PMT17-04017 City of Menifee Permit No.: PMT17-04017
29714 Type: Residential Electrical
�CCELn? MENIFEE,EE, C CA 92 92586
MENIFEE Date Issued:
11/17I2017
PERMIT
Site Address: 29412 BOURIS DR, MENIFEE, CA 92584 Parcel Number: 364310-064
Construction Cost: $34,350.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM,21 PANELS,21 MICROINVERTERS, 6.867 KW
Work:
Owner Contractor
ALDO HERNANDEZ SEMPER SOLARIS CONSTRUCTION INC
29412 BOURIS DRIVE 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 PA Amount f$1
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 5.00
General Plan Maintenance Fee-Electrical 1 12.60
$408.60
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_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
1 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 o I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in Nil force and effect. the followingreason.
License Clas Gl� (,E License No. 135-7 By my signature below I acknowledge that,except for my personal residence
Expires o 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 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
by Section 3700 of the Labor Code,for the performance of work for which this application is submitted or at the following website:
this permit is issued. www.leeinfo.ca.gov/calaw.html.
Policy# Date
I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
sdWion 3700 of the Labor Code,for the performance of the work for which o By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's 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
Carrie' �Ivl'T �� - �p with all applicable city and county ordinances and state laws relating to
��,,tt((��77 qL� building construction.l authorize representatives of this city or county to
Policy# 'Ia �7i17 Expires d (O �� 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
o I certify that in the performance of the work for which this permit is issued, c
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# Q�J 9't>
worker's 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,I shall forthw h comply 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 thatthe
amounts
��''sp!ttt�e'cified an the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WO 'S COMPENSATIO OVERAGE IS cz Yes ypv0
UNLAWFUL,AND SHALL SULUECTAN EMPLOYER TO CRIMINAL PENALTIES ,A
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($300,000),IN Will the intended use of the building by the applicant or future building
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQM D)?See permitting checklist
forguideell as
CONSTRUCf1ON LENDING AGENCY 0Yes AVJa
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 �fio
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Gutdeand 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
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to ciYes aPr
construct,alter,improve,demolish or repair any structure,prior to its Date S
Issuance,also requires the applicant for the permit to fileasigned statement P TY OWNER OR AUT 0 GENT
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978
an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with
than($500), required practices.This includes rental property ownersand property
managers who do the paint-disturbing work themselves or through their
cz 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work and the structure is www.epa.eov/lead or contact the National Lead Information Center at
not Intended or offered for sale.(Section 7044,Business and Professions 1-800.424-LEAD(5323).
Code,The Contractors State License Law does not apply to an owner of a
o An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort builds or improves the p p /
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of
completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.:
not built or improved for the purpose of sale. D No EPA Lead-Safe Certified Firm is required for this project bemuse:
cz 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETYPERMIT/PLAN CHECK
♦ • 1 APPLICATION
McNfee
DATE 16111 1 PERMIT/PLAN CHECK NUMBER •�61,
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL MULTI-FAMILY ❑MOBILEHOME POOL/SPA []SIGN
SUBTYPE: ❑ADDITION []ALTERATION ❑DEMOLITION [-]ELECTRICAL [:]MECHANICAL
[:]NEW d [:]PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK UT.��II VW DO; 2l
PROJECTADDRESS 2CJ 2 'S0
ASSESSOR'S PARCEL NUMBER 2U!I - Alt) 15WL4 LOT My gWpnifee
N
PROPERTY OWNER'S NAME bPO BulWing Dept.
ADDRESS 2.1114I2, Y*U'wtS z NOV 0 8 2017
PHONE 'N'WV Zj';- I'1$Ia EMAIL °
APPLICANT NAME ALICIA ANDREWS
ADDRESS 1218 SPRING ST. RIVERSIDE,CA 92507
PHONE (619)357-0383 EMAIL alicia.andrews@sempersolaris.com
CONTRACTOR'S NAME SEMPER SOLARIS OWNER BUILDER? ❑YES❑✓NO
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$ 135-p•eo SQ FT L SO FT
APPLICANT'S SIGNATURE �� DATE II 311-1
DEPARTMENT DISTRIBUTION' CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP ✓
INVOICE � PAID AMOUNT
AMOUNT 01-1 (/' 0CASH OCHECKN OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-6 72-6 777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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CITY OF MENIFEE
TRANSMITTAL
Building Division
Date: 11/13/17
Project Location: 29412 Bouris Dr
Plan Check No.: PMT17-04017
BV Project#: 40017-039733.00
Project Description: PV Solar—6.867 kw roof mounted pv system
Reviewer Date Hour Hourly
Rate Total
1't Plan Check N Tuong 11/11/2017 1.0 $110.00 $110.00
2Id Plan Check
3rd Plan Check
4th Plan Check
Final Approval: N.Tuong 11/11/2017 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