PMT17-02723 City of Menifee Permit No.: PMT17-02723
29714 HAUN RD.
'tACCELP? MENIFEE,CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 08/14/2017
PERMIT
Site Address: 28580 DELPHINUS DR, MENIFEE, CA Parcel Number: 339-275-009
92586 Construction Cost: $12,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 10 PANELS, 1 INVERTER,3.48 kW
Work:
Owner Contractor
JORGE BUCIO 360 MANAGEMENT GROUP INC
28580 DELPHINUS DRIVE 6727 ODESSA AVENUE
MENIFEE, CA 92586 VAN NUYS, CA 91406
Applicant Phone:8183968070
VIC LUNA License Number: 992379
360 MANAGEMENT GROUP INC
6727 ODESSA AVENUE
VAN NUYS, CA 91406
Fee Description City Amount 1E1
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_BIdg Permit 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 contractors)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 Contractor's State License Law for
Professions Code and my Ilcense is in full force and effect 7 �j the following reason:
License Class J d Uc e lo. Z 4 ' By my signature below I acknowledge that,except for my personal residence
Expires-��—Signatures ' 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 ww�n,.leainfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
rave and will maintain worker's 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 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
Carrier :574 _ FvtiD with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# 9�6��6 7 Expires 5g/w 48 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
O 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#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to thew Aer's ompensation provisions of Section 3700 of the Labor
Code,I shall 1, ht it comply with se provisions. Will the applicant or future building occupant handle hazardous material or a
Applican Date & ` l mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:F URE TO RE WORKER'S COMPENSATION COV RAGE IS ❑Yes ❑No
UNLAWFUL,AND SHA 9UBIECT 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 ❑Yes ❑No
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 CNII 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
Contractor's License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning
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
construct,alter,Improve,demolish or repair any structure,priorto its PROPERTY OWNER OR AUTHORIZED AGEM
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(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 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.epa.goy/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 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. ❑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 Contractor's 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.
APPLICATION& SAFETY PERMIT/PLAN CHECK
.ienifee
DATE PERMIT/PLAN CHECK NUMBER - ,a
TYPE 0 COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: C: ADDITION 'OALTERATION " DEMOLITION t< ELEcrRICAL OMECHANICAL
^.NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Q;OT: "L)/N'7
xw
PROJECTADDRESS 2 19500 Do'JoHlIVC15 t l t- Ac��
ASSESSOR'S PARCEL NUMBER � , - �,6` ea, LOT TRACT
OWNER NAME 'S'A2Gc_ UG/
Buliding & Safety Dep
ADDRESS _43540o Po�Y,Pk} I///VS AU
PHONE 951 -((7 / 015- - EMAIL
APPLICANT NAME (L L UAJA Received
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME !SuArrima E& OWNER BUILDER? O YES ONO
BUSINESS NAME
ADDRESS 6-7 27 O A�4 Vs'v l'-UL/ 5 ,,I/ , /
PHONE �l0 6OZ ( ( /7�9 EMAIL , 6C-Z- P✓ . (JNT/*�'[=/� /
V�K y
CONTRACTOR'S STATE LIC NUMBER 97 Z3 7 (p LICENSE CLASSIFICATION z f - v
VALUATION $ 1 2- 1<--- SO FT L SO FT
APPLICANT'S SIGNATURE DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE 1 A pglD AMOUNT
AMOUNT 'uo OCASH 0 CHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH :.'CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
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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: 40017-039404.00 Project: PMT17-02723
Reviewer: Khoa Duong, P.E Description: Roof Mounted PV System
Direct: 714-431-4123
General: 714-431-4100
Khoa.duong@us.bureauveritas.com Project Address: 28580 Delphinyus Or
Owner(s): Jorge Bucio
Occupancy Group(s): R-3/U
Construction Type: V-B
PC 1 REVIEW COMMENTS
August 09, 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
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CITY OF MENIFEE
TRANSMITTAL
Building Division
Date: 8/09/2017
Project Location: 28580 Delphinyus Drive
Plan Check No.: PMT17-02723
BV Project#: 40017-039404.00
Project Description: PV Solar—Jorge Bucio
Reviewer Date Hour Hourly
Rate Total
1n Plan Check Khoa Duong 8/09/2017 1.0 $110.00 $110.00
2nd Plan Check
3rd Plan Check
41h Plan Check
Final Approval: Khoa Duong 8/09/2017 1.0 $110.00 $110.00
Bureau Veritas North America,Inc.
1665 Scenic Avenue,Suite 200
Costa Mesa, CA 92626
M:714.431.4100 F:714.325.0685