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.
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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: 40017-039436.00 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
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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
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