PMT17-04015 City of Menifee Permit No.: PMT17-04015
29714 HAUN RD.
�CCEL/> MENIFEE,CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 1 111 712 01 7
PERMIT
Site Address: 24872 COLDWATER CANYON TR, Parcel Number: 358-680-003
MENIFEE, CA 92584 Construction Cost: $53,955.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 33 PANELS, 1 INVERTER, 10.791 KW
Work:
Owner Contractor
ANDREW WHITECROSS SEMPER SOLARIS CONSTRUCTION INC
24872 COLDWATER CANYON TRAIL 1805 JOHN TOWERS AVENUE
MENIFEE, CA 92584 EL CAJON,CA 92020
Applicant Phone: 6197154054
ALICIA ANDREWS License Number:978152
SEMPER SOLARIS CONSTRUCTION INC
1805 JOHN TOWERS AVENUE
EL CAJON, CA 92020
Fee Description Pity. Amount(EI
Solar, Residential or Small Commercial 1 252.00
Building Permit Issuance 1 27.00
Additional Plan Review Electrical 110 110.00
GREEN FEE 1 3.00
SMIP RESIDENTIAL 1 8.00
General Plan Maintenance Fee-Electrical 1 12.60
$412.60
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 Iicensure under the Contractor's State License Law for
Professions Code and my license is in II force and effect the followingreason:
License Clas CID - (,t Ltcense No.
y my signature below I acknowledge that,except for my personal residence
Expires 0 31 (Y 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
o I hereby affirm under penalty of perjury one of the following declaration:) 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.eov/calaw.html.
Policy# Date
le
have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
tion 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.I have read this
number are: r,\ application and the information I have provided is correct.I agree to comply
Carrier q✓I�l-C `—� - I�+y with all applicable city and county ordinances and state laws relating to
cy �/� �Z 1� p O ( �� building construction.I authorize representatives of this city or county to
Pali # Vy Ex ires 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
o I certify that in the performance of the work for which this permit is issued, �f'��j G �
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# ✓ r J�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 shall forthw'h camply with those provisions Will the applicant or future building occupant handle hazardous material or a
Applicant Date S mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE W 'S COMPENSATIO OVERAGE IS Dyes q(Ivo
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($100,000I,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(SCA0MD)7 See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air
Quality
CONSTRUCTION LENDING AGENCY oYes alNa
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 �lo
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 forthe 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 oYes of(c,
Business and Professions Code).Any city or county that requires a permit to Date S /
construct,alter,improve,demolish or repair any structure,prior to its p TY OWNER OR AUT 0 -GENT
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 IRRPI
License Law(Chapter9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting RAP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensure receiving compensation far most work that disturbs paint in a preracto
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence ompensor atire facilitytobeork that
and comply With
then
Applicant fora permit subjects the applicant toacivil penalty of not more required practices.This includes rental property ownersand property
than($500]. managers who do the paint-disturbing work themselves or through their
01,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.epa.gov/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 Umnse Law does not apply to an owner of a rzAn 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 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 RAP
Acknowledgement.
BUILDING & SAFETY PERCHECK MIT/PLAN A.. •
"Menifee
DATE 11 al fl PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA 1-]SIGN
SUBTYPE: [-]ADDITION []ALTERATION ❑DEMOLITION []ELECTRICAL [-]MECHANICAL
❑NEW []PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 10- lat tW4 TXX/
PROJECTADDRESS Z`'��611' CA1lA1NK1�P- �.I�(pN 1� �
ASSESSOR'S PARCEL NUMBER �j LAW • �� LOT City 0t e
PROPERTY OWNER'S NAME
r9 V'+ VWtitll Balldnry ept.
ADDRESS 1' lv 2 (',1>1 wtm-Cff1j1 tj 'CF-, NOV 202017
PHONE 9216 (0111 O;C6 EMAIL Rece'
ved
APPLICANTNAME ALICIAANDREWS
ADDRESS 1218 SPRING ST. RIVERSIDE,CA 92507
PHONE (619)357-0383 EMAIL alicia.andrews@sempersolads.com
CONTRACTOR'S NAME SEMPER SOLARIS OWNER BUILDER? ❑YES ONO
BUSINESS NAME
ADDRESS 1805 JOHN TOWERS AVE. EL CAJON,CA 92020
PHONE (619)357-4142 EMAIL
CONTRACTOR'S STATE LIC NUMBER 978152 LICENSE CLASSIFICATION B,C10,C46,C36
VALUATION$ vo SQFT LSQFT
�APPLICANT'S SIGNATURE DATE 'L
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOIC
AMOUNT ,L90 PAIDAMOUNT
O CASH O CHECK A vCRED1T CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-6 72-5 77 7
www.cityofnIenifee.us Inspection Request Line 951-246-6213
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CITY OF MENIFEE
TRANSMITTAL
Building Division
Date: 11/13/2017
Project Location: 24872 Codwater Canyon Tr
Plan Check No.: PMT17-04015
BV Project#: 40017-039732.00
Project Description: 4.13 kw. Roof mounted solar pv system
Reviewer Date Hour Hourly
Rate Total
I"Plan Check N. Tuong 11/11/2017 1.0 $110.00 $110.00
2nd Plan Check
3rd Plan Check
4th Plan Check
Final Approval: N.Tuong 11/11/2017 1.0 1 $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:714.825.0686