PMT18-02740 City of Menifee Permit No.: PMT18-02740
29714 HAUN RD. Type: Residential Electrical
MENIFEE,CA 92586
MENIFEE MENIFEE Date Issued: 0 6/0 512 01 8
PERMIT
Site Address: 26151 PINEVALLEY, MENIFEE,CA 92584 Parcel Number: 337-022-007
Construction Cost: $1,500.00
Existing Use: Proposed Use::
Description of DERATE MAIN PANEL TO 100A
Work:
Owner Contractor
MARY WESTBROOK COMPLETE SOLAR INC
26151 PINE VALLEY RD 1850 GATEWAY DRIVE SUITE 450
SAN MATEO,CA 94404
Applicant Phone:8772994943
AUSTIN VAN SANT License Number:961988
1850 GATEWAY DRIVE SUITE 450
SAN MATEO,CA 94404
Fee Description QtV Amount fSl
Services,Switchboards,Control Centers&Panels 1 116.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Electrical 1 5.80
$149.80
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.rpl 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 ❑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 0 Lice se W. .q1KI By m signature below I acknowledge that,except for m y g g p y personal residence
Expires Signature in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
D 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 this application is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which www.leginfo.ca.gov/calaw.htmi.
this permit is issued.
PoliryN � / �;QC, Date
D I 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 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 carder and policy owner or authorized to act on the property owne(s behalf.I have read this
number are/:' application and the information I have provided is correct.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy N /�j / �{�Expires 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
certify that in the performance of the work for which this permit is issued,
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE p
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
Cade,I shall forthwit /arp/ply w/iti th/aass revisions. /— Will the applicant or future building occupant handle hazardous material or a
Applicant Z4 Date �`7 —lit mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS O Yes '�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
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(SCAQMD)?See permitting checklist
forguidelines
CONSTRUCTION LENDING AGENCY ❑Yes <No
I hereby affirm that under the penalty of perjury there is a construction WIII 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) D Yes XNo
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
Contractor's 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 7031.5 hazardous mat al eporti /
Business and Professions Code).Any city or county that requires a permit to oyt�N �� Date
construct,alter,improve,demolish or repair any structure,prior to its RP OPERTY OWNER OR AUTHORIZED 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(RRPI
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 RAP-certified firms and comply with
an Appliont for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($S00), managers who do the paint-disturbing work themselves or through their
❑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.ena.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(5373).
Code;The Contractor's 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
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:
❑1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Cade:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA ARP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER Z
PLANNING CASE NUMBER
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: OADDITION O ALTERATION O DEMOLITION 94LECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK k r J0
PROJECTADDRESS ��/�/ /�i.,g /�� //y Rr] ZIP n72S�
ASSESSOR'S PARCEL NUMBER 1� LOT TRACT
OWNER NAME Mc r &A? /�br k
ADDRESS 9 6 1 '�-1 Pie2PQ
PHONE EMAIL
APPLICANT NAME
ADDRESS ;Z ,C /lel
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? 0 YES NO
BUSINESS NAME ^ /Jrl
ADDRESS G �.a C Vo �e e +'
PHONE 19 77, 2 r9 c( — yr9L/ EMAIL
CONTRACTOR'S STATE LIC NUMBER 141 q es LICENSE CLASSIFICATION
VALUATION$ / SW SO FT LSQFT r /'
APPLICANT'S SIGNATURE, L/ DATE i�ff
UTYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: �J,]�
CITY OF MENIFEE BU51NE55 LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE C-
INVOICETOTAL L4q. (� 7 GREEN I SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# t NOTARIZED LETTER '.DYES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofmenifee.us
BNI)
JK log A �It
JK Solar Inc.
15330 Anacapa Rd.,#2
Victorville, CA 92392
June 5,2018
City of Menifee
RE: Mary& Brian Westbrook
26151 Pine Valley
Menifee
Austin Van Sant has permission to pick up all documents associated with the solar permit.
Kind regards,
Jeremy Kanning
President
:Is