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PMT18-04456 City of Menifee Permit No.: PMT18-04456 * 29714 HAUN RD. 'fAV MENIFEE, CA 92586 Type: Residential Electrical MENIFEE MENIFEE Date Issued: 09/14/2018 PERMIT Site Address: 29874 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 17 Owner Contractor PARDEE HOMES TESLA ENERGY OPERATIONS, INC. 1250 CORONA POINTE CT, STE 210 6800 DUMBARTON CIRCLE CORONA,CA 92879 ATTENTION LICENSING Applicant Phone:6506815100 ARWEN WASHBOURNE License Number:888104 TESLA ENERGY OPERATIONS, INC. 6800 DUMBARTON CIRCLE FREMONT, CA 94555 Fee Description Qtv Amount fSl 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). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from Iicensure 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. By my signature below I acknowledge that,except formy personal residence Expires :' - 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 ❑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 this application is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which Hew.w.leeinio.c-.eov/tala�n•.html. this permit is Issued. Policy# Date ul have and will maintain workers compensaton 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 1 certify to each of the fallowing: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.1 have read this number are: application and the information I have provided is correct.I agree to comply Carrier L. ;}%ti;."�i ra-.� with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Polity#ps-,!i j„i=Fj Fi Expires ;+ ' LY 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 AGENT o I certify that in the performance of the work for which this permit is issued, I shall not emalov 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 -r Date mixture containing a hazardous material equal to or greater that the amounts specified an the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes ta-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)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY o Yes ef'No 1 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) ❑Yes EfNo 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 al Safety Code,Section 25505 and 25534 concerning hazardous,ma[erial reporting. checkmark(s)I have placed nett to the applicable item(s)(Section 7031.5 oyes ,[7 No Business and Professions Code).Any city or county that requires a permit to --_;ti Date construct,alter,improve,demolish or repair any structure,prior to Its PROPERTY OW�NtR 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 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 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 a 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 I )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 Contractors State License Law does not apply to an owner of a o 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. 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 CpdR:The Contractors State License Law does not apply to an owner of a Ai If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. il BUILDING & SAFETY PcPib9iT(PLA HECK APPLICATION M., ^' MENIFEER DATE: 9/6/2018 PERMIT/PLAN CHECK NUMBER GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: C)COMMERCIAL 0 RESIDENTIAL O MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA Q'SIGN SUBTYPE: OADDITION O ALTERATION ()DEMOLITION O ELECTRICAL () MECHANICAL ONEW ()PLUMBING ORE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK Residential roof mount solar, [ 14 ] panels, [ 4.41 ] kWs, [ 1 ] Wall- mounted inverter(s) OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS OYES ONO PROJECTADDRESS 29874 Holsteiner Way ZIP 92584 ASSESSOR'S PARCEL NUMBER LOT TRACT OWNERNAME Canvas Spec Lot 17 Phase 1-2 ADDRESS 29874 Holsteiner Way Menifee, CA 92584 PHONE EMAIL canvasspeclot17@solarcity.com APPLICANT NAME Arwen Washbourne ADDRESS 43320 Business Park Dr. Ste B-104, Temecula, CA 92590 PHONE 951.331 .0373 EMAIL TemeculaPermits@tesla.com CONTRACTOR'S NAME OWNER BUILDER? OYESONO BUSINESS NAME Tesla Energy Operations, Inc. ADDRESS 6800 Dumbarton Circle, Fremont CA 94555 PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER 888104 LICENSE CLASSIFICATION B/ C10/ C46 VALUATION$ 6.527 SQ FT L SQ FT APPLICANT'S SIGNATURE Arwen washbouvne DATE 09.06.2018 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICETOTAL 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 I ,.