PMT18-00452 City of Menifee Permit No.: PMT18-00462
29714 HAUN RD. Type: Residential Electrical
4;kCCEL1 MENIFEE, CA 92586
MENIFEE Date Issued: 0310212018
PERMIT
Site Address: 30668 STAGE COACH RD, MENIFEE, CA Parcel Number: 358-450-032
92584 construction Cost: $27,600.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 23 PANELS, 1 INVERTER,6.79 KW
Work:
Owner Contractor
WALTER ALDRICH PETERSEN-DEAN INC
30668 STAGE COACH ROAD 39300 CIVIC CENTER DRIVE
MENIFEE, CA 92584 FREMONT, CA 94538
Applicant Phone:5103716500
ASIA THOMAS License Number:468117
PETERSEN-DEAN INC
39300 CIVIC CENTER DRIVE
FREMONT,CA 94538
Fee Description f3yt Amount($)
Solar, Residential or Small Commercial 1 252.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 129 129.07
Additional Plan Review Electrical 158 157.50
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Electrical 1 12.60
$584.17
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 Marilee.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
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).
Chapters(commencing with section 7000)of Division 3 of the Business and 01 am exempt from licensure under the Contractor's State License Law for
Professions Coded Iny If icense is in full force and effect. -7 the following reason:
License Class UN( 4 License No. ��u�� /
Expires '�� l /; BY my signature below l acknowledge that,except formy personal residence
P Signature (./[.a-Cll in which I must have resided for at least one year pdorto completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I
(3 I hereby affirm under penalty of perjury one of the following declaretions:l have built as an owner-builder if it has not been constructed in its entirety by
licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure forworkers 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. t� www.leginfa ca eov/slaw html.
Date
s-1 have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
/ection 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 aa"re.,., application and the information I have provided is correct.I agree to comply
Carrier .Y/ . �\.11�� with all applicable city and county ordinances and stale laws relating to
building construction.I authorize representatives of this city or county to
Policy# 0-s V Expires '71 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
01 certify that in the performance of the work for which this permit is Issued, PROPERTY OWNER OR AUTHORIZED AGENT
Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#0 qs5
workers compensation laws of California,and agree that if I should become
subject to the workers compensation provisions of Section 3700 of the Labor HAZARDOUS MATERIAL DECLARATION
Code,I shall ith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant L�, l Y l Vy�� Date- `1 L-1 ' I q) mixture containing a hazardous material equal to or greater that the
amou
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS cz Yes ntt Noified on the Hazardous Materials Information Guide?
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),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 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
for guideJlines
CONSTRUCTION LENDING AGENCY ❑Yes �GNo
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) ❑yes IND
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 next to the applicable items)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to oYes �No I L+
construct,alter,improve,demolish or repair any structure,prior to its —Date U
Issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER OR AUTHORIZED AGENT
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
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 owners and property
_ 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
property who,through employees'or personal effort,builds or improves the o An EPA Lead-Safe Certified Renovator will be responsible for this project
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. 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.
A 5r.eu —%o rY 5-
0v
City Menefee
Building Dept.
DPETERSEN�DEAjN FEB 28 2018
ReceivGd°ary28, 2018
To Whom It May Concern:
I, Michael Clifton, certify that I am licensed as a contractor by the State of California
(License#t468117) expires 01/31/2019. I hereby authorize the following individual
Asia Thomas ,'to sign on my behalf for obtaining permits, obtaining refunds, as well as
obtaining business licenses. As the contractor, I understand that I am responsible to comply
with all applicable State laws and regulations regarding the permit when issued.
Homeowner Walter Aldrich
Permit Number PMT18 00452
Project Address: 30668 Stage Coach
Description During install homeowner requested that equipment be placed in garage.
Michael Clifton—RME Officer