PMT18-02837 City of Menifee Permit No.: PMT18-02837
29714 HAUN RD.
/ir MENIFEE, CA 92586 Type: Commercial Re-Roof
MENIFEE MENIFEE Date Issued: 06/11/2018
PERMIT
Site Address: 26800 NEWPORT RD, MENIFEE, CA Parcel Number: 338-170-019
92584 Construction Cost: $31,500.00
Existing Use: Proposed Use:
Description of REMOVE OFF EXISTING ROOFING SYSTEM, INSTALL NEW SINGLE PLY COOL ROOF- CARLISLE
Work: SUREWELD TPO
CRRC#0628-0002
Owner Contractor
RIVER SPRINGS CHARTER SCHOOLS, INC G L ROGERS INC
43466 BUSINESS PARK DR 940 WIND DRIFT DRIVE
TEMECULA, CA 92590 CARLSBAD,CA 92011
Applicant Phone:7605211821
HOWARD BOWEN License Number:564276
G L ROGERS INC
940 WIND DRIFT DRIVE
CARLSBAD, CA 92011
Fee Description 01t v Amount t81
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 2.00
New Construction Permit Fee 1 144.90
General Plan Maintenance Fee-Building 1 4.90
General Plan Maintenance Fee-New 1 7.25
Construction
$284.05
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_BIdg_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 contracter(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 full force and effect ,) the following reason:
License Class I U e-0N � `"( By my signature below I acknowledge that,except for my personal residence
Expires 1 Signature in which I must have resided for at least one year priorto completion of
improvements covered by this permit.I cannot legally sell a structure that I
ORKER'S COMPENSATION DECLARATIO have built as an owner-builder if it has not been constructed in its entirety by
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.leeinfo.ca.eov/calaw.html.
this permit
yi/s_issued.
a /� I �1
,P Iicyp Gi-lL�i, 1�7�"1 - 0` —I Dale
PROPERTY OWNER OR AUTHORIZED AGENT
I have and will maintain worker's compensation insurance,as required by
section 3700 of the Labor Code,forthe 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
n ber are: p n ,I/' application and the information I have provided is correct.I agree to comply
Carrier ,�y,Lx �I UCH. with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Poliryp Jim, ) 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
S21 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 11
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 f i ply with these provisions'
((� ` Will the applicant or future building occupant handle hazardous material or a
A plicant � � Y � Date"[ (l I� mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
ARNING:FAILURE T SECURE WORKER'S COMPENSATION COVERAGE IS D Yes VNo
UNLAWFUL,AND LL 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 37060FTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY o Yes 'IsdNo
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) Wes o No
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 25SOS and 25534 concerning
hazardous at Ireporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es "
Business and Professions Code).Any city or county that requires a permit to
_� Dale
construct,alter,improve,demolish or repair any structure,prior to its ,PE HER 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 IRRPI
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 7032.5 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 or through their
01,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 wwsv.eua.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 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. ❑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
Cade: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 rill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION _:' MENIFEE
A
DATE: 7 ,ZO/f PERMIT/PLAN CHECK NUMBER 1 D�IT J
PLANNING CASE NUMBER
TYPE: COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING// O RE-ROOF NUMBER OF SQUARES Y
DESCRIPTION OF WORK W
PROJECTADDRESS jj �j )�7Y� /�(Q ZIP
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME,�/�/f G
ADDRESS �76(� VS,%AW:5 f'K 1)f
PHONE EMAIL
APPLICANT NAME A�]
ADDRESS —j,rj-30 Qlgf k '
PHONE EMAIL
CONTRACTOR'S NAME 7 ,' 9 OWNER BUILDER? O YES O
BUSINESS NAME 70a/�j J
ADDRESS 4 br, a
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER 5;lpe�.76 /,// LICENSE CLASSIFICATION
VALUATION$ ,�i I �� SO FT /7,0 L SO FT
APPLICANT'S SIGNATURE //�� DATE
[iiPARTMENT
DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL 0< GREEN SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES 0 NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofm en ifee.us
NIF
of Menifeei City STATE OF CALIFORNIA .. `1
SOLAR REFLECTANCE INDEX CALCULATION WORKSHIding Dept.
CEC-NRCC-ENV-03E Revised 01/16 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE JUN 11 2018 NRCC-ENV-03-E
Solar Reflectance Index Calculation Worksheet (Page 2 of 2)
Project Name: L
7—
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. 1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: I n Documentation Author Signature
CamPany:�I I �' ba 6\( l� 5' �ture Date:
Address: L Let I CEA/ ERS Certification Id ntifia on Jif applicable):
zz-
City/State p: V1 r "1) /20' Phone:
RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design
identified on this Certificate of Compliance(responsible designer).
3. The energy features and performance specifications,materials,components,and manufactured devices for the building design or system
design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the California Code of
Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement
agency for approval with this building permit application.
5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s)issued for the
building,and made available to the enforcement agency for all applicable inspections.I understand that a completed signed copy of this
Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Designer Name: Responsible Designer Signature:
Company: Date Signed:
Address: license:
City/State/Zip: Phone:
,•,y♦w,
V
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance January 2016
STATE OF CALIFORNIA
SOLAR REFLECTANCE INDEX CALCULATION WORt g9TAenifee
CEC-NRCC-ENV-03E Revised 01116 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-ENV-03-E
Solar Reflectance Index Calculation Worksheet (Page 1 of 2)
Project Name: ,JU c,,r G I"tC- y Date Prepared: 6
„-7 IT
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a
A. Product Information
01 CRRC Product ID Number OrotAoftw 0&9zq -Ow
02 Manufacturer (q�{ £
03 Brand '5(JJ!-FJA/*-Lf3 TPO
04 Model M0
05 Product Type T
06 Roof Slope IVa
B.SRI Calculations
01 Aged Reflectance Listed with CRRC Yes O No
02 CRRC Listed Aged Solar Reflectance
03 Initial Solar Reflectance
04 Calculated Aged Solar Reflectance 7
05 Thermal Emittance
C.Results
01 1 Solar Reflective Index -79.55449483
4
V '
III
CA Building Energy Efficiency Standards-2016 Nonresidential Compliance January 2016