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PMT18-03614 City of Menifee Permit No.: PMT18-03614 29714 HAUN RD. 1 t MENIFEE,CA 92586 Type: Residential Electrical MENIFEE MENIFEE Date Issued: 07/20/2018 PERMIT Site Address: 29754 HOLSTEINER WAY,MENIFEE, CA Parcel Number. 92584 Construction Cost: $6,527.00 Existing Use: Proposed Use: Description of ROOF MOUNTED SOLAR SYSTEM, 14 PANELS, 1 INVERTER,4.41 KW Work: CANVAS TR 32277-3 LOT 27 Owner Contractor PARDEE HOMES TESLA ENERGY OPERATIONS, INC. 1250 CORONA POINTE COURT,STE 210 6800 DUMBARTON CIRCLE CORONA, CA 92879 ATTENTION LICENSING Applicant Phone:6506815100 ARWEN LOTT License Number:888104 TESLA ENERGY OPERATIONS, INC. 6800 DUMBARTON CIRCLE FREMONT, CA 94555 Fee Description O_yt Amount($1 Solar, Residential or Small Commercial 1 252.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 1.00 General Plan Maintenance Fee-Electrical 1 12.60 $293.60 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 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). Chapter!)(commencing with section 7DDD)of Division 3 of the Business and o I am exempt from Iicensure under the Contractor's State License Law for Professions Code and my Ucense is in full force and effect. the following reason: License Class C/{I, License No. �YJr GG4 By my signature below I acknowledge that,except for my personal residence Expires I •'+ 1 rS' Signature /'.f,l.t in which I must have resided for at least one year prior to completion of ✓ improvements covered by this permit.I cannot legallysell a structure that I WORKER'S COMPENSATION DECLARATION 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 web0e: by Section 3700 of the Labor Code,for the performance of work for which w,wm.leeinio.c-.eov/ralaw.html. this permit is issued. Policy If Date cl have and will maintain workers compensaI con Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which D 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 owner's behalf I have read this number are: application and the information I have provided is correct.I agree to comply Carrier � �LrlLk r16L4',-,f,1h with all applicable city and county ordinances and state laws relating to - building construction.I authorize representatives of this city or county to Policy if&WS 1 G;14. ,; Expires /G'�r ' A- enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($SOO)or less PROPERTY OWNER OR AUTHORIZED AGENT D 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 4 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` lcomply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant ;i Date n mixture containing a hazardous material equal to OF greater that?he amounts specified on the Hazardous Materials Information Guide. WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ciYes sTNo 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)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY 0Yes ofNa 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) Dyes dNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that 1 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 al Safety Code,Section 25505 and 25534 concerning hazardousNI M terial reporting. checkmark(s)I have placed next to the applcable i[em(s)(Section 7031.5 DYes dN . Business and Professions Code).Any city or county that requires a permit to ') � , Date 01i'Ur Y /� construct,alter,Improve,demolish or repair any structure,prior to its PRBPEI(TY O�R OR AUTHORIZED AGENTIssuance,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[RRPI 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)orthat he or she is exempt from Iicensure 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 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 D 1,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.¢ov/lead or contact the National Lead Information Center at not intended or offered for sale,(Section 7044,Business and Professions 1-BDD-424-LEAD(5323). Code,The Contractors State License Law does not apply to an owner of a D 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. D No EPA Lead-Safe Certified Firm Is requlred 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 dp: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. �r1 BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE 07/17/2018 PERMIT/PLAN CHECK NUMBER Y — TYPE: O COMMERCIAL 4 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION %0 ELECTRICALCit9[BEM"I% O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES__Bukinq De DESCRIPTION OF WORK Install( 14 )rooftop solar panels, ( 441 ) kW 1 wall-mounted inverter PROJECTADDRESS 29754 Holsteiner Way, Menifee, CA 92584 ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME Canvas Spec Lot 27 Phase 1-1 ADDRESS 29754 Holsteiner Way Menifee, CA 92584 PHONE 5555555555 EMAIL canvasspeclot27@solarcity.com APPLICANT NAME Arwen Washbourne ADDRESS 43320 Business Park Dr. Suite B-104, Temecula, CA 92590 PHONE (951) 331-0373 EMAIL TemeculaPermits@tesla.com CONTRACTOR'S NAME OWNER BUILDER? O YES O NO BUSINESS NAME Tesla Energy Operations, Inc. ADDRESS 3055 Clearview Way San Mateo, CA 94402 PHONE 650-638-1028 EMAIL CONTRACTOR'S STATE LIC NUMBER 888104 LICENSE CLASSIFICATION B, C10,C46 VALUATION$ $ 6,527.00 SO FT L SO FT APPLICANT'S SIGNATURE A"den wasnboume DATE 07/17/2018 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION A CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN , SMIP 1 INVOICE PAID AMOUNT AMOUNT OCASH OCHECK9 0CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH OCHECK# 0 CREDIT CARD VISA/MC OWNER BUILDERVERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213