PMT17-01321 City of Menifee Permit No.: PMT17-01321
29714 HAUN RD. Type: Residential Electrical
�^CCEL/> MENIFEE, CA 92586
r-1-119YI—" MENIFEE Date Issued: 07105/2017
PERMIT
Site Address: 26387 MEHAFFEY ST, MENIFEE, CA Parcel Number: 335-293-004
92586 Construction Cost: $8,721.86
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 10 PANELS, 10 MICROINVERTERS,2.80 kW
Work:
Owner Contractor
SANDY OSBERG VISION INSTALLATION
26387 MEHAFFEY STREET 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 Obit Amount IEl
Solar, Residential or Small Commercial 1 252.00
Building Permit Issuance 1 27.00
Additional Plan Review Electrical 55 55.00
Additional Plan Review Electrical 55 55.00
Additional Plan Review Electrical 110 110.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 2.00
General Plan Maintenance Fee-Electrical 1 12.60
$514.60
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_Perntt_Terrplate.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 perjury that I am under provisions of with licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7D00)of Division 3 of the Business and ❑I am exempt from licensure underthe Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
L Q
License Class UcensNo.� By my signature below I acknowledge that,except for my personal residence
Expires • nature 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 1
WORKER'S COMPENSATION DECLARATION 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 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
this permit is issued. www.leeinfo.ca.Rov/calaw.htm1.
Policy# Date
❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,forthe 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 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 (�a �� with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# Expires /) enter the above identifi property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less Date
P ERTY OWNER 11 HORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued, 1 ..
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If T3 l lO
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers comp! tion provisions of Section 3700 of the Labor
Code,I shall for with comp) w'h tho, provisions. Will the applicant or future building occupant handle hazardous material or a
Appiica 5 Date �'' mixture containing a hazardous material equal to or greater that the
amounts s e ified on the Hazardous Materials Information Guide?
WAR NI All RE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yest 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(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidlefJnes
CONSTRUCTION LENDING AGENCY ❑Yes NZWo
I hereby affirm that underthe 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) ❑Yes riNo
OWNER'BUILDER DECLARATIONS I have read the Hazardous Material information Guide and the SCAQMD
I hereby affirm under penalty of perjurythat I am exempt from the permitting checklist.I understand my requirements underthe State of
California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous m terial repycNn
checkmark(s)I have placed nextto the applicable item(s)(Section 7031.5 oyes [\
Business and Professions Code).Any city or county that requires a permit to f Date
construct,alter,improve,demolish or repair any structure,prior to its PROPEW6WER OR AUTF115RIZED 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 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 indudes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
o 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.epa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80D-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 for this 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.
vl Stp n
J�
DATE (i f PERMIT/PLAN CHECK NUMBER — ao
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA []SIGN
SUBTYPE: []ADDITION []ALTERATION []DEMOLITION ❑✓ ELECTRICAL ❑MECHANICAL
❑✓ NEW ❑PLUMBING El RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Install of solar panels on an existing residential roof. Q
10 O
PROJECTADDRESS 26387 Mahaffey Street
ASSESSOR'S PARCEL NUMBER 335-293-004 LOT 48 TRACT 0
PROPERTY OWNER'S NAME Sandy Osberg Building &Safety De t.
ADDRESS 26387 Mahaffey St. APR 2 7 201?
PHONE EMAIL
APPLICANT NAME
ADDRESS 5255 N Edgewood Dr.#125
PHONE (888)781-7074 EMAIL Permits@ionsolar.com
CONTRACTOR'S NAME Vision Installation OWNER BUILDER? ❑YES❑✓NO
BUSINESS NAME Vision Installation
ADDRESS 5255 N Edgewood Dr.Provo UT, 84604
PHONE (888)781-7074 EMAIL Permits@ionsolar.com
CONTRACTOR'S STATE LIC NUMBER 853582 LICENSE CLASSIFICATION C-10
VALUATION$ $8,721.86 SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE f`
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN �- SMIP
INVOICE PAIDAMOUNT ,.�1
AMOUNT 4- LRO Lw 0CASH 0 CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# OCREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES C 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
�pU Vf9
� a
0 N
/f20
Bureau Veritas City of Menifee
1665 Scenic Avenue, Suite 200 29714 Haun Rd.
Costa Mesa, CA 92626 Menifee, CA. 92586
BV Project: 40017-039092.00 Project: PMT17-01321
Reviewer: N. N. Martinez/Khoa Duong Description: Roof Mounted PV System
Direct: 714-431-4123
General: 714-431-4100
nabetamartinez@gmail.com Project Address: 26387 MehaffeySt
Owner(s): Osberg
Occupancy Group(s): R-3/U
Construction Type: V-B
PC3-APPROVED
July 03, 2017
This plan has been reviewed and approved for conformance to the minimum requirements of the 2016
California Building Standards Code,as amended and adopted by the City of Menifee, California.
1665 Scenic Avenue ♦ Suite 200 ♦Costa Mesa,CA 92626
Phone: (714)431-4100 1 Fax: (714) 825-0685 ♦ www.us.bureauveritas.com
An Equal Opportunity Employer
Page 1 of 1
�pU VE9
Ca
� a
0 N
1829
CITY OF MENIFEE
TRANSMITTAL
Building Division
Date: 7/03/2017
Project Location: 26387 Mehaffey St
Plan Check No.: PMT17-01321
BV Project #: 40017-039092.00
Project Description: PV Solar-OSBERG
Reviewer Date Hour Hourly
Rate Total
l't Plan Check N Martinez 5/9/2017 1.0 $110.00 $110.00
2"d Plan Check K Duong 6/27/2017 0.5 $110.00 $55.00
3rd Plan Check K Duong 7/03/2017 0.5 $110.00 $55.00
4th Plan Check
Final Approval: K Duong 7/03/2017 2.0 $110.00 $220.00
Bureau Veritas North America,Inc.
1665 Scenic Avenue,Suite 200
Costa Mesa,CA 92626
M:714A31.4100 F:714.825.0685