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PMT17-02929 City of Menifee Permit No.: PMT17-02929 29714 HAUN RD. Type: Residential Electrical �ACCF-LA> MENIFEE, CA 92586 MENIFEE Date Issued: 09112/2017 PERMIT Site Address: 30864 CARRIAGE HILL DR, MENIFEE, Parcel Number: 364-330-018 CA 92584 Construction Cost: $20,000.00 Existing Use: Proposed Use: Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 18 PANELS, 18 MICROINVERTERS,5.22KW Work: Owner Contractor JAYME RODRIGUEZ CALSTATE SOLAR INC 30864 CARRIAGE HILL DR 27576 COMMERCE CENTER DR MENIFEE,CA 92584 TEMECULA,CA 92590 Applicant Phone: 9497897990 TOM MALONE License Number: 1006247 CALSTATE SOLAR INC 27576 COMMERCE CENTER DR TEMECULA, CA 92590 Fee Description Oft Amount IEI 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_Pernit_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 Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Class Lice. . No."AOOk N_7 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 WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell 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: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 atthe following website: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. vvww.leeinfo_ca,Kov calaw.html. Policy# 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 workers 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 ((''��,,9L3 i�, building construction.I authorize representatives of this city or county to Policy#7 Z,(Q�Z0(-7 Expires `7/y/z QJ� $ 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 ❑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 worker's compensation provisions of Section 3700 of the Labor Code,l sh forthwi of rtiply with those provisions. nn//,,,, //'' Will the.applicant or future building occupant handle hazardous material or Applicant . Date mixture containing hazardous material equal to or greater that the y/ '' .. amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes )INo 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($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 37060E THE LABOR[ODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes YNO I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) ❑yes I*o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)Indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable hem hazardous material reporting.$)(Section 7031.5 *_ 0 Business and Professions Code).Any city or county that requires a permit to Date Z / construct,alter,improve,demolish or repair any structure,prior to its PROPERTY O ERR 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(RRPI 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) mor that he or she is exempt from 7031.5 b receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section of norm o residence or childcare facility to be RRP-cert'rfied firms and comply with than 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 orthrough their o 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.ep"ollead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-900-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a property who,through employees'or personal effort,builds or improves the ❑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 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 forthis 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 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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION + J DATE PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL 04 RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA O SIGN SUBTYPE: CI ADDITION O ALTERATION C%DEMOLITION C) ELECTRICAL O MECHANICAL O NE`W I O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK ) L w v S • 2 2 PROJECTADDRESS ASSESSOR'S PARCEL NUMBER 3'SO� Ot% LOT �ja`l TRACT OWNER NAME Z ADDRESS 36D"�� PHONE �7 0 Z_ L —AU 5 EMAIL APPLICANT NAME r' ^'� /"� `� �•� ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNERBUILDER7 OYESONO BUSINESSNAME , I ADDRESS �� Lo..�o�. e �CQ PHONE �. I -- `6`(Ci- ,�� 67 EMAIL CONTRACTOR'S STATE LIC NUMBER 2� LICENSE CLASSIFICATION VALUATION$ 2- U � - SO L SO FT APPLICANT'S SIGNATURE / -�z DATE " - ( CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINE S LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE PAID AMOUNT AMOUNT +CASH C%CHECK# OCREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES CS NO DL NUMBER NOTARIZED LETTER O YES 0 NO - _`. -- City ofP✓lenlfee 8ul(drnc& Deonrirnznt 29714 raern Fcl. IV!enliz 6vwvw.citycfinenif2e.us!nsi)ection Request Line 95 -[46_621 aNl apU vE9 o m )820 Bureau Veritas City of Menifee 1665 Scenic Avenue, Suite 200 29714 Haun Rd. Costa Mesa, CA 92626 Menifee, CA. 92586 BV Project: 40017-039469.00 Project: PMT17-02929 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: 30864 Carriage Hill Dr Owner(s): Jayme Rodriguez Occupancy Group(s): R-3/ U Construction Type: V-B PC 1-APPROVED August 25,2017 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 �pU VE9 � a m N /g28 CITY OF MENIFEE TRANSMITTAL Building Division Date: 8/25/2017 Project Location: 30864 Carriage Hill Dr Plan Check No.: PMT17-02929 BV Project#: 40017-039469.00 Project Description: PV Solar— Jayme Rodriguez Reviewer Date Hour Hourly Rate Total 1st Plan Check Khoa Duong 8/25/2017 1.0 $110.00 $110.00 2nd Plan Check 3rd Plan Check 4th Plan Check Final Approval: Khoa Duong 8/25/2017 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