PMT19-00061 City of Menifee Permit No.: PMT19-00061
29714 HAUN RD.
l MENIFEE, CA 92586 Type: Residential Electrical
MEIVIPEE MENIFEE Date Issued:
01/10/2019
PERMIT
Site Address: 29210 GLENCOE LN, MENIFEE, CA
Parcel Number: 372-370-031
92584
Construction Cost: $2,900.00
Existing Use: Proposed Use:
Description of INSTALL ROOF MOUNTED SOLAR, 5.94 KW, 18 MODULES AND 1 INVERTER
Work:
OwnerJONA — — — — — — - - - -
Contractor
29210 G E MOE LAN SEMPER SOLARIS CONSTRUCTION INC
MENI EE, CA 9E LANE 1805 JOHN TOWERS AVENUE
MENIFEE, CA 92584 EL CAJON, CA 92020
Applicant
CARMEN BARRERA Phone:6197154054
SEMPER SOLARIS CONSTRUCTION INC License Number: 978152
1805 JOHN TOWERS AVENUE
EL CAJON, CA 92020
Phone: (619)715-4054
Foe Descriotion — — — — — — —
9ht Amount
Solar, Residential or SMafll C;oeaa,merd-Sf 1
Building Permit Issuance 2 27.00
1 .00
Addificnal Kan Rev;ej+r,Building 171
GREEN FEE 171.14
1 SMII.P RES1Gt't'�4�7t;�L 1.00
1
General Plan Maintenance Fee-Electrical 1.
1 12.60
0
— — — — — — $464.74
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited
AA_Bldg_Permit Template.rpt
Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class IS �O �j License No.�7 8/S2-
By my signature below I acknowledge that,except for my personal residence
Expires Po Signature in which I must have resided for at least one year prior to completion of
WORKER'$COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
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
by Section 3700 of the Labor Code,for the performance of work for which this application is submitted or at the following website:
this permit is issued. www.lepiri[o.ca. ov calaw.html.
Policy# Date
I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Cede,for the performance of the work for which rn 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
number are: ( application and the information I have provided Is correct.I agree to comply
Carrier _5 � -� T t- v� -1 with all applicable c]ty and county ordinances and state laws relating to
u,1 building construction,I authorize representatives of this cityor countyto
Policy# `7 27� ' Expires . « �' enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less Date
❑I certify that in the performance of the work for which this permit is issued, PROPERTY OWNER OR AUTHORIZED AGENT
I shall not�em I•n 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
subject to the worker's compensation provisions of Section 3700 of the Labor HAZARDOUS MATERIAL DECLARATION
Code,I shall forthwF ly with those provisions. / Will the applicant or future building occupant handle hazardous material or a
Applicant Date L- ( mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:_FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes ❑No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
Will the intended use of the building the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS(S100,000),IN
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction
ruction modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)D)?See permitting checklist
for guidelines
CONSTRUCTION LENDING AGEAlCY ❑Yes ❑No
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) ❑Yes ❑No
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
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Cade,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to oYes ❑No
construct,alter,improve,demolish or repair any structure,prior to its Date
issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION REPAIR AND HINTING RRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
and the basis For the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-comply
w t78
h
an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with
than($500), required practices.This Includes rental property owners and property
managers who do the paint-disturbing work themselves a through their
❑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.e a. ov led 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
property who,through employees'or personal effort,builds or improves the An EPA Lead-Safe Certified Renovator will be responsible for this project
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
completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.:
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.
F3�111.i"fi11qC; X� ;AFE I'Y PERMIT/PLAN CHECK APPLICATION A :M;ENI_FEE
DATE: PERMIT/PLAN CHECK NUMBER
GRADING/ PLANNING CASE NUMBER OTHER RELATED CASES
TYPE: Q COMMERCIAL 4) RESIDENTIAL (F)MULTI-FAMILY O MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: ADDITION Q ALTERATION Q DEMOLITION 4) ELECTRICAL 0 MECHANICAL
O NEW QPLUMBING ORE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK KW(DC) `' MODULES INVETER
OCCUPANCY GROUP CONSTRUCTION TYPE P SPRINKLERS C)YES NO
PROJECTADDRESS / ^L, ( ZIP 'C
ASSESSOR'S PARCEL NUMBER .3 E V • LOT TRACT
OWNER NAME {j �` 4 ��
ADDRESS 2 cf 7 10
i
PHONE S/ 2 ' — _c EMAIL
APPLICANT NAME CARMEN BARRERA
ADDRESS 1218 SPRING ST RIVERSIDE CA 92507
PHONE (909)2780002 EMAIL carmen.barrera@sempersolaris.com
CONTRACTOR'S NAME SEMPER SOLARIS OWNER BUILDER? C)YES(VO
BUSINESS NAME SEMPER SOLARIS
ADDRESS 1805 JOHN TOWERS AVE EL CAJON CA 92020
PHONE (619)715 4054 EMAIL
CONTRACTOR'S STATE LIC NUMBER 978152 LICENSE CLASSIFICATION C10 C46 C39 B
VALUATION$ SQ FT L- L SO,FT
APPLICANT'S SIGNATURE _ _— DATE - I
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY,, CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL . GREEN �. SMIP .W
OWNER BUILDER VERIFIED ()YES O NO DRIVERS LICENSE# NOTARIZED LETTER ? YES NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofineni fee,LIS City Of Menifee
Building Dept.
EMIR
JAN 0 4 2019
Received