PMT18-02998 City of Menifee Permit No.: PMT18-02998
29714 HAUN RD.jW
MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE MENIFEE Date Issued: 0 612 712 01 8
PERMIT
site Address: 27185 HOWARD DR, MENIFEE, CA Parcel Number: 335-313-004
92586 Construction Cost: $30,346.65
Existing Use: Proposed Use:
Description of INSTALL 7.97 KW ROOF MOUNTED PV SOLAR SYSTEM WITH 27 MODULES AND 1 INVERTER
Work:
Owner Contractor
LORRAINE NOLAN COMPLETE SOLAR INC
27185 HOWARD STREET 1850 GATEWAY DRIVE SUITE 450
MENIFEE, CA 92586 SAN MATEO, CA 94404
Applicant Phone:8772994943
COMPLETE SOLAR INC License Number:961988
1850 GATEWAY DRIVE SUITE 450
SAN MATEO, CA 94404
Phone:8772994943
Fee Description DIV Amount
Solar, Residential or Small Commercial 1 252.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 129 129.07
GREEN FEE 1 2.00
SMIP RESIDENTIAL 1 4.00
General Plan Maintenance Fee-Electrical 1 12.60
$426.67
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 staled,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 lam under provisions of with a licensed contractors)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 andp��ffpe(ct. the following reason:
License ass M ) License No. ` UL `l.V, By my signature below l acknowledge that,except for my personal residence
Expires,Signature ) in which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
a 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 website:
by Section 370D of the Labor Cade,for the performance of work for which
this permit is issued, www.le info.ca.4/ov w.html. Cam,
Policy# ( s' \ Date
❑I have and will maintain workers compensation insurance,as required by
PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Cade,for the performance of the work for which D By my signature below 1 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 owners behalf.1 have read this
numb O \ application and the information I have provided soared.I agree to comply
IL/1`L�/C, with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy ff n`1-l.]"'I Expires - Derr t/hie(aQb�o/ve id�entifie�d typr(oppeerty for inspection purposes.`
(This section need not to he completed is the permit is for one-hundred ( 9JY Date I J
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
a I certify that in the performance of the work for which this permit is issued, '
Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
worker's compensation laws of California,and agree that if Ishould become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,Ish rthwiithh c`,o, lywthth se provisions. Will the applicant or future building occupant handle hazardous material or
Applicant IG'�► \ mixture containing a hazardous material equal to orgreater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE W RKER'S[ MPENSATION COVERAGE IS Oyes o No
UNLAWFUL,AND SHALL SUBJECF AN EMPLOYERTO 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 requires permit for the construction or modification from South
IN SECTION ON TO
06 OF
LABOR CODE,INTERTION,DAMADATTOGES AS R ATTORVIDEDNEYS
FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECilON 37060E THE LABOR[ODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY a Yes D No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 3000 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 ❑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 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable items)(Section 7031.5 hpzarcdous material reporting.
Business and Professions Code).Any city or county that requires a permit to f ti/V Io1filY l \W� Date
construct,alter,improve,demolish or repair any structure,prior to its t^ ,
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(Chapter9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Cade)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.S by residence or childcare facility to be RRP-certified firms and comply with
than
Applicant fora permitSubjects[he applican[toa civil penaltyof not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code,The Contractors State License Law does not apply to an owner of a a An EPA Lead-Safe Certified Renovator will he responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that It was
not built or improved for the purpose of sale. a No EPA Lead-Safe Certified Firm is required for this project because:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a IF your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: 1 PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: 0 COMMERCIAL * RESIDENTIAL G MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL 0 MECHANICAL
O NEW O PLUMBING 0 RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK rfsr4��4/i oYl 07p 7, 1 roo-A Muudi F PV .S "r
P.
PROJECT ADDRESS 21l eS 14z)w..-d 5�� NIP111' CC G/f ZIP E16jI rD ONt•
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME 6OW4aC jvilfaA
FERN1 nn�� a //'+►
ived
ADDRESS Z'11 wAc) S`I' /�Crt:l`LG A 1i Z S 8 Pec
PHONE is I , a(70, -1 Sd 16 EMAIL �M�I rS Ga✓+�Jel c$Olu�•G UM
APPLICANT NAME C.k&a Aac(
ADDRESS 1�n 64fnjgA4 Pr , Sv, �c 41' $w/t /�twfe0 q L�, OW
PHONE C(pSO) Zoe{ . Lj33(p EMAIL erm/AsQ Con+ (efC Glw/'. GUM
CONTRACTOR'S NAME Q -. OWNER BUILDER? 0 YES ONO
BUSINESS NAME L cAr Sd1wtj6vA of 6A1J4frn '
ADDRESS /BfQ 6d ij6ce 4 i C Wf/-e 456
PHONE 6(do) Zoy- AIM a EMAIL dcooper yarn . .tarn/
CONTRACTOR'S STATE LIC NUMBER SIG I5S LICENSE CLASSIFICATION (0
VALUATION$ 3q, (hZ' SQ FT L SQ FT
APPLICANT'S SIGNATURE / " DATE
DEPARTMENT DISTRIBU7ENIA
ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNINGEERING FIRE
INVOICE TOTAL GREEN SMIP
OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER C YES 0 NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
Garr o0
www.cityofinenifee.us
MENIFEE
4