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PMT18-02855 City of Menifee Permit No.: PMT18-02855 29714 HAUN RD. Type: Residential Electrical Aq/4 MENIFEE,CA 92586 MENIFEE MENIFEE Date Issued: 0611412018 PERMIT Site Address: 28143 HIGHWOOD CT, MENIFEE, CA Parcel Number: 340-380-033 92584 construction Cost: $25,000.00 Existing Use: Proposed Use: Description of INSTALL ROOF MOUNTED SOLAR SYSTEM WITH 28 MODULES AND 28 MICROINVERTERS,8.12 Work: KW Owner Contractor WILLIAM BROWN CALIFORNIA SOLAR SYSTEMS INC 28143 HIGHWOOD COURT 1400 N BURTON PLACE MENIFEE,CA 92584 ANAHEIM,CA 92806 Applicant Phone:8552276527 CALIFORNIA SOLAR SYSTEMS INC License Number:920108 1400 N BURTON PLACE ANAHEIM,CA 92806 Phone:8552276527 Fee Description Qty Amount f$1 Solar, Residential or Small Commercial 1 252.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 129 129.07 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee- Electrical 1 12.60 $425.67 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.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). 1 hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and O 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 Cla — �� License No. D By my signature below I acknowledge that,except for my personal residence Expires 3 l � O Signature in which 1 must have resided for at least one year prior to completion of WORKER'S COMPENSATION N improvements covered by this permit.I cannot legally sell a structure that I RAFI c--- 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 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 following webslte: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. wwvj.leeinfo.ca.eov/calaw.html. Policy# Date a 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 a By my signature below 1 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: application and the information I have provided is correct.I agree to comply Carrier 'r� Cy(d 6�c with all applicable city and county ordinances and state laws relating to y building construction.I authorize representatives of this city or county to Policy WELDErC R060243�t Expires 7 al )� 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 D I certify that in the performance of the work for which this permit is issued, shall not emolov any persons In any manner so as to become subject to the CITY BUSINESS LICENSE if workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation rovis' o ection 3700 of the Labor Code,I shall fo h-Cdzn lywi o rov"• ns. // Will the applicant or future building occupant handle hazardous material or a Applica " Date CCU S( mixture containing a hazardous material equal to or greater that the amounts specified an the Hazardous Materials Information Guide? WARN N_FA1 TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes8�' U W AND SHALLSUB1ECi AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant orfuture building A CIVIL FINES UP TO ONE HUNOREDTHOUSAND 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 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guideli�e/s CONSTRUCTION LENDING AGENCY DYes X1 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) D Yes 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 Rem(s)(Section 7032.5 hazardous ma vial reporting. Business and Professions Code).Any city or county that requires a permit to ayes construct,alter,improve,demolish or repair any structure,prior to its Date 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 fRRPI 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 apre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facilitytoheork that disturbs and comply With than 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 ❑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 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. a No EPA Lead-Safe Certified Firm is required for this project because: a 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 rill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE Ail - - /-•� -- - __ _ .`--- DATE: )) (>I PERMIT/PLAN CHECK NUMBER v�Ow PLANNING CASE NUMBER TYPE: O COMMERCIAL t61RESIDENTIAL 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 C� DESCRIPTION OF WORK n• - v OV-VI}•P6i t� SL14,✓ U• la Kw r1 ;-VW . U /udc `t-o pXA L4 IXA s>� PROJECTADDRESS /� �urtll,;?� - ,�t��'f1� �2}' ZIP ` jpu ASSESSOR'S PARCEL NUMBER -•i"L d �.J v�J LOT TRACT ��"� City of en ft OWNER NAME LW; tp•v1 rp;,J�. Building De t. ADDRESS �Sp-',O I Y((/?GL'r� C ('� PHONE La(r, EMAIL APPLICANT NAME ✓t LX/'i^ Receiiv� ADDRESS )L wo il, e .i11 PHONE 'J I L{ IJ U'7 -, R 9 EMAIL j'QCCit Pf vl_t S ^ • LGc CONTRACTOR'S NAME G, -;-x d 4 v S "fiNER BUILDER? O YES4NO BUSINESS NAME/ ADDRESS I I.oo �q-C I✓v PHONE 6-^1 EMAIL OC,-J erYn S CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION I0 VALUATION$-" S j e'6 t' SQ FT // L SO FT APPLICANT'S SIGNATURE-.-------)---..- d C7 DATE V` Il1 1 r Q CITY STAFF USE ONL� DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER �( BUILDING PLANNING ENGIN RING FIRE w c):LL>C:T OpU Ll INVOICETOTAL PsarvaE GREEN SMIP OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE k NOTARIZED LETTER O YES O NO City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofmenifee.us NIF e�