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PMT17-02859 City of Menifee Permit No.: PMT17-02859 29714 HAUN RD. 4"ACCEL/? MENIFEE, CA 92586 Type: Residential Electrical " MENIFEE Date Issued: 08/24/2017 PERMIT Site Address: 29558 TWO HARBOR LN, MENIFEE,CA Parcel Number: 333-561-007 92585 Construction Cost: $24,000.00 Existing Use: Proposed Use: Description of INSTALL ROOF MOUNTED SOLAR SYSTEM,22 PANELS,22 MICROINVERTERS,6.050 kW Work: Owner Contractor DWAYNE NEELY INLAND EMPIRE SOLAR 29558 TWO HARBOR LANE 13653 COBALT RD MENIFEE, CA 92585 VICTORVILLE, CA 92392 Applicant Phone: 9512518902 CARLOS SERRANO License Number: 1002207 INLAND EMPIRE SOLAR 13653 COBALT RD VICTORVILLE, CA 92392 Fee Description Oty Amount($1 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 4.00 General Plan Maintenance Fee-Electrical 1 12.60 $406.60 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 Men'rfee.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 cantractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from Iicensure under the Contractor's State License Law for Professions Code and my license is in full force and effect, the following reason: 11 License Class nse No. -- By my signature below I acknowledge that,except formy personal residence - Expires e2 -�i— C1 Signature in which I must have resided for at least one year priorto completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I 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:) 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 by Section 3700 of the Labor Code,forthe performance of work forwhich this application is submitted or at the following website: this permit is issued. www.leginfo.ca.gov/calaw.htmL Policy Jt Date ❑I have 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 with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy p Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($100)or less Date fTFcerflfy that in the performance of the work for which this permit is issued, PROPERTY OWNER OR AUTHORIZED AGENT I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE H worker's compensation laws of California,and agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Labor HAZARDOUS MATERIAL DECLARATION Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant ti Date —71f=I --) mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes JLNo UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the intended use of the building by the applicant or future building ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist CONSTRUCTION LENDING AGENCY forguidelines❑Yes dANo 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 4d.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&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting. Business and Professions Code).Any city or county that requires a permit to Y N�,p construct,alter,improve,demolish or repair any structure,prior to its Date 9 issuance,also requires the applicant for the permit to file a signed statement PROPERTY OW AUTHORIZEDAGENT that he or she Is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING fRRP) License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt from Iicensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978 an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with than($500). required practices.This includes rental property owners and property managers who do the paint-disturbing work themselves or through their in 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.ella-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 property who,through employees'or personal effort,builds or improvesthe ci An EPA Lead-Safe Certified Renovator will be responsible for this project 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 completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.: 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. �pU vF9 � a m a �828 Bureau Veritas City of Menifee 1665 Scenic Avenue, Suite 200 29714 Haun Rd. Costa Mesa, CA 92626 Menifee, CA. 92586 BV Project: 40017-039436.00 Project: PMT17-02859 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: 29558 Two Harbor Lane Owner(s): Dwayne Neely Occupancy Group(s): R-3/ U Construction Type: V-B PC 1-APPROVED August 21, 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 ap U VP9 a a � a m y Ig28 CITY OF MENIFEE TRANSMITTAL Building Division Date: 8/21/2017 Project Location: 29558 Two Harbor Lane Plan Check No.: PMT17-02859 BV Project#: 40017-039436.00 Project Description: PV Solar— Dwayne Neely Reviewer Date Hour Hourly Rate Total 1'` Plan Check Khoa Duong 8/21/2017 1.0 $110.00 $110.00 2nd Plan Check 3rd Plan Check 4ch Plan Check Final Approval: Khoa Duong 8/21/2017 1.0 $110.00 $110.00 Bureau Veritas North America, Inc. 1665 Scenic Avenue,Suite 200 Costa Mesa, CA 92626 M:714.431 Al 00 F: 714,825.0685 At DATE ILA PERMIT/PLAN CHECK NUMBER �� Q TYPE: O COMMERCIAL tiLRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O.DEMOLITION U ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK \\ w PROJECTADDRESS LX_At^� G ASSESSOR'S PARCEL NUMBER ?iaa- asl -(oq LOT TRACiit Building abl e 9 $ Safety OWNER NAME Dept. ADDRESS cS AU PHONE EMAIL Received APPLICANTNAME v ADDRESS PHONE ��G_ 2 n2 - �7 EMAIL %Q CONTRACTOR'S NAME TtsbAOWNER BUILD R? OYES BUSINESS NAME ADDRESS6 rkg�! PHONE EMAIL i2.�5��P,.rCo�Ja vh -- CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION $ j 4/ rs(f/1 SO FT LSQFT APPLICANT'S SIGNATURE DATE l DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP INVOICE � M V 1 MM ��AMOUNT .9 vo PAID AMOUNT _N 0CASH O CHECK# OCREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES •'.% NO I ✓la ir-e k P;. e or::it ; ; , t,Ir, '`:d. ;V1 i"Et? r_ _ _