PMT17-02892 City of Menifee Permit No.: PMT17-02892
29714 HAUN RD.
4ACCELA? MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 0 8/3 012 01 7
PERMIT
Site Address: 28204 LONG MEADOW DR, MENIFEE, Parcel Number: 340-280-012
CA 92584 Construction Cost: $13,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 16 PANELS, 1 INVERTER,4.640 kW
Work:
Owner Contractor
THOMAS WATSON FRANK JBANKER
28204 LONG MEADOW DRIVE 31090 CORTE ARROYO VISTA
MENIFEE,CA 92584 TEMECULA, CA 92592
Applicant Phone:9513260848
FRANK BANKER License Number:991843
31090 CORTE ARROYO VISTA
TEMECULA, CA 92592
Fee Description gty Amount(SI
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_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
with a licensed contractor(s)pursuant to the Contractors State License law).
I hereby affirm under penalty of perjury that 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. pp the following reason:
License Class License No. O By my signature below I acknowledge that,except for my personal residence
Expires /�g Signature in which l must have resided for at least one year prior to completion of
/ / / improvements covered by this permit.I cannot legally sell a structure that
9RKER'S COMPENSATION DECLARNTIfON have built as an owner-builder if it has not been constructed in its entirety by
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
this permit is issued. www.leginfo.ca.eov/calaw.html.
Policy# ¢.7 Date
D 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.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# Expires l ' enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for o e-hundred
Date
dollars($100)or less
PROPERTY OWNER OR AUTHORIZED AGENT
p1rcertffy that in the performance of the work for which this permit is issued, p�G/_`
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# O�V(PJ
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers co pensation provisions of Section 3700 of the Labor
de,I shall forthw' provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant. Date G mixture con ng a hazardous material equal to or greater that the
amounts sp ied on the Hazardous Materials Information Guide?
WARNI .FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes o
UNLAWFUL,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 Quali Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guideline
CONSTRUCTION LENDING AGENCY ❑Yes o�No
I hereby affirm that under the penalty of perjury there is a construction Will the propo ed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boun ry of a school?
(Section 3097 Civil Code) ❑Yes X.
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
1 hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health&Sa Code,Section 25505 and 25534 concerning
haze
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 r us mat r i
Business and Professions Code).Any city or county that requires a permit to Date ZO,2 4
construct,alter,improve,demolish or repair any structure,prior to its O RTY OWNER OR ADWORIZED 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 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
❑1,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.eoa.eov/lead orcontactthe National Lead Information Centerat
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:
D I,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.
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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: 40017-039465.00 Project: PMT17-02892
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: 28204 Long Meadow Dr
Owner(s): Jackie McDonald
Occupancy Group(s): R-3/ U
Construction Type: V-B
PC1-APPROVED
August 24,2017
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 1 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: 8/24/2017
Project Location: 28204 Long Meadow Dr
Plan Check No.: PMT17-02892
BV Project#: 40017-039465.00
Project Description: PV Solar— Jackie McDonald
Reviewer Date Hour Hourly
Rate Total
I" Plan Check Khoa Duong 8/24/2017 1.0 $110.00 $110.00
2nd Plan Check
3rd Plan Check
4tn Plan Check
Final Approval: Khoa Duong 8/24/2017 1.0 $110.00 $110.00
Bureau Veritas North America,Inc.
1665 Scenic Avenue,Suite 200
Costa Mesa, CA 92626
M: 714.431.4100 F: 714.825.0685
SAFETYBUILDING & PERMIT/PLAN CHECK APPLICATION
Menifeh.
DATE 17 PERMIT/PLAN CHECK NUMBERQ '
TYPE: O COMMERCIAL V`RESIDENTIAL O MULTI-FAMILY O MOBILE HOME C%POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK n�,q lfoLnp w Z L 0 17? ,AID " q C
l ,lAr, cp
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER , ) ^ Q' e�. LOT TRACT
�nCK/IE. M
OWNER NAME /�' ` / �/A C12A V. r-T 0,�4
ADDRESS d -
PHONE �p/( c Z I qLe 7G EMAIL
APPLICANT NAME
ADDRESS /C' "27 o4,e,/1cyG U" G �,E/�7.fGU.L 61 / 2.$—j
PHONE Z.G 0 5 q EMAIL ��,a...Lc'r �.i��nr.Su�rG� , 601M
CONTRACTOR'S NAME „Q / ,�_ OWNER BUILDER? O YES AO
BUSINESS NAME
ADDRESS PHONE psi EMAIL
CONTRACTOR'S STATE LIC NUMBER �� L� YS LICENSE CLASSIFICATION
VALUATION$ SQ FT L SO FT
APPLICANT'S SIGNATURE DATE ;�S
7 4
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT OCASH OCHECK# JCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH OCHECK# "I CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES ''0 NO