PMT17-02478 City of Menifee Permit No.: PMT17-02478
29714 HAUN RD. T Residential Electrical
��CCELA7. MENIFEE, CA 92586 yam'
MENIFEE Date Issued: 0 810 212 01 7
PERMIT
Site Address: 25385 ROCKING HORSE CT, MENIFEE, Parcel Number: 358-541-008
CA 92584 Construction Cost: $20,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 18 MODULES, 18 MICROINVERTERS 4.950KW
Work:
Owner Contractor
SUSAN RYAN INLAND EMPIRE SOLAR
25385 ROCKING HORSE CT 13653 COBALT RD
MENIFEE, CA 92584 VICTORVILLE, CA 92392
Applicant Phone:9512518902
CARLOS SERRANO License Number: 1002207
INLAND EMPIRE SOLAR
13653 COBALT RD
VICTORVILLE,CA 92392
Fee Description Qtv Amount ISI
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_Pennit_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 ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class C4 o License No. WOZZ0-7
By my signature below I acknowledge that,except for my personal residence
Expires q•5t- (g( Signature CA44d 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
❑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 website:
by Section 3700 of the Labor Code,for the performance of work for which www.IegInfo.ca.jzov/caIaw.htmI.
this permit is issued.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
❑I have and will maintain worker's compensa ton 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 worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
number are: 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 building construction.I authorize representatives of this city or county to
Policy# 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($300)or less PROPERTY OWNER OR AUTHORIZED AGENT
,Mlcertty 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 If
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith co ty with those provisions. Will the applicant or future building occupant handle hazardous material or a
��2—(� mixture containing a hazardous material equal to or greater that the
Date
Applicant (.flV/ amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes a Vo
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 guidelines
CONSTRUCTION LENDING AGENCY ci Yes zcNo
I hereby affirm that under the penalty of perjury there Is a construction WIII 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 sfNo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)Indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 jVes ❑N� �
Business and Professions Code).Any city or county that requires a permit to C..ra7ti� Date _
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER 0 HORIZED 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter9(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 forthe alleged exemption.Anyviolation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicantto 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.epa.goy/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professlons 1-800-424-LEAD(5323).
Code;The Contractor's 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. da--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.
BUILDING & SAFETY PERMIT/.PERMIT/PLAN CHECK APPLICATION
Ali
=*Memee
DATE 7 PERMIT/PLAN CHECK NUMBER TI rl - OaL- g
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA v SIGN
SUBTYPE: O ADDITION O'ALTERATION O DEMOLITION O-ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
r
PROJECTADDRESS pp
ASSESSOR'S PARCEL NUMBER LOT TRACT 3�
OWNER NAME
ADDRESS t3 i
PHONE - EMAIL
APPLICANT NAME GAY["
ADDRESS jojg6 `
PHONE 01Cj , 2eo7 19Ij EMAIL
CONTRACTOR'S NAME 1�'I OWNER BUILDER?` O YES 0
BUSINESS NAME 1p./
ADDRESS re Q1, CA 72_ 2
PHONE 9(1'%- ?r�)•.5'rIC�' EMAIL %C_ @q6wAvl ,(p{M
CONTRACTOR'S STATE LIC NUMBER 16D22U'7 LICENSE CLASSIFICATION C
VALUATION$ SO FT i3ze) L SO FT
t[DEPARTMENIT
SIGNATURE DATE
STRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
NING ENGINEERING FIRE GREEN SMIP�] PAID AMOUNTQ`q OCASH OCHECKB OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 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
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Bureau Veritas City of Menifee
1665 Scenic Avenue, Suite 200 29714 Haun Rd.
Costa Mesa, CA 92626 Menifee, CA. 92586
BV Project: 40017-039318.00 Project: PMT 17-02478
Reviewer: Khoa Duong, P.E Description: Roof Mounted PV System
Direct: 714 4314123
General: 714 4314100
Khoa.duong@us.bureauveritas.com Project Address: 25385 Rocking Horse Ct
Owner(s): Susan Ryan
Occupancy Group(s): R-3/ U
Construction Type: V-B
PC1-APPROVED
July 24,2017
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 4 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
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CITY OF MENIFEE 40
TRANSMITTAL , -/0
Building Division obi 9 6
Date: 7/24/2017 �✓-�
�!0
Project Location: 25385 Rocking Horse Ct
Plan Check No.: PMT17-02478
BV Project#: 40017-039318.00
Project Description: PV Solar—Susan Ryan
Reviewer Date Hour Hourly
Rate Total
1" Plan Check Khoa Duong 7/24/2017 1.0 $110.00 $110.00
2nd Plan Check
3rd Plan Check
4th Plan Check
Final Approval: Khoa Duong 7/44/2017 1.0 $110.00 $110.00
Bureau Veritas North America,Inc.
1665 Scenic Avenue,Suite 200
Costa Mesa,CA 92626
M:714A31.4100 F:714.825.0685