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PMT17-04308 City of Menifee Permit No.: PMT17-04308 29714 HAUN RD. Type: Residential Electrical <A-CCEL/-> MENIFEE, CA 92586 MENIFEE Date Issued: 1 2/1 512 01 7 PERMIT Site Address: 28219 MILLSTREAM CT, MENIFEE, CA Parcel Number: 333-612-007 92584 Construction Cost: $32,257.00 Existing Use: Proposed Use: Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 24 MODULES, 1 INVERTER,24 OPTIMIZERS, Work: 8.64KW Owner Contractor JACQUELYN LINDSEY N B BAKER ELECTRIC INC 28219 MILLSTREAM CT 2140 ENTERPRISE STREET MENIFEE, CA 92584 ESCONDIDO,CA 92029 Applicant Phone:7605466000 RAMON LOPEZ License Number:858088 N B BAKER ELECTRIC INC 2140 ENTERPRISE STREET ESCONDIDO, CA 92029 Fee Description CityAmount lSl Solar, Residential or Small Commercial 1 252.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 110 110.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 5.00 General Plan Maintenance Fee-Electrical 1 12.60 $408.60 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing builiding operations being carried an thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA_Bldg_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that 1 am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect the following reason: License Class C-10 '�_ Cc­lC License No. � �$U�� By my signature below l acknowledge that,except for my personal residence Expires y'3 L 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 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 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 fallowing 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. Policy# Date --p I 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: 11 ` application and the information I have provided is correct I agree to comply Carrier U�d �-n.. b�=c (-vzS �-o wfth all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# Y(wG '389 �-A Expires 3 enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($300)or less Date PROPERTY OWNER OR AUTHORIZED AGENT tt o I certify that in the performance of the work for which this permit is issued, m�Gy 1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE p CJ ........CC)) 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 shallorth ith comply with those provisions. 4 Will the applicant or future building occupant handle hazardous material or Applicant O`""1/ Date r'6' mixture containing a hazardous material equal to or greater that the amounts speyfled on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes p'No 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($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Aft Quality Management District coct(SCtionor See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast AirlQ CONSTRUCTION LENDING AGENCY oyes UNo 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 bou0dary of a school? (Section 3097 Civil Code) 0 tYNo 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 checkmark(s)I have placed next to the applicable item(s)(Section 70315 Dyes material reporting. . Business and Professions Code).Any city or county that requires a permit to ores o No �y�/ Date construct,also requires the forth permiany t tofile,prior signed to PROPERTY OWNER OR AUT RIZED 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 IRRP) 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 orthrough 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 7D44,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 responsiblefor 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 RRP Acknowledgement. SAFETY . . CHECK APPLICATION ,`Menifee DATE 12/04/2017 PERMIT/PLAN CHECK NUMBER -0 30"Z/ TYPE: ❑COMMERCIAL [Z RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME POOL/SPA ❑SIGN SUBTYPE: ❑✓ ADDITION ❑ALTERATION [-]DEMOLITION ❑ELECTRICAL [-]MECHANICAL ❑NEW ❑PLUMBING FIRE-ROOF-NUMBEROFSQUARES DESCRIPTION OF WORK Photovoltaic Rooftop 8.64kW PROJECT ADDRESS 28219 Millstream Ct Menifee CA 92584 ASSESSOR'S PARCEL NUMBER 333-612-007 LOT _ (9 TRACT PROPERTY OWNER'S NAME Jacquelyn Lindsey ADDRESS 28219 Millstream Ct Menifee CA 92584 PHONE (909)786-5328 EMAIL doccogergo@aol.com APPLICANT NAME Ramon Lopez ADDRESS 2140 Enterprise St,Escondido,CA 92029 8+9- PHONE (760) S yb-6 a S -31 EMAIL I*mW@BakerElectricSolaccom CONTRACTOR'S NAME Ted Baker OWNER BUILDER? ❑YESONO BUSINESSNAME Baker Electric Solar ADDRESS 2140 Enterprise St,Escondido,CA 92029 PHONE (760).546-6000 EMAIL CONTRACTOR'S STATE LIC NUMBER 858088 LICENSE CLASSIFICATION C10&C46 VALUATION$ $32,257.00 SO FT L SO FT z APPLICANT'S SIGNATURE - c, DATE /Z- L/ / DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP J INVOICE PAID AMOUNT AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-677 7 www.cityofinenifee.us Inspection Request Line 951-246-6213 �pU VF9 4 � � a 0 y r82a CITY OF MENIFEE TRANSMITTAL Building Division Date: 12/14/2017 Project Location: 28219 Millstream Ct Plan Check No.: PMT17-04308 BV Project#: 40017-039799.00 Project Description: Residential Rooftop Solar Panels w/Micro Inverters—8.64kW Reviewer Date Hour Hourly Rate Total 15t Plan Check R. Banowetz 12/14/2017 1.0 $110.00 $110.00 2nd Plan Check 3rd Plan Check 4th Plan Check Final Approval: R. Banowetz 1 12/14/2017 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