PMT14-00998 City Of Menifee Permit No.: PMT14-00998
29714 HAUN RD.
VELA-* MENIFEE, CA 92586 Type: Residential Electrical
cvrn ,u ax`""" MENIFEE Date Issued:
OS/02/2014
PERMIT
Site Address: 29788 TIERRA SHORES LN, MENIFEE, Parcel Number: 340-500-010
CA 92584 Construction Cost: $500.00
Existing Use: Proposed Use:
Description of ADD PV LOAD CENTER 100 AMP
Work:
Owner Contractor
MARY&DAVID BILLINGS AMERICAN SOLAR DIRECT INC
29788 TIERRA SHORES LANE 11766 WILSHIRE BLVD STE 500
MENIFEE, CA 92584 LOS ANGELES, CA 90025
Applicant Phone: 4242146700
AMERICAN SOLAR DIRECT INC License Number: 941069
11766 WILSHIRE BLVD STE 500
LOS ANGELES, CA 90025
Fee Description
_ t3.yt Amount
S'ervices,Sw,tfchboSrds,Control Centers&Penels 9 116,;pp
Bwlding Permit Issuance 1 27.00
GREEN FEE 1 100
$144,00
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 thereunderwhen 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,orwhere 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
I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions Code and my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class C(b 01 License y(G� who builds or improves thereon, and who contracts for the projects with a
Expires Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION ❑ I am exempt from licensure under the Contractors'State License Law for the
❑ I hereby affirm under penalty of perjury one of the following declarations:
following reason:
_ I have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that, except for my personal residence in
compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of
Section 3700 of the Labor Code, for the performance of work for which this improvements covered by this permit, I cannot legally sell a structure that I have
permit is issued. built as an owner-building if it has not been constructed in its entirety by licensed
Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the
VI have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http'//www.IeciinfQ.m.gov/mIaw.htmI.
permit is issued.My workers'compensation insurance carrier and policy number are:
Property caner or Authorized Agent Date
Carrier ( � d�r�l hCt
Expires Policy# - '�.
IA � L'Q ffy my Signature below, I certify to each of the following: I am the property
hJ
Name of Agent ,-4X Co-t J"x.�lfi Phone# / / 7 O owner or authorized to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I agree to comply
(This section need not be completed if the permit is for
one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building
construction.I authorize represen Ives of this city or county to enter the above-
El I certify that in the performance of the work for which this permit is issued,I id I i erty for the Re on ur $as. /,
shall not employ any persons in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor o Owner or ulho ized Agent Date
Code,I shall forthwith comply with those provisions.
City Business License#
Date; Applicant;
WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION, AYES OCCUPANT HANDLE A HAZARDOUS MATERIALORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ONO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
INFORMATION GUIDE?
1 hereby affirm that under the penalty of perjury there is a construction lending
agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address ❑NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
GUIDELINES
OWNER BUILDER DECLARATIONS PRINT NAME:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the reason(s)indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable items)(Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, ❑NO SCHOOL?
or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the I HAVE READ THE HAZARDOUS MATERIAL
provisions of the Contractor's State License Law(Chapter 9 (commencing with
Section 7000)of Division 3 of the Business and Professions Code)or that he or DYES
INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE, SECTION
ECTIOUS N 25505RIALifE5533 GD 25534 CONCERNING
HAZAR❑ I, as owner of the property, or my employees with wages as their sole
compensation,will do( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code; X
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 property,
provided that the improvements are not intended or offered for 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 not built or improved for the
purpose of sale).
CITY OF MENIFEE PLCKNo: Permit No:
City of Menifee 6
29714 Haun Road Building & Safety Dept — O
Date: ate5
Menifee, CA 92586 MAY 01 2014 Amount Amount:
Phone: (951)672-6777
Fax:(951)679-3843
Received Ck#. Ck#:
Building Combination Permit
To Be Completed By Applicant
Legal Description: PlanningCase:
F: L: Rl: R:
Property d s �. Assessor's P I Number.
��e�` h b 6D6 O
Project/Tenant Name: Unit#: Floor#:
Name: r�1 Ph ne o.
a Jrd !J,- �/y h -r�[/d - Fax No. _
Property Address: -
Owner Unit Number Zip Co
Email Address:
Name: /L/ Ir/ Pf, 78"' qr� Fax No.
P f-f-�/,1
Applicant Addre U o Unit Number 0 t Zip C
Nt . it f
Email Address: (
LAddresz;:
e:
-!1` . L. J� i cL L Phone No. Fax No.
Contractar -t ��t° 7 State Zip' e
2-i 4rs / /
7actor's Cry Business tense o. Contractor's City Slate o/Calif i License No.
r7 r Classification:G
Number of Squares:
Square Footage
G'o
Description of Work: h
Applicant's Signature V
Date: _
mpleted By y Sta Onl - - - ,_ -
Intlicate As R-Received or N/A-Not Applicable
7 Campletzs-seLs'bf Cully dimensianed,draWnlo sale plans which include: 1 set of documen6 which include
❑ Title Sheet ❑ Elevations ❑ Electdcal Plan ❑ Geo Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on a''/.x 11)
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Structural Calculations
❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition` Means/Alethads
Work Type: Repair' Retrofit` Revision to EXlsting Pemtif Required? YES NO
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units: d Stories: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate Indicate it Indicate allNGeo-tech.Haz-Zone
At Project Construction Spdnklered YESorNO that apply: Coastal Zone
Completion:
Type(s): C Of 0 YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commis, Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator
Fez Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit Spacial Case:Bld,.
nfidaiA pmval
Expedite Project(,): Child Care City Project Green Building Landmark I Affordable Housing
For Staff Use Only
Building/Safety IPermit Specialist City Planning I Civil Ergineenng I EPWM-Admin Transporialion Mgml. ftenl Cpnfml
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY