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PMT17-03168 City of Menifee Permit No.: PMT17-03168 29714 HAUN RD. 'q%CCEL/k? MENIFEE,CA 92586 Type: Residential Electrical MENIFEE Date Issued: 0 9/2 212 01 7 PERMIT Site Address: 25846 ROUNDUP CIR, MENIFEE, CA Parcel Number: 358-511-011 92584 Construction Cost: $28,900.00 Existing Use: Proposed Use: Description of 9.315KW SOLAR SYSTEM-27 345W MODULES, INTEGRATED MICROINVERTERS Work: Owner Contractor DAN WOLOSUK PELL SOLAR INC 25846 ROUNDUP CIRCLE 780 S MILLIKAN AVE MENIFEE, CA 92584 #G Applicant Phone: 8666468499 PELL SOLAR INC License Number: 949122 780 S MILLIKAN AVE #G ONTARIO, CA 91761 Phone: 8666468499 Fee Description Otyt Amount(E) Solar, Residential or Small Commercial 1 252.00 Building Permit Issuance 1 27.00 Additional Plan Review Electrical 110 110.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Electrical 1 12.60 $407.60 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'dee.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_Perntt_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 Code and my license is in full force and effect.t q the following reason: License Class G 1 Lic se No. 9 r By my signature below I acknowledge that,except for my personal residence Expires 6 3 D/3 r e_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 DECLARATION 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 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.lealnfo.ca.eov/calaw.html. Policy K Date 2!9have 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)have provided Is correct.I agree to comply Carrier s}'fr �—C`k^Se+'4~ 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 -J. �H r"T Expires 1?- ,I / r 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 PROPERTY OWNER OR AUTHORIZED AGENT ❑i certify that In the performance of the work for which this permit is issued, s j! 1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE k fp 2. ^/ workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall fo0withRmply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date ' 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 Vo 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($100,00(01),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR CwspantQuality Management District(SC construction or See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes I hereby affirm that under the penalty of perjury there is a construction WIII 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) 0 Yes 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 Contractors License Law for the reason(s)Indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Business and Professions Code).An city or county that requires a permit to es ❑No ,Q L7 Y LY LY eq P i1't-.i Date 1/•L r�ll� 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(RAP) 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 _ ❑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.eoa.gov/lead or contact the National Lead Information Center at not Intended or offered for sale.(Section 7044,Business and Professions 1-BOG-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: 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. Y f Bureau Veritas City of Menifee 1665 Scenic Avenue, Suite 200 29714 Haun Rd. Costa Mesa, CA 92626 Menifee, CA. 92586 BV Project: 40017-039532 Project: PMT17-03168 Reviewer: Neil Tuong Description: 9.315 kw roof mounted pv Direct: 714-431-4193 system. General: 714-431-4100 Neii.tuong@us.bureauveritas.com 2554,, {ZcondVp GEC Project Address: Owner(s): Dan Wolosuk Occupancy R3 Group(s): Construction VB Type: PC 1 REVIEW COMMENTS September 18, 2017 This plan has been reviewed for conformance to the minimum requirements of the 2016 California Building Codes,as amended and adopted by the City of Menifee, California. The approval of plans and specifications do not permit the violation of any section of the building code, or any other applicable local,state or federal ordinance, rule, regulation, order,or law. BUILDING COMMENT APPROVED— READY FOR PERMIT ISSUANCE END OF COMMENTS 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 vea x a � a N N 1g28 CITY OF MENIFEE TRANSMITTAL Building Division Date: 9/18/2017 Project Location: 25846 Roundup Circle Plan Check No.: PMT17-03168 BV Project #: 40017-039532.00 Project Description: 9.315 kw roof mounted pv system Reviewer Date Hour Hourly Rate Total 15t Plan Check N. Tuong 9/18/2017 1.0 $110.00 $110 2nd Plan Check 3rd Plan Check 4th Plan Check Final Approval: N.Tuong 9/18/2017 1.0 $110.00 $110.00 TOTAL: $110.00 Bureau Veritas North America,Inc. 1665 Scenic Avenue,Suite 200 Costa Mesa,CA 92626 M:714.431.4100 F: 714.825.0685 1 r ' l 77 BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION S `I..Wenifee DATE: 9/8/17 PERMIT/PLAN CHECK NUMBEa'4Fn-0N Wg TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION `?ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK 9.315kW PV Solar System - 27 345W modules, integrated microinverters PROJECTADDRESS 25846 Roundup Circle, Menifee, CA 92854 ZIP 92584 ASSESSOR'S PARCEL NUMBER 358511011 LOT 87 TRACT OWNER NAME Dan Wolosuk ADDRESS 25846 Roundup Circle, Menifee, CA 92584 PHONE 909-237-4089 EMAIL danwolosuk@gmail.com APPLICANT NAME Sterling Picton ADDRESS 780 S Milliken Ave, Suite G, Ontario CA 91761 PHONE 951-823-9497 EMAIL sterling@pellsolar.com CONTRACTOR'S NAME Pell Solar, Inc. OWNER BUILDER? O YES ONO BUSINESS NAME Pell Solar, Inc. ADDRESS 780 S Milliken Ave, Suite G,Ontario CA 91761 PHONE 866-646-8499 EMAIL Jparra@pellsolar.com. CONTRACTOR'S STATE LIC NUMBER 949122 LICENSE CLASSIFICATION C10 VALUATION$ 28900 SQ FT L SQ FT APPLICANT'S SIGNATURE DATE 9/8/17 DEPARTMENT DISTRIBUTION CITY OF�MENIFEE BUSINESS LICENSE NUMBER ✓ 3r BUILDING PLANNING ENGINEERING FIRE �"n ACCEPTED BY: :.)u -J PERMIT FEE 2��, SMIP GREEN PLAN CHECK FEE INVOICETOTAL OWNER BUILDER VERIFIED O YES C NO DRIVERS LICENSE# NOTARIZED LETTER C YES C NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 925869�Qiw72t fee WWW.cityofinenifee.us Building & afety Dept. SEP 0 8 201'