PMT18-04347 City of Menifee Permit No.: PMT18-04347
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE MENIFEE Date Issued: 0910 712 01 8
PERMIT
Site Address: 29850 CORTE CRUZADA, MENIFEE, CA Parcel Number: 340-083-015
92584 Construction Cost: $12,000.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR SYSTEM WITH 18 PANELS, 1 INVERTER, 5.49 KW
Work:
Owner Contractor
JEREMIAH ZAPATIER RAYKER INC
29850 CORTE CRUZADA 3130 WILSHIRE BLVD STE 200
MENIFEE,CA 92584 SANTA MONICA, CA 90403
Applicant Phone: 3104777686
RAYKER INC License Number: 1018241
3130 WILSHIRE BLVD STE 200
SANTA MONICA, CA 90403
Phone: 3104777686
Fee Description Div 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
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 and mylicense Is In full force and effect. the following reason:
License Class C-1 License No. By my signature below I acknowledge that,except for my personal residence
Expires AA l UP) Signature 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 or perjury one of the fallowing 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 or work for which w,ww.leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
o I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 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 worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
numberare: application and the information I have provided Is correct.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
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-hundred
dollars($SOD)or less Date
PROPERTY OWN ER OR AUTHORIZED AGENT
J)"Lcertlfy 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 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
Applicant47� Date �� mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNI :FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes 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 applicant
ant orifuti re 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 guidelines
CONSTRUCTION LENDING AGENCY o Yes &
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 bo dary of a school?
(Section 3097 Civil Code) - ❑Yes 7No
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
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es ❑N / �y
Business and Professions Code).Any city or county that requires a permit to ! -n�— � Date
construct,alter,improve,demolish or repair any structure,prior to its 46WRTY OWNER OR UTH IZED 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(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 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($500), managers who do the paint-disturbing work themselves or through their
O I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.epaRov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 71344,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.if,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
❑I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: q/y 1I8 PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O.COMMERCIAL gCRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION W ELECTRICAL O MECHANICAL
ONEW OPLUMBING�_ORE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK 5-M (Q Kcj rad rymrlw 6clAr Sy$
18 40e-IS nv
PROIECFADDRESS A9D5_n (e6C4,e_ (t-,j ZIP-Aj In
y
ASSESSOR'S PARCEL NUMBER JytJ 'V`D 3'Off LOT TRACT
OWNER NAME erefi h I r
(,IyO
ADDRESS ajg Sn td-4,e, C ti IrkG in Dept.
PHONE 7&6 _ 6'kI+ 6;719y EMAIL �g
APPLICANT NAME ) j grafel
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ADDRESS C../III �✓ (q/J �+
PHONE qdy 1*047 94+�9'j EMAIL AOro4h. e"Aoy 49.
CONTRACTOR'S NAME rCe / OWNER BUILDER? O YES AO
BUSINESS NAME r,0_,er)L59jY'
ADDRESS W115LI I'1"L 13(U4 6c04h. b0i CA fc�413
PHONE /cj q�FF -Z/p�.p EMAIL US (A. teen Q1c.
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ Ian 00CJ 0U' SO FT L SQ FT APPLICANT'S SIGNATURE DATE qlq 11eq
DEPARTMENT DISTRIBUTION ACCEPTED BYPLQ CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE "/'� �1
INVOICE TOTAL 2-/lL�' (QO GREEN SMIP
OWNER BUILDER VERIFIED OYES O 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
NIF