PMT18-03156 City of Menifee Permit No.: PMT18-03156
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE MENIFEE Date Issued: 06/28/2018
PERMIT
Site Address: 29724 BERFA RD, MENIFEE,CA 92584 Parcel Number: 339-284-014
Construction Cost: $24,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR PV SYSTEM 33 PANELS, 1 INVERTER, 10.065kW, REQUIRES
Work: 200AMP MAIN SERVICE UPGRADE
Owner Contractor
BRAD DALEY RAYKERINC
29724 BEREA RD 3130 WILSHIRE BLVD SUITE 200
MENIFEE,CA 92584 SANTA MONICA,CA 90403
Applicant Phone:3104777686
AUSTIN CARRY License Number: 1018241
RAYKERINC
3130 WILSHIRE BLVD SUITE 200
SANTA MONICA,CA 90403
Fee Description QQt Amount f51
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 Marilee.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_Perrnit_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 a 1 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 Class License No. /04-
By my signature below I acknowledge that,except for my personal residence
Expires Q Signaturef 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
' 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 workers 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for
by Section 3700 of the Labor Code,for the performance of work for which this application is submitted or at the fallowing website:
this permit is issued.
www.leginfo.ca.eov/calaw html.
Policy# Date
I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
IsecRan 37GO 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 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 C' 7YJf�',"� with all applicable city and county ordinances and state laws relating to
//���L,*/y ] building construction.I authorize representatives of this city or county to
Policy# 7 Vf3(0 Expires YQZ9IL� 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 AG ENT
❑I 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#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant/��— �pate �//Jy7//t7 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 ❑Yes )tT'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($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)7 See permitting checklist
IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES far guideli es
CONSTRUCTION LENDING AGENCY ❑Yes No
I hereby affirm that under the penalty of perjury there is a construction Will the p oposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outerbou daryofaschool7
(Section 3097 Civil Code) o Yes XJo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item hazardous material reporting.$)(Section 7031.5 ,�ctamy _
Business and Professions Code).Any city or county that requires a permit to 79-s �,
construct,alter,improve,demolish or repair any structure,prior to its ppTy OWNER OR AU i0R�D AGSM Date
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 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 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 byan residence or childcare facility to he RRP-certified firms and comply with
than($500).Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than
managers who do the paint-disturbing work themselves or through their
O 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 1-800424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a
property who,through employees'or personal effort,builds or improves the o An EPA Lead-Safe Certified Renovator will be responsible for this project
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:
❑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 notcomply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
�•
DATE: 619-V18 PERMIT/PLAN CHECK NUMBER
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: 000MMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME -- POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
ANEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK 10.o K W
3 LU 1 V in GL a
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS OYES XNO
PROIECTADDRESS gJR,p ZIP o2
ASSESSOR'S PARCEL NUMBER 3 ��'O�'f'"lll '7 LOT TRACT
OWNER NAME JRrad DAM
ADDRESS 29JAq erQ
PHONE �j p`tl.��p» �69y EMAIL
APPLICANT NAME
ADDRESS (a!{ / 'd(Jd
PHONE yd9-8d9 EMAIL , ,Cgyr,
CONTRACTOR'S NAME 5 reen6P ir6 OWNER BUILDER? O YES NO
BUSINESS NAME Jr• re8r1 P,
ADDRESS ELI L/ ICGL *90
PHONE •?Id LC/j�k -7C86 EMAIL AL&h.LU
CONTRACTOR'S STATE LIC NUMBER /01 Q(1// LICENSE CLASSIFICATION
;tyaao.or,
VALUATION$ SQ FT L SO FT
APPLICANT'S SIGNATURE _— DATE 610,5/l8
TYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL I g j6.(V0 GREEN SMIP
OWNER BUILDER VERIFIED O YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofmenifee.us
r
i ENIFE
ov0
RAYKER INC
DBA GREENSPIRE CONSTRUCTION
Contractor's License 1018241
2/16/2018
To all agents of jurisdictions for the purposes of permitting construction:
KENNETH GARY GIETZ (California License 1018241) hereby authorizes the following
employees of Greenspire Construction, to submit, receive, and pay for permits:
Austin Carry
City of Menifee
Building Dept.
Cordi JUN 2 8 2018
Received
KEN ETH GARY IET nse Holder
A notary public or other officer completing this
certificate verifes only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
r A
County o! �3 tF c t,P& �
On before me, \!v/yileA ► Z
(insert name and title of the ofncer)
personally appeared 1`` C/ar— 14Z,
who proved to me on the basis of satists tory evidence to be the person(s)whose name(s) islare
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
D;'tLu:N GAS"GIE:is
2079040
WITNESS m hand and official seal.
Y
_.-. ,rani.:,._. ... ... ..,.
Signature (Seal) N
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