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PMT17-01667 City of Menifee Permit No.: PMT17-01667 29714 HAUN RD. Type: Residential Electrical S4CCELA4? MENIFEE,CA 92586 MENIFEE Date Issued: 06/09/2017 PERMIT Site Address: 33477 LITTLE REB PL, MENIFEE, CA Parcel Number: 388-040-008 92584 Construction Cost: $11,000.00 Existing Use: Proposed Use: Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 41 MODULES, 1 INVERTER 11.68KW Work: Owner Contractor KEVIN HALEY ENERGY RENOVATION CENTER 33477 LITTLE REB PL 11731 STERLING AVE UNIT G MENIFEE, CA 92584 RIVERSIDE, CA 92503 Applicant Phone: 9513197760 ANTHONY FLOURNOY License Number: 1009326 ENERGY RENOVATION CENTER 11731 STERLING AVE UNIT G RIVERSIDE, CA 92503 Fee Description PY Amount t51 Solar, Residential or Small Commercial 1 252.00 Building Permit Issuance 1 27.00 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 $404.60 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_Pennit Template.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 a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Class (—W License N 4 , By my signature below I acknowledge that,except for my personal residence Expires Val 3--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 1 WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by ci 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 yv,,y,�,le¢info.ca.eov/calaw.html. this permit is issued. Policy# Date PROPERTY OWNER OR AUTHORIZED AGENT I have and will maintain workers compensation insurance,as required by 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 authorized to act on the property owners behalf.I have read this number are: �+_ application and the information 1 have provided is correct.I agree to comply Carrier 51 (�lyt� �NStM` L�L/� r1r7 with all applicable city and county ordinances and state laws relating to 4115), �1 I pl building construction.I authorize representatives of this city or county to Policy# "115 LI 2-4-Z Expires 3/5 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 ❑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 co pe ation provisions of Section 3700 of the Labor Code,I shall forthwith ov' 'was— q 2 Will the applicant or future building occupant handle hazardous material or a Applicant Date l T- mixture containing a hazardous material equal to or greaterthatthe amounts;p cified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes No UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES WIII 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 37DS OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidel) es CONSTRUCTION LENDING AGENCY ❑Yes 7NNa I hereby affirm that under the penalty of perjurythere 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 Cade) ❑Yes aft 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 thepermitting checklist.I understand my requirements under the State of California Health&Safety Cade,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the h(zardoygmaterl ting. checkmark(s)I have placed next to the applicable items)(Section 7031.5 es (, Business and Professions Code).Any city or county that requires a permitto Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY 0 E O RIZED NT Issuance,also requires the applicantfor the permitto file a signed statement that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR 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 orshe 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 ❑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.eoa.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 ownerof a p D An EPA Lead-Safe Certified Renovatorwill 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. PERMIT/PLANBUILDING & SAFETY A• • • Menifee DATE S �� PERMIT/PLAN CHECK NUMBERFmn V TYPE: O COMMERCIAL C`RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW Ot`PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK �k-(06 Kw DL w-zT �(�S S (4k, tlloO Es, (a� c c �c�v�r��—rL, �7No �r1lt�� c� ui�,E�eroE PROIECTADDRESS —2Z9 -4- (T O 'i�E-VP G ASSESSOR'S PARCEL NUMBER :5 7-1 LOT _ TRACT OWNERNAME ADDRESS 3 i -- / �tTTIC , PHONE "L�( : `, EMAIL APPLICANT NAME G(J(.L(G1.77J ADDRESS ,4-4-1u1 �IA/61 PHONE l 30 �A It.X��-� EMAIL /k�3t�FOT2�{ i QEAJ�✓BF-iT�A1C�'�UyZI K CONTRACTOR'S NAME Ovf'i I y O 60J-T(�WNER BUILDER? O YES Y6Q BUSINESS NAMEEy ` ' ,�r� ADDRESS -13I % S��'�-L�/�V(� ` e .� lv&I�S1 PHONE " 5 � I � EMAAI/IL �y�M1�( O�iI7,0fr,vA)C� ,cpfy CONTRACTOR'S STATE LIIC.�NyU�MBER -d�j, C.(� LICENSE CLASSIFICATION VALUATION$ 11 6 (lilt/ LSQFT APPLICANT'S SIGNATURE DATE l� / Y . DEPARTMENT DISTRIBUTION ^ (if7 CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE � AID AMOUNT AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT I OCASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 pU VEP C 0 19]B Bureau Veritas City of Menifee 1665 Scenic Avenue, Suite 200 29714 Haun Rd. Costa Mesa, CA 92626 Menifee,CA. 92586 BV Project: 40017-039184.00 Project: PMT 17-01667 Reviewer: Khoa Duong, P.E Description: Roof Mounted PV System Direct: 714 4314123 General: 714 4314100 Khoa.duong@us.bureauveritas.com Project Address: 33477 Little Leb Place Owner(s): Kevin Haley Occupancy Group(s): R-3/U Construction Type: V-B PC1-APPROVED June 06, 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 ♦ Fax: (714)825-0685 ♦ www.us.bureauveritas.com An Equal Opportunity Employer Page 1 of 1 CPU VF9 C � a 0 N 1828 CITY OF MENIFEE TRANSMITTAL Building Division Date: 6/06/2017 Project Location: 33477 Little Reb PI Plan Check No.: PMT17-01667 BV Project#: 40017-039184.00 Project Description: PVSolar—Kevin Haley Reviewer Date Hour Hourly Rate Total 1st Plan Check Khoa Duong 6/06/2017 1.0 $110.00 $110.00 2nd Plan Check 3rd Plan Check 4th Plan Check Final Approval: Khoa Duong 6/06/2017 1.0 $110.00 $110.00 Bureau Veritas North America,Inc. 1665 Scenic Avenue,Suite 200 Costa Mesa.CA 9262C M:714A31.4100 1 :714.825.0665