PMT18-03216 City of Menifee Permit No.: PMT18-03216
29714 HAUN RD.
!I ' MENIFEE,CA 92586 Type: Residential Electrical
MENIFEE MENIFEE Date Issued: 0612 712 01 8
PERMIT
Site Address: 26193 BRADSHAW DR, MENIFEE, CA Parcel Number: 331-441-004
92585 Construction Cost: $12,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM, 19 PANELS, 1 INVERTER, 5.61 KW
Work:
Owner Contractor
ADDISON COLLINS NB BAKER ELECTRIC INC
26193 BRADSHAW DRIVE 2140 ENTERPRISE STREET
MENIFEE, CA 92585 ESCONDIDO, CA 92029
Applicant Phone:7605466091
RAMON LOPEZ License Number:858088
NB BAKER ELECTRIC INC
2140 ENTERPRISE STREET
ESCONDIDO, CA 92029
Fee Description Qtv Amount($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 2.00
General Plan Maintenance Fee-Electrical 1 12.60
$423.67
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
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 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 Class C/0 C'I License No. F5
By mysignature below I acknowledge that,except for my personal residence
�
Expires 1-31- 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.)cannot legally sell structure that I
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.)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 3700 of the Labor Code,for the performance of work for which
this permit is issued. wwwJeeinfo.ca.eov/calaw.html.
Policy Date
lE l 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 o By my signature below l 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 1 have provided is correct I agree to comply
Carrier C)U �Lpl 1�lI'c (-rn S 1, with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# /41,JC d385 �-6c Expires enter the above identified property for Inspection purposes.
(This section need not to he 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, z1 i j
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE B
workers compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,Ishall�o,ct/hvrith comply with those provisions. q -z Will the applicant or future building occupant handle hazardous material or
Applicant (LY / Date r'b-fir mixture containing a hazardous material equal to or greater that the
amounts spey'fled on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o yes p'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 apermit for the construction or modification from South
ADDITION SECTION
3 06 OF THE
LABOR CODE,INTERTION,DAMAGES
ST, A AND
DS Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 37060FTHE LABOR CODE,INTEREST,ANO ATTORNEYS FEES forguide11 9'
CONSTRUCTION LENDING AGENCY oYes tdNo
I hereby affirm that under the penalty of perjury here 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) oyes No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury hbt 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 25534concerning
checkmark(s)I have placed next to the applicable item(s)(Section 70315 hazardous material reporting.
2
Business and Professions Code).Any City or county that requires a permit to Was o No / Date
construct,alter,Improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUT RIZEF� DAGENT
issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of he Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP)
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 painting pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence o childcare facility most work
that
sand complypre-19th
than
Appin($50n[fora permit subjects the applicant too civil penalty of not more required practices.This includes rental property owners and property
than($SOD). managers who do the paint-dlsturbing work themselves or through heir
ol,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.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(5323).
Code;The Contractoes State License Law does not apply to an owner of a 0An 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;
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: u PERMIT/PLAN CHECK NUMBER l0
TYPE: 0 COMMERCIAL « RESIDENTIAL .' MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA C SIGN
SUBTYPE: C ADDITION O ALTERATION 0 DEMOLITION O ELECTRICAL O MECHANICAL
NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES City of enl e
DESCRIPTION OF WORK PV System - Roof Mount- No Panel Upgrade Building Dept,
Size 5.61 kW- 19 Module 1 Inverter
PROJECTADDRESS 26193 Bradshaw Dr Zip 92585
ASSESSOR'S PARCEL NUMBER 331 441 004 LOT TRACT ReceiV d
OWNER NAME Addison Collins
ADDRESS 26193 Bradshaw Dr., Menifee, CA., 92585 11
PHONE 951-973-4142 EMAIL
APPLICANT NAME Ramon Lopez
ADDRESS 2140 Enterprise St, Escondido, CA., 92029
PHONE 760-546-6022 EMAIL k,6,A0J OICARY v ' e n
CONTRACTOR'S NAME OWNER BUILDER? O YES ONO
BUSINESS NAME Baker Electric Solar
ADDRESS 2140 Enterprise St, Escondido, CA., 92029
PHONE 760-54M000 EMAIL `A'wilkes@bakerhomeenergy.com
CONTRACTOR'S STATE LIC NUMBER 858088 LICENSE CLASSIFICATION C10&C46
VALUATION$ 12,000 SQ FT L SQ FIT
APPLICANT'S SIGNATURE DATE U'2 S`J/ Y
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION - -,• CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: ,M'/-/. >
PERMIT FEE SMIP GREEN
PLAN CHECK FEE INVOICETOTAL
OWNER BUILDER VERIFIED OYES 0 NO DRIVERS LICENSE# NOTARIZED LETTER O YES NO
City of Nlenifee Building& Safety Department 29714 Houn Rd. P✓lenifee, CA 925855 951-672-6777
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