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PMT17-01825 City of Menifee Permit No.: PMT17-01825 29714 HAUN RD. �!-�CCEL/�' MENIFEE, CA 92586 Type: Residential Electrical MENIFEE Date Issued: 0 612112 01 7 PERMIT Site Address: 28944 E WORCESTER RD, MENIFEE, CA Parcel Number: 337-140-009 92586 Construction Cost: $16,000.00 Existing Use: Proposed Use: Description of INSTALL 16 ROOF MOUNTED SOLAR- PV MODULES, 1 WALL MOUNTED STRING INVERTER,4.56 Work: KW Owner Contractor SUSAN SULLIVAN PEAK POWER SOLUTIONS INC 28944 E WORCESTER RD 1542 EDINGER AVENUE SUITE D MENIFEE,CA 92586 TUSTIN, CA 92780 Applicant Phone: 7142583900 HENRY AFFRE License Number:973253 PEAK POWER SOLUTIONS INC 1542 EDINGER AVENUE SUITE D TUSTIN, CA 92780 Fee Description QQt Amount($) 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_Permit Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and a I am exempt from Iicensure under the Contractor's State License Law for Professions Code an y license is in full force and effect. ✓ the following reason: License Class U ise No. `' By mysignature below I acknowledge that,except formy personal residence Expires 3( Signatur i 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 a I hereby affirm under penalty of perjury one of the following declarations:) 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 website: by Section 3700 of the Labor Code,for the performance of work for which www.leeinfo.ca.aov/calaw.html. this permit is issued. Policy if Date have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT se ion 3700 of the Labor Code,for the performance of the work for which D 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 (� T with all applicable city and county ordinances and state laws relating to © q-7 !( / b building construction.I authorize representatives of this city or county to Policy#J, 2D4(� 22017 Expires Z 1/ b 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, /�3�1 I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# V ` 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,I s a o with cc p th hose p visions. Will the applicant or future building occupant handle hazardous material or Applican M. - Date / mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FA RE7 SECUREWORKER'5 COMPENSATION COVE GEIS Dyes �No UNLAWFUL,AN 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($300,000),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 o Yes FT10 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) ❑Yes XNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist I understand my requirements under the State of California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes No Business and Professions Code).Any city or county that requires a permit to Date T ( 7 construct,alter,improve,demolish or repair any structure,priorto its PROPERTY EX 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 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 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-certifled 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 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). Code,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. ❑No EPA Lead-Safe Certified Firm is required for this project because: a 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. BUILDINGa PERMIT/PLAN CHECK APPLICATION y,. "Menifee DATE 06/08/2017 PERMIT/PLAN CHECK NUMBER 01 U 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 16 ROOF MOUNTED P.V.MODULES,1 WALL MOUNTED STRING INVERTER,4.56 KW PROJECTADDRESS 28944 E WORCESTER RD, SUN CITY, ��C////A992586 ASSESSOR'S PARCEL NUMBER S�—) - 140 ' OT � TRACT PROPERTY OWNER'S NAME SUSAN SULLIVAN ADDRESS 28944 E WORCESTER RD.SIN CITY,CA 92586 PHONE (951)743-5645 EMAIL IM HENRYAFFRE APPLICANT NAME \ �r ADDRESS 1542 EDINGER AVE.SUITE D,-TUSTIN, CA 92780 PHONE (562)682-4511 EMAIL haffre562@gmail.com CONTRACTOR'S NAME PEAK POWER SOLUTIONS O�BUILDER? ❑YES❑✓NO 10 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$ $16,000.00 SO FT 281.6 L SO FT APPLICANT'S SIGNATU E DATE O6/08/2017 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CRY OF MENIFEE BUSINESS UCENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE -%tnPAIDAMOUNT AMOUNT L .� G CASH OCHECK# OCREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES 0 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 �„V Vf9 C J �BRB Bureau Veritas City of Menifee 1665 Scenic Avenue, Suite 200 29714 Haun Rd. Costa Mesa, CA 92626 Menifee, CA.92586 BV Project: 40017-039221.00 Project: PUT 17-01825 Reviewer: Khoa Duong, P.E Description: Roof Mounted PV System Direct: 714 4314123 General: 714 4314100 Khoa.duong@us.bureauveritas.com Project Address: 28944 E.Worcester Road Owner(s): Susan Sullivan Occupancy Group(s): R-3/U Construction Type: V-B PC1-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 ♦ www.us.bureauveritas.com An Equal Opportunity Employer Page 1 of 1 CPU VE9 ¢ �t m u 1gy8 CITY OF MENIFEE TRANSMITTAL Building Division Date: 6/19/2017 Project Location: 28944 E. Worcester Road Plan Check No.: PMT17-01825 BV Project#: 40017-039221.00 Project Description: PV Solar—Susan Sullivan Reviewer Date Hour Hourly Rate Total 1st 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 Verila5 North America.Inc. 1666 Scenic A,enue,Suite 200 Costa mesn CA 4267f. W. 71,1.4 S 1:9100 I .71-0.825.06 b5