PMT14-02770 i
i
City of Menifee Permit No.: PMT14-02770
29714 HAUN RD.
Type: Residential Electrical
4W6C�. MENIFEE, CA 92586
MENIFEE Date Issued: 1011612014
PERMIT
a
Site Address: 28897 EVENING PASSAGE DR, Parcel Number: 372-352-002
MENIFEE, CA 92584 Construction Cost: $26,250.00
Existing Use: Proposed Use:
Description of PANEL DOWNGRADE TO 175A; SOLAR PMT14-02769
Work:
Owner Contractor
RICHARD VOSS WEST COAST APPLAINCE SERVICES INC
28897 EVENING PASSAGE DRIVE 1282 FAYETTE ST
MENIFEE, CA 92584 EL CAJON, CA 92020
Applicant Phone: 6195570446
WEST COAST APPLAINCE SERVICES INC License Number: 810930
1282 FAYETTE ST
EL CAJON, CA 92020
Fee Description 4ty Amount
e, ICes4S.wltChd Contr Ee ra R c s
Building Permit Issuance 1 27.00
G EEN,F;-E1' 2�00-
$145.00
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_eldg_Permit_Template,rpt Page 1 of 1
City Of Menifee
1i 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
11
Professions Code and my license is in full force and ff� Code:The Contractor's License Law does not apply to an owner of a property
License Class C/- O License No. g �� who builds or improves thereon, and who contracts for the projects with a
Expires 6l 6Signatu licensed contractors)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors'State License Law for the
�,.
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
u 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
j Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the
8 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'I)www Ieainfo ca aov/calaw html.
III permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier
��-e�Ni cc) roperty caner or Authorized Agent Date
Expires Policy# wC_(901gf0t746
I ❑ By my Signature below, I certify to each of the following: I am the property
j Name ofA Agent Phone#g owner or authorized to act on the property owner's behalf. I have read this
be completed if the permit is for application and the information I have provided is correct. I agree to comply
(This section need not com
one-hundred dollars be less) with all applicable city and county ordinances and state laws relating to building
i
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 property4r the inspection purposes.
shall not employ any persons in any manner so as to become subject to the l 'G tz-r
workers'compensation laws of California, and agree that if I should become
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# V S� 0 Q�
Date; (� �6 et Applicant; Cam' r
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 MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE � MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ff N0 EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
INFORMATION GUIDE?
I 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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address l7 NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS PRINT NAME: C -IcrD
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 AYES 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, LrnO 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 f9 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE SECTION
IONMAT 25505RIAL I�EPOR�WG D 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole
compensation, will do ( )all of or( )porting of the work, and the structure is PROPERTY OWNER O T
not intended or offered for sale.(Section 7044,Business and Professions Code; `y �--
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF ME' IFEE PLCKNo: Permit No:
Building Of Menifee "j1�1- -t p
29714 Haun Road g & Safety Dept, Date: Date:
Menifee, CA 92586 60 -14- L4
Phone: (951)672-6777 OCT 16 2014 Amount, Amount
Fax:(951)679-3843 Ck#:deceived Ck#:
Building Combination Permit (�H Z
To Be Completed By Applicant
Legal Description: p _ r, S-otL M Planning Case: F: L: Rt: R:
Property Address: Assessor's Parcel Number.
,Z
S$T ) -evc-N l V rr- 3-/Z- :3S'2 -(Q0 Z- .
Project/Tenant Name: Unit#: Floor#:
Name: PLl S.L4 a vo S. S - - Phony No.-4 Fax No.
(e[ `tto -45b
Property Address: g�rl �"✓C T, . Unit Number - Zip C d
Owner /vf/lam rr /�i9"sg �Z7
Email Address:
Name: CO�.� L[�cg G.�RV(tGS Phone�o_S��`�� Fax No. -
Applicant Address: Unit Number Zip ode
PP (28Z e-t`�e P 2020
Email Address:
Wr- A on. 1, eon-,
Name: - Phone No. Fax No.
tuv eS� Cz kS�j+/ 7P dev �'t�✓[cam Gtq S'�7-`ZYYG
Contractor Address: i 282- tz Q-�l e Qf City State Zi�CRde
Contractor s�i BBusin a Licenseo. Contract 's C State of California License No_ Classiric�{iorc�
Number of Squares: v `-
Square Footage
Description of Work: T*7wn Te YVfG t h 6 / "„ � �(y6 Date:
Applicant's Signature �_-o-lAf y � 'ES�'rii
/? Dale: (-Olt( �Cf
P.leted.BY..C.ftY.ZStaffyOnlYs�?"sif5' ie � ?i�._v' s�1c•.i?'. �.at:'r a: ei
Iridicale 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
❑ Goo Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 6'G x 11)
El Structural Calculations
❑ Foundation Plan ❑ Cross Section ❑ 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` Means/Methods
Work Type: I 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 Spnnklered that apply: Coastal Zone
Completion: Type(s): Colo / Noise Zone
Required? YES or NO
q Y 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 Special Case:Bldg.
Official Approval
Expedite.Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safety Permit Specialisl City Planning Civil Engineering EPWM-Admin ITransportation btgmt Rent Control
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