PMT14-02051 4
1
City of Menifee Permit No.: PMT14-02051
29714 HAUN RD.'WCCF—L—A> MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 0 810 7/2 01 4
PERMIT
Site Address: 27217 PALOMA WAY, MENIFEE, CA Parcel Number: 336-011-026
92586 Construction Cost: $1,600.00
Existing Use: Proposed Use:
Description of MAIN PANEL UPGRADE 125 AMP
Work:
Owner Contractor
SANDRA LAFON Al SOLAR POWER INC
27217 PALOMA WAY 15025 OXNARD ST 200
MENIFEE, CA 92586 VAN NUYS, CA 91411
Applicant Phone: 8554104700
KENNETH SUAZO License Number: 493623
Al SOLAR POWER INC
15025 OXNARD ST 200
VAN NUYS, CA 91411
Phone: 7144016853
Fee Description Qtv Amount f$1
Se ire Sw c b dsGpn�rbl Gin e s^^$¢Panels 0
Building.Permit Issuance _ 1 27.00
$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 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
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 CID License No. who builds or improves thereon, and who contracts for the projects with a
Expires 'jl 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
❑ 1 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, 1 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
4 1 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'llwww Ieainfo ca aovlcalaw html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier 0oD IN54110J1 r1SUfawtil <v�(( Property Owner or Authorized Agent Date
Expires '3'31'ILI Policy# g033$12
By my Signature below, I certify to.each of the following: I am the property
Name of Agent Phone# 7wner or authorized to act on the property owner's behalf. I have read this
(This section need not be completed if the permit is for application and the information I have provided is correct. I agree to comply
one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
I certify that in the performance of the work for which this permit is issued, I identified property for the inspection purposes.
hall 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 S•7•Ilf
subject to the workers'compensation provisions of Section 3700 of the Labor property Owner or Authorized Agent Date
Code,I shall forthwith comply with those provisions.
City Business License#
Date; 9•7'Ill Applicant;
WARNING: FAILURE TO S -CURE 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, OYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES p'NO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there is a construction lending
INFORMATION GUIDE?
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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address vfi0 DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
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 item(s)(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, AD 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
provisions of the Contractor's State License Law(Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or ZES 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($500).) CODE, SECTIOUS ON
25505
505AL!';E5533'WGD 25534 CONCERNING
❑ 1, as owner of the property, or my employees with wages as their sole
compensation,will do ( )all of or( ) porting of the work, and the structure is PROPERTY PWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFEE PLCKNo: Permit No:
29714 Haun Road City Building o
f Menifee
Menifee, CA 92586 Safety Dept. Date: Date:-
BILA
Phone: (951)672-6777 AUG 0 7 2014 Amount: Amolnt:��
Fax:(951)679-3843 Ck#;
Received
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R
Property Address: 72-1 7 Assessor's Parcel Number.
Project(Tenant Name: Unit Floor#;
Name: phone j o. Fax No.
Property Address: Z Unit Number Zip God
Owner HG
Email Address:
Name: Phone No. Fax No.
z0 L • 1 D/'
Applicant Address: Unit Number Zip Code
Email Address:
60dtkl, LAII r � .
Name: Phone No. Fax No.
1 t f 1zl' 1 of /v$S
Contractor Address: J ✓ Ciryl State Zip Code
N (/ 0
ontractor s C ty Busmes icense o. Contractor's 6ity-Sttate of Califomia License bid. Classification:C,
(
Number of Squares:
Square Footage /I
Description of Work: 12S A ost of Work:$ I/�
Applicant's Signature 1"
Date: c7, 7
To Be Completed Byxpity Staff Only CJ
Indicate As R-Received or N/A-Not Applicable
5 Completes sets of fully dimensioned,drawn to sale plans which include: 1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan
❑ Geo Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 Y x 11)
❑ Structural Calculations
❑ Foundation Plan ElCross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Delaiits ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' Means/Methods
Work Type:HRepair* Retrofit' Revision to Exisfing Permit` Required? YES NO
Proposed Building Use(s): Existing Building Use(s);
#Buildings: #Units: #Stories: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate Indicate if Indicate all Geo-tech.Haz.Zone
At Project Sprinklered YES or NO
Completion:
Construction that apply: Coastal Zone
Type(s): C Of O YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. Planning Comm. Zoning Administrator
Fee Exempt: city Project Elea Vehicle Charger Landmad< Seismic Retrof t special case:Oles.
Olficial Approval
Expedite Project(s): Child Care City Project Green Building Landmark Alford'dnle Housing
For Staff Use Only
Building/Safely Permit Specialist Cily Planning Ciwl Engineering EPWM-Atlmin Transportation Mgmt. Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY