PMT14-03176 City of Menifee Permit No.: PMT14-03176
29714 HAUN RD. Type: Residential Electrical ?,
C L MENIFEE, CA 92586
d°""""wgmk'� MENIFEE Date Issued: 1 210412 01 4 J�
0
PERMIT
Site Address: 30574 LAKE POINT DR, MENIFEE, CA Parcel Number: 364-064-043
92587 Construction Cost: $1,400.00
Existing Use: Proposed Use:
Description of PANEL UPGRADE 125 AMP FOR SOLAR PERMIT PMT14-02755
Work:
Owner Contractor
BRANDON CONSALVI SMITH ELECTRICAL CONTRACTORS INC
30574 LAKE POINT DR 8733 N MAGNOLIA AVE 112
MENIFEE, CA 92584 SANTEE, CA 92071
Applicant Phone:6197589829
RANDY COLE License Number: 871200
SMITH ELECTRICAL CONTRACTORS INC
8733 N MAGNOLIA AVE 112
SANTEE, CA 92071
Fee Descriotion Amount l$)
e d
Building Permit Issuance 1 27.00
GR�E F=
$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 building 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 force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License C14ss C(V License No. ?121Jt7 who builds or improves thereon, and who contracts for the projects with a
6 Expires �7 (a Signature licensed contractor(s)pursuant to the Contractors State License Law).
I'
WORKERS COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors'State License Law for the
j. ❑ 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 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
f 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
Ak 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:htto'//www.leginfo.ra.q-ovJcalaw.htmi.
permit is issued.My workers compensation insurance carrier and policy number are:
Property Owner or Authorized Agent Date
Carrier t a trc�.
Expires 0/Zile Policy#71d'0001(214015 t
�FBy 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 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 Agent Q Date
Code,.l shall forthwith comply with those provisions.
/' City Business License#
Date; ( 7 Applicant- � G�
_ 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 OR A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES J<NO 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 ENO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
I hereby affirm under penally 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 OYES 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, `1NO 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 Slate License Law (Chapter 9 (commencing with INFORMATION GUIDE AND THE SCAQMD PERMITTING
Section 7000)of Division 3 of the Business and Professions Code)or that he or ES
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($500).) CODRUS255055533D 25534 CONCERNING
HAZARDOUS AE G
❑ I, as owner of the property, or my employees with wages as their sole
compensation, will do( ) all of or( )porting of the work,and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions code;
The Contractor's State License Law does not apply to an owner of a property
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CllllY OF _" E YFEE PLCK No: P No:
" —rl3i c�
29714 Haun Road Date: Date:
Menifee, CA 92586 12>14114
Phone: (951)672-6777 Amount: Amount:
Fax:(951)679-3843 Ck#: Ck#:
Building Combination Permit CGl
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R
Property Address: 30574 Lake Point D Assessor's Parcel Number. 364064043
Projectrrenant Name: Unit#: Floor#:
Name: ConSalvi, Brandon F(619) 758-9829 Fax No.
Property Address: 30574 Lake Point D Menifee 92587 Unit Number Zip code 92584
Email Address:
Name: Randy Cole P 619-405-2648
FNo
Applicant .
Address: Unit Number Zip Code
Email Address:
Name' Smith Electrical Contractors on(619)758-9829 Fax No.
Conlactor Address: 8733 N Magnolia Ave #112 till Santee sca CA zip cod 92071
ontractor s tty Business e'"P51 o 14 Contractor's City State r 871200 lo- Classift C10
Number of Squares: J
Square Footage
Description of Work: panel upgrade to 125 Amp �br GROX cost of work:$ 1400.00
Applicant's Signature—
pAA' Lt—a a-1SS Dale: i LA /
Lf
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 call only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 Y:x 11)
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Structural Calculations
❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan It Detals ❑ Shoring Plan I ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' Means/Methods
Work Type:HRepair' Retrofit' Revision to Existing PemuP IRequired? 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 Spdnklered that apply: Coastal Zone
Completion:
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 Elec.Vehicle Charger Landmark Seismic Retrofit I Special Case:Bldg.
Officia)Apprimal
Expedite Project(s): Child Care City Project Green Building I Landmark I Affordable Housing
For Staff Use Only
Building/Safety Permit Specialist I City Planning ICivil Engineering EPWM-Admin I Transportation Mgml. I Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY