PMT17-03938 City of Menifee Permit No.: PMT17-03938
29714 HAUN RD.
'c�kCCEL, MENIFEE,CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 11/15/2017
PERMIT
Site Address: 27356 POTOMAC DR,MENIFEE,CA Parcel Number: 336-332-031
92586 construction Cost: $15,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 15 MODULES, 1 INVERTER,4.5KW, REQUIRES
Work: 200AMP PANEL UPGRADE
Owner Contractor
IRENE DAVIS PEAK POWER SOLUTIONS INC
27356 POTOMAC DR 151 KALMUS DR STE L2
MENIFEE,CA 92586 COSTA MESA,CA 92626
Applicant Phone:7142583900
HENRY AFFRE License Number:973253
PEAK POWER SOLUTIONS INC
151 KALMUS DR STE L2
COSTA MESA, CA 92626
Fee Description ,OQt Amount($)
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_Pennit 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 o I am exempt from Rcensure under the Contractors State License Law for
Professions Code an y license is in full force and effect. ✓ the following reason:
License Class �r o U g se No. 7 2�5 By my signature below I acknowledge that,except for my personal residence
sExpire 3( 0 Signatur in which 1 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
o 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 far 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 www.leeinfo.ca.eov/alaw.html.
this permit is issued.
Polity If
Date
have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
sec oon 3700 of the Labor Code,for the performance of the work for which o By my signature below l 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.1 have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier L yA (6_ Q Ot, ) 2 with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#Q2( q(A22017 Expires 2�/ j / b enter the above identified property for inspection purposes.
— r
(This section need not to be completed is the permit Is for one-hundred Date
dollars"($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o l certify that in the performance of the work for which this permit is issued, a�9
Ishallnotemolov 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
kubjectto the workers compen at)on provisions of Section 3700 of the Labor
Code,Is a o with co p v th hose p visions. Will the applicant or future building occupant handle hazardous material or a
Applfcan 7 Date 7 mixture containing a hazardous material equal to or Information
that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FA RE T SECURE WORKER'S COMPENSATION COVERAGE IS oyes plNo
UNLAWFUL,AN SHALL SUBJECTAN 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,D00),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
CONSTRUCTION LENDING AGENCY o Yes 7110
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) o Yes INo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjurythatlam 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 Cade,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes No I 7Business and Professions Code).Any city or county that requires a permit to Date T
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY O E 0 ORI2 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
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.eoa.eov/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 Contractors State License Law does not apply to an owner of a o 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. o No EPA Lead-Safe Certified Firm is required for this project because:
o 1,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.
n ® e ♦ e e ♦ ♦ � � a
u [Vienifee
DATE.-11/1/2017 PERMIT/PLAN CHECK NUMBER VVITI-7-051V
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O 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 15 ROOF MOUNTED P.V. MODULES, 1 WALL MOUNTED STRING-
INVERTER, 4.5 KW, NEW 200A PANEL UPGRADE
PROJECTADDRESS 27356 PPOT/O�MAC DR. ZIP 92586
ASSESSOR'S PARCEL NUMBER ;J'.�p � ��' LOT ?29 TRACT 95011
OWNER NAME IRENE DAVIS
ADDRESS 27356 POTOMAC DR. SUN CITY, CA 92586
PHONE 951-679-8552 EMAIL
APPLICANTNAME HENRY AFFRE
ADDRESS 151 KALMUS DR. STE L-2, COSTA MESA, CA 92626
PHONE 562-682-4511 EMAIL
CONTRACTOR'S NAME PEAK POWER SOLUTIONS OWNER BUILDER? O YES 0
BUSINESS NAME
ADDRESS 151 KALMUS DR.STE L-2, COSTA MESA, CA 92626
PHONE 800-265-6357 EMAIL
CONTRACTOR'S STATE LIC NUMBER 973253 LICENSE CLASSIFICATION B
VALUATION$ 15,000.00 263 L SO FT
APPLICANT'S SIGNATURE DATE 11/1/2017
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY:
PERMIT FEE �OA ,UO I SMIP GREEN 1 e
PLAN CHECK FEE INVOICETOTAL
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZEDLETTER O YES O NO
City of Menifee Building&Safety Department 29714 Haun Rd.Menifee,CA 92586951-672-6777
www.citvoj`nienij`ee.us
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