PMT14-02279 i
i
City of Menifee Permit No.: PMT14-02279
29714 HAUN RD.iCCE1, MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 08/25/2014
PERMIT
Site Address: 31157 MILLBURY DR, MENIFEE, CA Parcel Number: 372-480-026
92584 Construction Cost: $1,500.00
Existing Use: Proposed Use:
Description of EXISTING ELECTRICAL PANEL UPGRADE 225 AMPS
Work:
Owner Contractor
THOMAS RITCHIE SMITH ELECTRICAL CONTRACTORS INC
31157 MILLBURY DR 8733 N MAGNOLIA AVE 112
MENIFEE, CA 92584 SANTEE, CA 92071
Applicant Phone: 6197589829
GAIL LANGFORD License Number: 871200
SMITH ELECTRICAL CONTRACTORS INC
8733 N MAGNOLIA AVE 112
SANTEE, CA 92071
Fee Description 3h Amount I$1
�Recep aele_Swi�"c lt0 toe&Fbct�"A �" � fia nn
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_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 ❑ 1, 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 Cla s ( License-No... who builds or improves thereon, and who contracts for the projects with a
Expires 7- Signature t / licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLAR TION
❑ 1 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' gy my signature below I acknowledge that, except for my personal residence in
compensation, issued by the Director of Industrial Relations as provided for which I must have resided for at least one year prior to completion of
Section 3 of the Labor Cade, for the performance of work for which thisis improvements covered by this permit, I cannot legally sell a structure that I have
permit is issued. built as an owner-bullding if it has not been constructed in its entlrety by licensed
Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the
Jf7 I 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:ILW—w2.leqlnfo,ca.gov/calaw.html.
permit is issued.
My workers'compensation insurance carrier and policy number are:
Carrier V-exS�- f�Q' i�Y�C� Property Owner or Authorize Agent
Date
Expires �� / Policy#�LaE)V(:�)V�_[C)ii� S
,E By my Signature below, I certify to each of the following: I am the property
Name of Agent Phone# -owner 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-
El I certify that in the performance of the work for which this permit is issued, I identified prooppeerty for the inspectio purposes,
shall not compensation
any persons in any manner so as to become subject to me Property >
workers' compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of,he Labor Owner or Autho44 ed Agent Date Code, I shall forthwith comply with those provi ions. ``
Date; //Y. Applicant; (oodf3lm
City Business License#
WARNING: FAILURE TO SECURII 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 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 3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE
APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address NO DISTRICT (SCAQMD) SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reasons)indicated below by the checkmark(s)I have placed []YES 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, �aNO 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 AYES 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do ( )all of or ( ) porting of the work, and the structure is PROPE Tl?ON(NER O UTHORI AGEN
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFIEE PLCK No: MAmount:
29714 Haun Road Date:
Menifee, CA 92586 Phone: (951)672-6777 Amount:Fax:(951)679-3843 ev
Ck#:
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R
Property Address: Assessor's Parcel Number.
A��;MLLBURY DR. MENIFEE CA 92584PiTrWIP
anI Name: Unit#: Floor#:
Name: T. RITCHIE Ph9rrf$f*25-1961 Fax No.
Owner Address: Unit Number Zip Code
Email Address:
Name: Pn
GAIL LANGFORD or)elyo_758-9829 Fax No.
Applicant Addre�s�.33 IN MAGNOLIA AVE #112, SANTEE, CA unitONu�m�Jber
Email AddTergs: SMITHELECTRICSD.COM
Name: 0 L Phone No. Fax No.
Contractor Address: City I State Zip Code
M6GNOLIA AVE #112 1 SANTEE CA 92071
ontractor s try B ss�f is a No. Contractor's City State of California License No. Classification:
Number of Squares: 7CJ _
Square Footage
Description of Work: EXISTING ELECTRICAL PANEL UPGRADE 225 AMPS Cost of work $ t
Applican' Sign r
2Gri Date: 25 14
To Be Completed By City Staff Only.
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 ❑ Gad Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan El Mechanical Plan ❑ Title 24 Energy(on 8'/: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 I ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' MeanslMeNods
Work Type: Repair" Retrofit' Revision to Existing 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 Spdnklered YES or NO
Completion: Construction that apply: Coastal Zone
Type(s) YESorNO Noise ZoneCqOd?
Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costat Commiss Arch.Review Board Landmark Comm. P1 9 Comm.Zoning Administrator
Fee Exempt City Project Elec.VehiGe Charger Landmark Seismic Retrofit specie Case:Bldg.
OmgalA roval
Expedite Project(s): Child Care City Project Green Building I It-andmarkiAffordable Housing
For Staff Use Only
Building/Safety Permit Specialist I Lily Planning I Civil Engineering I EPWM-AdminI Transponation Mgml. Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY