PMT17-02857 City of Menifee Permit No.: PMT17-02867
29714 HAUN RD.
"�CCEL/QA MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 0 8/2 312 01 7
PERMIT
Site Address: 27961 GARDA CT, MENIFEE, CA 92585 Parcel Numbers 333-741-007
Construction coat: $19,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 10 PANELS, 10 MICROINVERTERS,3.600 kW
Work:
Owner Contractor
ANTHONY COLEMAN PRECIS DEVELOPMENT INC
27961 GARDA COURT 36625 KEVIN ROAD STE 147
MENIFEE,CA 92585 WILDOMAR, CA 92595
Applicant Phone: 9516969400
NICHOLAS MARTISOFSKI License Number. 952305
PRECIS DEVELOPMENT INC
36625 KEVIN ROAD STE 147
WILDOMAR, CA 92595
Fee Description
Q�t Amount 1El
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
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)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 Cade and my license is in full force and effect. the following reason:
9
License Class Ucel se No. 3 By my signature below I acknowledge that,except for my personal residence
Expires�� Signature !/ �+-- 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 DECLA ON have built as an owner-bullder 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 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.lggInfo.ca.gov/mIaw.html.
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 N'9y 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
with all applicable city and county ordinances and state laws relating to
Carrier�r' M building constru on. authorize representatives of this city or county to
Policy# 90 L}GJ3-"/ ✓� Expires a enter the abov entified roperty for inspection purposes..
(This section need not to be completed is the permit Is for one-hundred Date
dollars($100)or less PERTY R R AUTHORIZED AGENT —TT
❑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 compen W;tion provisions of Section 3700 of the Labor
Code,I shall fort with comply fth those pro isions. Will the applicant or future building occupant handle hazardous material or a
2 �� mixture containing a hazardous material equal to or greater that the
Applicant Date y amounts specified on the Hazardous Materials Information Guide?
WARNIN : ILURE TO SE RE WORKER'S COMPENSATION COVERAGE IS - ❑Yes pRo
UNIAWF 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 ❑Yes eNo
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 allo
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 underthe State of
California Health al Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below bythe
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 70315.
oyes ❑No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED 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-certlfied 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.ew.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 ❑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:
❑1,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.
pU Vf9
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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: 40017-039434.00 Project: PMT17-02857
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: 27961 Garda Ct
Owner(s): Anthony Coleman
Occupancy Group(s): R-3/U
Construction Type: V-B
PC 1-APPROVED
August 22, 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: 8/22/2017
Project Location: 27961 Garda Court
Plan Check No.: PMT17-02857
BV Project#: 40017-039434.00
Project Description: PV Solar— Anthony Coleman
Reviewer Date Hour Hourly
Rate Total
1st Plan Check Khoa Duong 8/22/2017 1.0 $110.00 $110.00
2nd Plan Check
3rd Plan Check
4th Plan Check
Final Approval: Khoa Duong 8/22/2017 1.0 $110.00 $110.00
Bureau Veritas North America, Inc.
1665 Scenic Avenue, Suite 200
Costa Mesa, CA 92626
M: 714.431,4100 F:714.825.0685
PERMIT/PLAN& SAFETY APPLICATIONl
_ Menifee
DATE Cr' Al-) 7 PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL 9RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: C ADDITION O ALTERATION O DEMOLITION .4 ELECTRICAL O MECHANICAL
O NEEW O PLUMBING C%RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK }l 'J�tjp TV So la r
-17. 6.ory ktt/-])C -W -360 -Cq-AC Ae /4,dk/P5
PROJECTADDRESS .2746 (iarJa 6— f M✓� ��e C,4
ASSESSOR'S PARCEL NUMBER LOT TRACTS , Clty Of McDitee
DeP,/ l t.
OWNER NAME w0r 414o. �o/P.K�a/` ,J //�1 ,1 q
ADDRESS AUG i
Z -79G ( fAarl�n `evr'( Mr,,, f/�o C, l 2�95
PHONE Sp K ' (.17 - '5l f9 EMAIL Received
//^
APPLICANT NAME IV'tLia4 s / , V;f B`Qk
ADDRESS -'� ✓
6C a 5 I�sv+'n 9,4 ✓r/�o�v r `,4 9 ' 5 9 S
PHONE q5/ - 696 - `/coa yy// EMAIL /1;C4 le. �' CrTSsglar• cO/�
CONTRACTOR'S NAME Cgr;,4;a� ,(o woo d OWNER BUILDER? O YES pfNO
BUSINESS NAME
ADDRESS 3662 5 /C.,,; SIP Iq7 �✓'��a....r
PHONE qS/- Il L - Q Yyn EMAIL r. co,--
CONTRACFOR'SSTATE LIC NUMBER �f Sa 3 Q S LICENSE CLASSIFICATION
VALUATION$ l e aA9 SQ FT L SO FT
�. � Sly/i7
APPLICANT'S SIGNATURES! DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT OCASH OCHECK# `.)CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 11
w CREDIT CARD VISVMC
OWNER BUILDERVERIFIED OYES C; NO DL NUMBER NOTARIZED LETTER O YES C` NO
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