PMT17-01824 City of Menifee Permit No.: PMT17-01824
29714 HAUN RD.
�CCEL/k� MENIFEE,CA 92586 Type: Residential Electrical
MENIFEE Datelssued:
06/2112017
PERMIT
Site Address: 28715 PORTSMOUTH DR, MENIFEE, CA Parcel Number: 339-161-010
92586 Construction Cost: $20,000.00
Existing Use: Proposed Use:
Description of INSTALL 20 ROOF MOUNTED PV MODULES,5.7 KW, 1 WALL MOUNTED STRING INVERTER
Work:
Owner Contractor
KATHERINE REYNOLDS PEAK POWER SOLUTIONS INC
28715 PORTSMOUTH DR 1542 EDINGER AVENUE SUITE D
MENIFEE, CA 92586 TUSTIN, CA 92780
Applicant Phone:7142583900
HENRY AFFRE License Number:973253
PEAK POWER SOLUTIONS INC
1542 EDINGER AVENUE SUITE D
TUSTIN, CA 92780
Fee Description OQt Amount(9)
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 3.00
General Plan Maintenance Fee-Electrical 1 12.60
$405.60
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_Permil_Template.rpl Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
With a licensed contractors)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that 1 am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and D 1 am exempt from Iicensure under the Contractors State License Law for
Professions Code an y license is in full force and effect. _ the following reason:
License Class U ise No. `' ' �� By my signature below I acknowledge that,except for my personal residence
Expires 3( Signatur 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 DECLARATION 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.leeinfo.ca.eov/calaw.html.
this permit is issued. _
Policy H Date
have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
sec oon 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.I have read this
number are: _ � ) application and the information I have provided is correct.I agree to comply
Carrier l Or-4 with all applicable city and county ordinances and state laws relating to
�7 building construction.I authorize representatives of this city or county to
Policy If 2oq(.)n .201 ? 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
❑I certify that In the performance of the work for which this permit is issued,
1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE Jr
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compen ation provisions of Section 3700 of the Labor
Code,Is a o�{rwith co p v thjfhhoose/provisions. Will the applicant or future building occupant handle hazardous material or a
Applican V Dale / mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FA RET SECURE WORKER'S COMPENSATION COVE GE IS Dyes �No
UNLAWFUL,AN SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applimatorfuture 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
CONSTRUCTION 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 boundary of a school?
(Section 3097 Civil Code) o Yes I'No
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 perjurythat I am exempt from the
California
Contractors License law for the reason hazzardou
s)indicated below by the Health&Safety Code,Section 25505 and 25534 concerning
hazardous materiiil reporting.
checkmark(s)1 have placed next to the applicable items)(Section 7031.5 oyes No
Business and Professions Code).Any city or county that requires a permit to Date f 7 f r
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY ZOWEX O ORIZE 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(RRP)
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-certifed 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
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.eoa.eov/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).
Cade,The Contractors State License Law does not apply to an owner of a D 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. 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 If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 06/09/2017 PERMIT/PLAN CHECK NUMBER I
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA [_]SIGN
SUBTYPE: []ADDITION []ALTERATION [-]DEMOLITION ❑✓ ELECTRICAL ❑MECHANICAL
❑NEW []PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 20 ROOF MOUNTED P.V. MODULES,5.7 KW, 1 WALL MOUNTED STRING INVERTER
PROJECT ADDRESS 28715 PORTSMOOUTH DR.SUN CITY, CA 92586
ASSESSOR'S PARCEL NUMBER 3�5 1 , I Lp I . 01CLOT TRACT
PROPERTY OWNER'S NAME KATHERINE REYNOLDS
ADDRESS 28715 PORTSMOUTH DR.SUN CITY, CA 92586
PHONE (951)679-7383 EMAIL
APPLICANTNAME HENRYAFFRE
ADDRESS 1542 EDINGER AVE.SUITED,TUSTIN,CA 92780
PHONE (562)682-4511 EMAIL haffre562@gmail.com
CONTRACTOR'S NAME PEAK POWER SOLUTIONS OWNERBUILDER? ❑YES❑✓NO
BUSINESS NAME
ADDRESS 1542 EDINGER AVE.SUITED,TUSTIN,CA 92780
PHONE (800)265-6357 EMAIL
CONTRACTOR'S STATE LIC NUMBER 973253 LICENSE CLASSIFICATION B
VALUATION$ $20,000.0 Q FT 352 L SO FT
APPLICANT'S SIGNATURE p DATE 9 ` 1 7
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENNIIFIEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN
INVOICE �,(T PAID AMOUNT
AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT () CASH OCHECK# OCREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES q NO
City of Menifee
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 925 Ih¢7&-8A%ty Dept.
www.cityofinenifee.us Inspection Request Line 951-246-6213
JUN 0 9 2017
Received
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BIB
NIZZIM
Bureau Veritas City of Menifee
1665 Scenic Avenue, Suite 200 29714 Haun Rd.
Costa Mesa, CA 92626 Menifee, CA.92586
BV Project: 40017-039220.00 Project: PUT 17-01824
Reviewer: Khoa Duong, P.E Description: Roof Mounted PV System
Direct: 714 4314123
General: 714 4314100
Khoa.duong@us.bureauveritas.com Project Address: 28715 Portsmouth Drive
Owner(s): Katherine Reynolds
Occupancy Group(s): R-3/U
Construction Type: V-B
PC 1-APPROVED
June 19,2017
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 4 www.us.bureauveritas.com
An Equal Opportunity Employer
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CITY OF MENIFEE
TRANSMITTAL
Building Division
Date: 6/19/2017
Project Location: 28715 Portsmouth Drive
Plan Check No.: PMT17-01824
BV Project#: 40017-039220.00
Project Description: PV Solar—Katherine Reynolds
Reviewer Date Hour Hourly
Rate Total
lst Plan Check Khoa Duong 6/19/2017 1.0 $110.00 $110.00
2nd Plan Check
3rd Plan Check
4th Plan Check
Final Approval: Khoa Duong 6/19/2017 1.0 $110.00 $110.00
Bureau Verilas North America.Inc.
166S Scenic Avenue,Suite'00
Costa Mpe a CA 9762C
1d:714li31 A 100 1 : 714,82 5.0885