PMT18-03884 City of Menifee Permit No.: PMT18-03884
29714 HAUN RD.
Type: Residential Electrical
G MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 0 810 912 01 8
PERMIT
Site Address: 30201 CALLE POMPEI, MENIFEE, CA Parcel Number: 364-113-003
92584 Construction Cost: $14,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED 6.405 KW SOLAR,21 MODULES W1 MICRO INVERTERS AND NEW 70A
Work: SUBPANEL
Owner Contractor
MICHAEL&TRACY YOUNG JK SOLAR INC
30201 CALLE POMPEI 14176 AMARGOSA RD STE F
MENIFEE, CA 92584 VICTORVILLE,CA 92392
Applicant Phone:7602419150
JK SOLAR INC License Number.987540
14176 AMARGOSA RD STE F
VICTORVILLE, CA 92392
Phone:3233010672
Fee Description gty Amount 15)
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 carded 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).
Chapter9(commencing with section 7000)of Division 3 of the Business and O I am exempt from licensure under the Contractor's State License Law for
Professions Code T y license is in full force and effect. / /,D the following reason:
License Cla G ll it /`J License No. C`/C-L By my signature below I acknowledge that,except for my personal residence
Expires ✓ a�Signature in which 1 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
❑1 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 website:
by Section 3700 of the Labor Code,for the performance of work for which www.leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
0I have and will maintain worker's compensalfon insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which 0 By my signature below I 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 ownees behalf.I have read this
number are: application and the information I have provided is correct I agree to comply
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# Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one- undyed Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
I certify that in the performance of the work for which this permit is issued,
I shall not employ 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 I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's co nsation provisions of Section 37 00 o the abor
Code,I shall forthwith coy ply ith those provisions. ^ Will the applicant or future building occupant handle hazardous material or a
(f mixture containing a hazardous material equal to or greaterthat the
Applicant Date amounts sp ified on the Hazardous Materials Information Guide?
WARNING:FAILUR O U WORKER'S COMPENSATION C ERAGE IS 0 Yes 000
UNLAWFUL,AND SHALL SQIJFXT 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 for guide�inrTls
CONSTRUCTION LENDING AGENCY aYes =0
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 boun ary of a school?
(Section 3097 Civil Code) 0 Yes o
OWNER BUILDER DECLARATIONS 1 have rea the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the have
ttm the
I understand my requirements under the State of
Contractols License Law for the reason(s)indicated below by the Calif.-" mate al Safety Code,Section 25505 and 25534 concerning
hazardou material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 'Yes o
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT
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 Contractor's 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)or that 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 7031.5 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
in 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.aov/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 Contractor's State License Law does not apply to an owner of a a 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. 0 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 Contractoes 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: PERMIT/PLAN CHECK NUMBER Q - V
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: O COMMERCIAL V<ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION 0 ELECTRICAL OMECHANICAL
O NEW O PLUJMBIBING 0 RE-ROOF NUMBER OF SQUARES /
DESCRIPTION OF WORK 6-D O� (/ d
2-I S 7
OCCUPANCY GROUP r2 CONSTRUCTION TYPE SPRINKLERS O YES O NO
PROJECT ADDRESS ?>�L�-' ( I3 d�3 ZIP S
ASSESSOR'S PARCEL NUMBER LOT TRACT
e
OWNER NAME
ADDRESS Cl �C� wl P^ r
PHONE / O _ `( l- -( /��D EMAIL
APPLICANT NAME r I l__
ADDRESS
2 ✓/� VI ✓`t j
PHONE ✓�7 �0��7�_ EMAIL
9
CONTRACTOR'S NAME OWNER BUILDER? 0 YES
BUSINESS NAME
ADDRESS --7
PHONE � /j ����-- ! 0f EMAIL �y,
CONTRACTOR'S STATE LIC NUMBER p !-7 S q O LICENSE CLASSIFICATION 0
VALUATION$ l I/00® SQ FT '-;�L- L SQ FT I
APPLICANT'S SIGNATURE DATE g/
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED : (�F:1 CI F MENIFEE BUSINESS{ICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE PLO
INVOICE TOTAL GREEN SMIP
OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER O YES 0 NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofinenifee.us
ENIFE