PMT14-02390 City of Menifee Permit No.: PMT14-02390
29714 HAUN RD. Typectrica
CEL—A. MENIFEE, CA 92586 e: Residential Electrical I
MENIFEE Date Issued: 09106/2014 f
PERMIT
Site Address: 26180 BRANDYWINE DR, MENIFEE, CA Parcel Number: 335-142-012
92586 Construction Cost: $2,000.00
Existing Use: Proposed Use:
Description of MAIN PANEL UPGRADE 200 AMP
Work:
Owner Contractor
JOAN GOUKER SMART ENERGY SOLAR INC
26180 BRANDYWINE DRIVE 1641 COMMERCE STREET
MENIFEE, CA 92586 CORONA, CA 92880
Applicant Phone: 9512739595
YANCY ARIAS License Number: 990049
SMART ENERGY SOLAR INC
1641 COMMERCE STREET
CORONA, CA 92880
Phone: 9517074310
Fee Description ON Amount l$)
Building Permit Issuance 1 27.00
E:
$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
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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 CA License No. q q OQLQ C - who builds or improves thereon, and who contracts for the projects with a
Expires l.P 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 3 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
/,p0 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:bttp:llwww leolnfo ca govlcalaw htm1.
permit is issued.Myy Workers'compensation insurance carrier and policy number are:
Carrier lIL v' l_ Property caner or Authorized Agent Date
Expires I t'T Policy# L 151— i 5
Name of Agent Phone# El By my Signature below, I certify to each of the following: I am the property
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 ofthis 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,,
shall not compensation
any persons in any manner so r to become subject to the - i�!
workers' compensation laws of California, and agree that if I should become °J'i I'— J_
subject to the workers'compensation provisions of Section 3700 of the Labor Property Owner or 1 th riz d Agent Date
Date; Applicant; '
Code, I shall forthwith comply with those provisions.
��_ City Business License# 1
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, ❑YES 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 XNO 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 AYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address �O 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 reason(s)indicated below by the checkmark(s)I have placed AYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5. Business and Professions Code: a�^' BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, /� O 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
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 orjyES 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORYING.
compensation, will do( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR UTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF 1TlEi' NgF�'i�i' menifeE PLCKNo: Permit No:
Building &f safety
29714 Haun Road ate Date:051 11 11
Menifee, CA 92586 SEP 0 5 201 Amount: Aro nt: m
Phone: (951)672-6777 �4
Fax:(951)679-3843 R Ck#:
E?Cet��'�A„-+
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R
Property Address: ,� , Assessor's Parcel Number: :
- . Sitar G' 33 — a-
Projectf-renant Name: Unit#: Floor#:
Name: Phi e No.
Property Addr Fax No.
es;: 11 Unit Number Zip Code
Owner � oY, `o
Email Address:
Name: J (. hone N_ o.
/ l^- ]:F:a:xxNo.
� v`i _�' IO
Applicant Address, + COMMUnit Number Zip Cede
UPWICICC101 Kt_.
Email Addi LP ress: �� S a n y Urn n COM
Name�� 11M �.1C(�p v-esu Phone No. Fax No.
Contractor Address: i ��m�, City Slate . Zip ode
J
ontractor s Cry utustrel License NO, Contractor's ityBState_ of California License No. Classification:
Number of Squares: H �TW
Square Footage
Description of Work: ZOO Cost of Work:$
Applicant's Signature An Date: + '
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 ❑ Geo Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8%x 11)
❑ ❑ Cross Section ❑ Structural Calculations
Foundation Plan ❑ Plumbing Plan ❑ 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' MeanslMethods
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 YES or NO Indicate all Geo-tech.Haz.Zone
At Project Construction Sprinklered that apply: Coastal Zone
Completion: Type(s): C Of O Noise Zone
Required? YES or NO
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 Elec.Vehicle Charger Landmark Seismic Retrofit ORiciilA pedal mval
asa:s g.
pp Expedite Projects): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safety Building/Safety Permit Specialist I Cily Planning I Civil Engineering I PWM-AUmm I Transportation Mgml. I Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY