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PMT18-01731 City of Menifee Permit No.: PMT18-01731 29714 HAUN RD. Type: Residential Electrical <A—CCF-ILl7 MENIFEE, CA 92586 MENIFEE Date Issued: 04/19/2018 PERMIT Site Address: 30072 LEEWARD CT, MENIFEE,CA Parcel Number: 92584 Construction Cost: $3,730.00 Existing Use: Proposed Use: Description of INSTALL ROOF MOUNTED SOLAR SYSTEM,8 PANELS, 1 INVERTER,2.52 KW Work: REFLECTIONS TR 37161 LOT 22 Owner Contractor PULTE GROUP TESLA ENERGY OPERATIONS, INC. 27101 PUERTA REAL,#300 3055 CLEARVIEW WAY MISSION VIEJO, CA 92691 ATTN ZOE STEELE Applicant Phone:6509635100 ARWEN LOTT License Number:888104 TESLA ENERGY OPERATIONS, INC. 3055 CLEARVIEW WAY SAN MATEO, CA 94402 Fee Description Pt( Amount(S) Solar, Residential or Small Commercial 1 252.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 1.00 General Plan Maintenance Fee-Electrical 1 12.60 $293.60 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. it it 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). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. (� the following reason: License Class i �� f r L)(� � Lcense No. � v I _-. - � +� ------------By-mysignature-below-I acknowledge that,-except-for-my persona l residence - Expiresi 1 Signature -( in which I must have resided for at least one year priorto completion of improvements covered by this permit.I cannot legallysell 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 for worker's 7044 of the Business and Professions Code,is available updn 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.lesinfo.ca.eov/calaw.html. this permit is issued. Policy ft Date ,"A have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which ❑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 with all applicable city and county ordinances and state laws relating to Carrier ``/n'1 ,^`tom I am rr� building construction.I authorize representatives of this city or county to Policy 4 NN W -2 L, 'Qx�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 ertffy that in the performance of the work for which this permit is issued, V��-q( shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE ff ^ worker's compensation laws of California,and agree that if I should become I HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 c the Labor IL) Code,,s II forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a — — mixture containing a hazardous material equal to or greater that the Applican J Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes bib 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 Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 370G OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes r0 1 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 `p 0 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for thea reason(s)indicated below by the hazardous material reporting. h hazardous 9Jo checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Business and Professions Code).Any city or county that requires a permit to 1c 0 A Date construct,alter,improve,demolish or repair any structure,prior to its pER OW R Oft-AOUTPICRIZED 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 Contractor's 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 orthrough their ❑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.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 Contractor's State License Law does not apply to an owner of a ❑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: safe.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. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑I,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 9 Acknowledgement. 9,_?1n ' g!sv �� j BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Q-6-P Menifee DATE 04/17/2018 PERMIT/PLAN CHECK NUMBER - CA-IN TYPE: COMMERCIAL ✓% RESIDENTIAL 0 MULTI-FAMILY <' MOBILE HOME 0 POOL/ ifee SUBTYPE: 0 ADDITION ALTERATION DEMOLITION ./' ELECTRICAL MECH94MiIg Dept. NEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Install( 8 )rooftop solar panels, ( 2.52 ) kW, 1 inverter Rang; PROJECTADDRESS 30072 Leeward Court, Menifee, CA 92584 ASSESSOR'S PARCEL NUMBER LOT qGI- TRACT lQ OWNER NAME Reflections Spec Lot 22 ADDRESS 30072 Leeward Court Menifee, CA 92584 PHONE EMAIL reflectionsspeclot22@solarcity.com APPLICANT NAME Arwen Lott ADDRESS 43320 Business Park Dr. Suite B-104, Temecula, CA 92590 PHONE (951) 331-0373 EMAIL Temecula Permits@tesla.com CONTRACTOR'S NAME OWNER BUILDER? ti:YES %NO BUSINESS NAME Tesla Energy Operations, Inc. ADDRESS 3055 Clearview Way San Mateo, CA 94402 PHONE 650-638-1028 EMAIL CONTRACTOR'S STATE LIC NUMBER 888104 LICENSE CLASSIFICATION B, C10, C46 VALUATION$ $ 3,730.00 SQ FT L SQ FT APPLICANT'S SIGNATURE DATE 04/17/2018 AfM4aY� DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE Qn O PAID AMOUNT AMOUNT CASH 0 CHECK# ?CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT "CASH ti`CHECK# %CREDIT CARD VISA/MC OWNER BUILDER VERIFIED YES NO DL NUMBER NOTARIZED LETTER 1) YES NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-572-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 I