PMT14-02934 i
City of Menifee Permit No.: PMT14-02934
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Electrical
e'"""`""gmt'�' MENIFEE Date Issued: 11/04/2014
PERMIT
Site Address: 29295 KNOLL CT, MENIFEE, CA 92586 Parcel Number: 338-203-013
Construction Cost: $1,400.00
Existing Use: Proposed Use:
Description of MAIN PANEL UPGRADE 200 AMP
Work:
Owner Contractor
ROGER SCHMID SMITH ELECTRICAL CONTRACTORS INC
29295 KNOLL COURT 8733 N MAGNOLIA AVE 112
MENIFEE, CA 92586 SANTEE, CA 92071
Applicant Phone: 6197589829
RANDY COLE License Number: 871200
SMITH ELECTRICAL CONTRACTORS INC
8733 N MAGNOLIA AVE 112
SANTEE, CA 92071
Phone:6194052648
Fee Description Oft Amount
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 ❑ 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 orce and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class '� License No. who builds or improves thereon, and who contracts for the projects with a
Expires� 7 Signatur ,� licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ 1 am exempt from Iicensure 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 Reation rovided 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 b this permit, cannot legally sell a structure that have
permit is issued. p Y p g y
Policy# built as an owner-building if it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
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.leoinfo.ca.gov/caiaw.html.
permit is Issued.My workers'
compensation insurance carrier and policy number are:
Carrie �S' 1 /t,/ntJ �7 � Property Owner orAuthonzedAgent Date
Expires ��
tW C Policy# / 6cO Dt 0P01'
Name of Agent Phone# ❑ 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 of this city or county to enter the above-
0 1 certify that in the performance of the work for which this permit is issued,I identified property for the inspection purposes.
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 Property Owner or Authorized A Code, I shall forthwith comply with those provisions. P Y gent Date
Date; / c( Applicant; ,_ ����✓ City Business License#
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 4NO 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 -
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
XN-0 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 []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, 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
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 S INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from Iicensure 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
El1, as owner of the property, or my employees with wages as their sale HAZARDOUS MATERIAL FfEPORIING.
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;
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 M ENIFEE PLCK No: Permit No:
City Of Menifee
29714 Haun Road Building & Safety Dept. Date: Date J'1
Menifee, CA 92586 NOV 0 y 2014 Amount ounk
Phone: (951)672-6777 ep
Fax:(951)679-3843 Ck#: ck#:
9eceiued
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F:
Property Address: 29295 KNOLL CT Assessor's Parcel Number. 338203013
Project/Tenant Name: Unit#: Floor#:
Name: ROGER SCHMID r(951)907-9555 Fax No.
Property Address,
29295 KNOLL CT MENIFEE, CA Unit Number zip Code 92586
Email Address: -
Name: Randy Cole P 619-405-2648 Fax No.
Applicant Address: Unit Number Zip Code
Email Address:
P.Q.,QC�e:�Cst�•C�
Name: Smith Electrical Contractors Phon(619) 758-9829 Fax No.
Contractor Address: 8733 N Magnolia Ave#112 ci0 Santee Ste—CA Zip Cod
92071
ontractor s City Business icense o. Contractor's City State c 871200 to. Classiti•C1 O
Number of Squares:
Square Footage
Description of w. Panel upgrade to 125Amp °ost°f W°``` $ 1400.00
APPlicar nat�u
Date:
I o 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 TechlSoils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8'/,x 11)
Foundation Plan ❑ Plumbing Plan ❑ Structural Calculations
❑ ❑ Cross Section ❑ Single Line diagram for else.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Wan 8 Details ❑ Shoring Plan I ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration* Addition* Means/Methods
Work Type: Repair' EJ 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
Construction 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- I Planning Comm.Zoning Administrator
Fee Exempt: City Project Else.Vehicle Charger Landmark Seismic Retrofit I Special Case:Bfdg_
Wricial Approval
Expedite Project(s): Child Care City Project Green Building Landmarki I
Affordable Housing
For Staff Use Only
Building/Safety I Permit Specialist I City Planning ICivil Engineering EPWM-Admin Transportation Mgmt, I Rent Control
THANK YOU FOR HELPING US CREATE ABETTER COMMUNITY