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PMT17-02518 City of Menifee Permit No.: PMT17-02518 29714 HAUN RD. �A CCCELA� MENIFEE, CA 92586 Type: Residential Electrical MENIFEE Date Issued: OSf18/2077 PERMIT Site Address: 26410 OKUMA RD, MENIFEE, CA 92584 Parcel Number: 360-290-010 Construction Cost: $18,630.00 Existing Use: Proposed Use: Description of INSTALL ROOF MOUNTED ON DETACHED GARAGE SOLAR PV SYSTEM,23 MODULES,23 Work: MICROINVERTERS, 6.21KW Owner Contractor BRIAN GOSSETT BARNES SOLAR INC 26410 OKUMA RD 16560 HARBOR BLVD UNIT R MENIFEE, CA 92584 FOUNTAIN VALLEY, CA 92708 Applicant Phone:9493516217 RICK ROOT License Number:943909 BARNES SOLAR INC 16560 HARBOR BLVD UNIT R FOUNTAIN VALLEY, CA 92708 Fee Description ON Amount I51 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 110 110.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL - 1 3.00 General Plan Maintenance.Fee-Electrical 1 12.60 $460.60 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.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 perjurythat I am under provisions of 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 �w �1 the following reason: _ I cense-Class—C-1b 4(O LIM f/h I dJ- -U ce9f}-yy�- �y-my-signature-below baeknowledge that-except-for my-personal-residence-- Expires Signature in which I must have resided for at least one year priorto 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 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.leginfo.m.goy/calaw.htnil. this permit is issued. Policy# Date ❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT 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.1 have read this number are, application and the information I have provided is correct.I agree to comply Carrier <`ll'J� with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# )a(V33 Expires 3LLV 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 employ 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 compensation provisions of Section 3700 of the Labor Code,I shall fo camp f s ith th provisions. Will the applicant or future building occupant handle hazardous material or a /y/y, ff/(r mixture containing a hazardous material equal to or greater that the Applicant N Date b amounts specified on the Hazardous Materials Information Guide? WARNING:FAIL TO SECURE W RKER'S COMPENSATION COVERAGE IS ❑Yes 300 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 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes I,LNo 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 )[No 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 California Health&Safety Code,Section 2S505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous mated r Qrtin checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 {Yes ❑No p. Business and Professions Code).Any city or county that requires a permit to y,��Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWN R AUTHORI D 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(RRPI 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 Ilcensure 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.epa.aov/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). ft Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Sa ICE �N dl be responsible for this project property who,through employees'or personal effort,builds or Improves the furl h0& �9p property provided that the improvements are not intended or offered for Certified Firm ame:�Q .. sale.If,however,the building or Improvement is sold within one year of Firm Certifi I dpfP completion,the Owner-Builder will have the burden of proving that it was AUG n 7 not built or improved for the purpose of sale. D No EPA Lead-Safe Certified Firm is 41?ed 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 4'" ' Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP fill out the RRP Acknowledgement. pU VF9 a +axa Bureau Veritas City of Menifee 1665 Scenic Avenue, Suite 200 29714 Haun Rd. Costa Mesa, CA 92626 Menifee,CA. 92586 BV Project: 40017-039326.00 Jurisdiction No.: PMT17-02518 Reviewer: Ed Chock Description: PV System Direct: 714-431-4192 General: 714-431-412 3 edwin.chock@bureauveritas.com Project Address: 26410 Okuma Drive Owner(s): Gossett Residence Occupancy Group(s): R-3, U Construction Type: V-B PC 2 APPROVED August 10,2017 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 � n 0 N r828 CITY OF MENIFEE TRANSMITTAL Building Division Date: 08/11/17 Project Location: 26410 Okuma Dr Plan Check No.: PMT17-02518 BV Project#: 40017-039326.00 Project Description: PV Solar—Gossett Residence Reviewer Date Hour Hourly Rate Total ft Plan Check E Chock 07/27/17 1.0 $110.00 $110.00 2nd Plan Check E Chock 08/10/17 .50 $110.00 $ 55.00 3rd Plan Check 4th Plan Check Final Approval: E Chock 08/10/17 1.5 $110.00 $165.00 Bureau Veritas North America,Inc. 1665 Scenic Avenue,Suite 200 Costa Mesa,CA 92626 M:714.4314100 F:714.825.0685 BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION `Menifee DATE I 1 ' ? PERMIT/PLAN CHECK NUMBER I -0 0115' TYPE: ❑COMMERCIAL PdRESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME POOLISPA ❑SIGN SUBTYPE: ❑ADDITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL ❑NEW J[]PLUMBING ❑RE-ROOF-NUMBER OF SQUARES V, DESCRIPTION OF WORK P 1/ I C.p OLA>-3 t-C-0 a3 A&L0,gItL_eC-5 . z'S OAI[CO-0 1 0� PROJECTADDRESS g6 4 JQ ASSESSOR'S PARCEL NUMBER 3c06-oZI(9' Lfl 10 ,LOT �rr TRACT PROPERTY OWNER'S NAME U` S S C in a-n Laux�� ADDRESS 2 fl � !��K LAVIA McrJ r elr �'Z��y PHONE Q-// 8,3 L f - 3� P It EMAIL APPLICANT NAME 1 C-�-""Y�� 1D_0 T- pp�� /� ADDRESS r <(o0 1-AA6o(Z- p ,A mj UA-Lin, T Z7�a PHONE 7!�- �j7j� �22(p EMAIL A-13#U1) Q >3i4-W Ce,SO LA Cd n1 CONTRACTOR'S NAME UA-yf u C S 9,,L.vq'I/Z_ OWNER BUILDER? [-IYESEZNO BUSINESS NAME iCS S01_rA-L. ADDRESS c�-(yb 1407 660- At- PHONE 71c{ 33-7 S'Z2 A- 6 EMAIL 0 ILA IA Q 64YZIIJ ES'^-oLv4A, (-QM CONTRACTOR'S STATE LIC NUMBER q zl K q LICENSE CLASSIFICATION VALUATION$ 17 1 (D -j 0 SQ FT L SO FT 1 APPLICANT'S SIGNATURE lot DATE -7 C�kilJ ���l"L DEPARTMENT DISTRIBUTION I CITY OF MENNIIFF0BUMEy$/�V'MBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP �/) INVOICE 1 �Q�. PAID AMOUNT AMOUNT -` OCASH OCHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586951-672-6777 www.cityofinenifee.us Inspection Request Line 957-246-6213 -7 hT.