNT
AMOUNT I � OCASH OCHECK# OCREDrrCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT I I OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 No DIL NUMBER NOTARIZED LE17ER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
Menifee PMT16-04125 OM01
12/23/2016
EsGil Corporation
In(Partnership with governmentfor Building Safety
DATE: 12/23/2016 C3 APPLICANT
0 JURIS.
JURISDICTION: Menifee El PLAN REVIEWER
0 FILE
PLAN CHECK NO.: PMT16-04125 SET: I
PROJECT ADDRESS: 2631OAdelinaDr
PROJECT NAME: Cuthbertson 3KW rooftop PV System
z 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.
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.
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.
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:
F-1 REMARKS:
By: Morteza Beheshti Enclosures:
EsGil Corporation
E] GA F-1 EJ F1 PC 12/16