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PMT18-04906 City of Menifee Permit No.: PMT18-04906 29714 HAUN RD. ff MENIFEE, CA 92586 Type: Residential Electrical MENIFEE MENIFEE Date Issued: 10/09/2018 PERMIT Site Address: 31089 NOKOTA LN,MENIFEE, CA 92584 Parcel Number: Construction Cost: $6,527.00 Existing Use: Proposed Use: Descriptlon of ROOF MOUNTED SOLAR SYSTEM, 14 PANELS, 1 INVERTER,4.41 Work: KADENCE TR 32277-3 LOT 88 Owner Contractor PARDEE HOMES TESLA ENERGY OPERATIONS, INC. 1250 CORONA POINTE CT,STE 210 6800 DUMBARTON CIR CORONA, CA 92879 ATTENTION LICENSING Applicant Phone:8448375201 ARWEN WASHBOURNE License Number:888104 TESLA ENERGY OPERATIONS, INC. 6800 DUMBARTON CIR FREMONT, CA 94555 Phone: 8448375201 Fee Description Q—t y 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 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 Templatexpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contactor(s)pursuant to the Contractors State License Law), 1 hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section?DOD)of Division 3 of the Business and o I am exempt from licensure under the Contactors State License Law for Professions Code and my license is in full force and effect. the following reason: _ i License No. :SJ-iN`'� License Class - By my signature below lacknowledge that except for my personal residence 1 Expires i'%' Al )W Signature in which l must have resided for at least one year prior to completion of a�Lr•r�± 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 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 ww•x•,leei tfo ca eovycalaw.litml. this permit is Issued. Date Policy If PROPERTY OWNER OR AUTHORIZED AGENT Oy1 have and will maintain workers compensal on insurance,as required by section 3700 of the Labor Code,for the performance of the work for which o By my signature below I certify to each of the following:)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 with all applicable city and county ordinances and state laws relating to Carrier -;r I+. i1 Lus--1 r A iN building construction.I authorize representatives of this city or county to Policy If 1014 -,� Expires /C, 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 ❑I certify that in the performance of the work for which this permit is issued, I shall not errant any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 9 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 Will the applicant or future building occupant handle hazardous material or Code,I shall forthwith complywith those provisions. d _ " mixture containing a hazardous material equal to or greater that the Applicant +. 7T Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes EfNo UNLAWFUL,AND SHALL SUBIECTAN 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 guidelines CONSTRUCTION LENDING AGENCY oYes cSNo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 100D 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 ErNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)Indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item of N s)(Section 7031.5 oYes o yr r Business and Professions Code).Any city or county that requires a permit to I) Date - { �7 construct,alter,improve,demolish or repair any structure,prior to its PR PE)fTY ONyJN ROR AUTHORIZED issuance,also requires the applicant for the permit to file a signed statement EPA RENOVATION REPAIR AND PAINTING fFIRM that he or she Is licensed pursuant to the provisions of the Contactors State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contactors Business and Professions Code)or that he or she is exempt from Ilcensure 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 epa 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 Contractor's State License Law does not apply to an owner of a aAn 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 o No EPA Lead-Safe Certified Firm Is required for this project bemuse: not built or improved for the purpose of sale. a 1,as owner of the property am exclusively contacting with licensed contractors to construct the project(Section 7044,Business and Professions rip: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. i BUILDING& SiiMiAFETY PERMIT/PLA 1.CHECKAPPL CAgq. MENIFEE TWw DATE: 10.05.201 8 PERMIT/PLAN CHECK NUMBER GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: O COMMERCIAL 0 RESIDENTIAL (F)MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA SIGN SUBTYPE: QADDITION 0 ALTERATION 0 DEMOLITION 0 ELECTRICAL 0 MECHANICAL 0 NEW OPLUMBING ORE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK Res. roof mount solar, 14 panels, 4.41 kW, 1 wall-mounted inverter OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS 0 YES ONO PROJECT ADDRESS ZIP City of Menifee Building Dept. ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME Kadence - Lot 88 OCT 0 5 2018 ADDRESS 31089 Nokota Lane, Menifee, CA 92594 PHONE EMAIL APPLICANT NAME Arwen Washbourne ADDRESS 43320 Business Park Dr. Ste B-104, Temecula, CA 92590 PHONE 951.331.0373 EMAILarlott@tesia.com CONTRACTOR'S NAME OWNER BUILDER? ©YES©NO BUSINESS NAME Tesla Energy ADDRESS 3500 Deer Creek Road, Palo Alto, CA 94304 PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER 888104 LICENSE CLASSIFICATION B C10 C46 VALUATION$ 6527 SQ FT L SQ FT 0 -0-a..- Date:2018.10.05 09:55:37-07'00' DATE 1 0.05.2018 APPLICANT'S SIGNATURE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICE TOTAL a �. �O GREEN , — SMIP ( - OWNER BUILDER VERIFIED OYES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO City of Menifee Building &Safety Department[ 29714 Haun Rd., Menifee,CA 92586 (951)672-6777""of www.cityofinenifee.us MENIFEE'