PMT17-03461 City of Menifee Permit No.: PMT17-03461
29714 HAUN RD.
"A\CCELAI7. MENIFEE,CA 92586 Type: Residential Re-Roof
MENIFEE Date Issued:
10/02/2017
PERMIT
Site Address: 26638 MEHAFFEY ST, MENIFEE, CA Parcel Number: 335-281-016
92586 Construction Cost: $3,320.00
Existing Use: Proposed Use:
Description of REMOVE EXISTING LAYERS, INSTALL NEW OWENS CORNING COOL ROOF SHINGLES IN ASPEN
Work: GRAY
"CRRC#0890-0010"
Owner Contractor
MERRY OHARA SOLARCITY CORPORATION
26638 MEHAFFEY STREET 3055 CLEARVIEW
MENIFEE, CA 92586 ATTN ZOE STEELE
Applicant Phone:6509635100
ARWEN LOTT License Number:888104
SOLARCITY CORPORATION
3055 CLEARVIEW
SAN MATEO, CA 94402
Fee Description Qtv Amount IS1
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
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 building operations being carded 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_Penmit_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 01 am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect.
�S f the following reason:
License Class�,ir)U-i C y{'license Nu: DO�-F�1 L'(- - - - - By-my-signature below-l-acknowledge that-except-f sr anypersonal residence-
Expires 4- Signature in which t 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.leeInfo.ca.Rov/caIaw.html.
Policy fJ Date
,101 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 0 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��,jj 6 with all applicable city and county ordinances and state laws relating to
�r11 r,) enter
rthe above
ruction led horize property for
p riscity or county to
Policyg��lAS 71) L-'� �x Tres enterthe above identified propertyfor inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less
�
t _sh PROPERTY OWNER OR AUTHORIZED AGENT
I ergfy that in the performance of the work for which this permit is issued, ij,���'V^�
all not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE tJ ;5 s
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 s tl forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
)� mixture containing a hazardous material equal to or greater that the
Applican Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS 0 Yes iiditb
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the Intended use of the building by the applicant orfuture building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000J,IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCNON LENDING AGENCY Oyu r0
1 hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
tending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yes cQfNo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed nett to the applicable item hazardous material reporting.$)(Section 7031.5 OYe� �-dJo I Business and Professions Code).Any city or county that requires a permit to f!//1.Y,-.�C- o ij A Date -2
construct,alter,improve,demolish or repair any structure,prior to its pROaER OW R O IZEDAGENT
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)orthat he or she is exempt from ficensure receiving compensation for most work that disturbs paint in a pre-197S
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 fora 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 workthemselves orthrough their -
❑I,as owner of the property,or my employee with wages as theirsole 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 or contact the National Lead Information Center at
not intended or offered for sale.(Section 7D44,Business and Professions 1-500-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a 0 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. 0 No EPA Lead-Safe Certified Firm is required for this project because:
01,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.
BUILDINGAPPLICATION
f.,
.d_0!1Menifee
DATE 09/29/2017 PERMIT/PLAN CHECK NUMBER —
TYPE: O COMMERCIAL 4, RESIDENTIAL O MULTI-FAMILY " MOBILE HOME O POOLISPA O SIGN
SUBTYPE: O ADDITION O ALTERATION .O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING %6 RE-ROOF-NUMBER OF SQUARES 11
DESCRIPTION OF WORK Re-roof Building Dept
PROJECTADDRESS 26638 Mehaffey St, Sun City, CA 92586
ASSESSOR'S PARCEL NUMBER -3-66— ZaM "a k-p LOT TR e c e i v e
OWNER NAME Merry Ohara
ADDRESS 26638 Mahaffey St Sun City, CA 92586
PHONE 7022663394 EMAIL kdy@vedzon.net
APPLICANT NAME Arwen Lott
ADDRESS 43320 Business Park Dr. Suite B-104, Temecula, CA 92590
PHONE 951.260.4306 EMAIL arlott@tesla.com
CONTRACTOR'S NAME OWNER BUILDER? O YES O NO
BUSINESS NAME Solarcity
ADDRESS 3055 Clearview Way San Mateo, CA 94402
PHONE 650-638-1028 EMAIL
CONTRACTOR'S STATE LIC NUMBER 888104 LICENSE CLASSIFICATION B, C10, C46
VALUATION $ $ 3,320.00 SO FT L SO FT
APPLICANT'S SIGNATURE ' ""��'�' DATE 09/29/2017
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE I PAID AMOUNT
AMOUNT <3 CASH OCHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT GCASH OCHECK# O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO
City of Menifee Building&Safety Department 29714 Hour, Rd. Menifee, CA 92586 951-572-5777
www.cityofinenifee.trs%nspection Re•aUest Line 951-246-6213
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