PMT15-00922 {I
City of Menifee Permit No.: PMT16-00922
29714 HAUN RD, Type: Residential Electrical
a�ACCIEI..AA. MENIFEE, CA 92586
0°"�A9A MENIFEE Date Issued: 04/13/2015
PERMIT
Site Address: 26517 CALLE EMILIANO, MENIFEE, CA Parcel Number: 330-280-027
92585 Construction Cost: $1,200.00
Existing Use: Proposed Use:
Description of ADD 5 CAN LIGHTS, 2 DIMMERS
Work:
Owner Contractor
SHERI BROOKS A A A RESTORATION INC
26517 CALLE EMILIANO 29850 2ND STREET
MENIFEE, CA 92585 LAKE ELSINORE, CA 92532-2420
Applicant Phone: 9514715828
JOSH BRUNETTE License Number: 834839
A A A RESTORATION INC
29850 2ND STREET
LAKE ELSINORE, CA
Fee Description Amount is
ece tacje Switch Outlet& ixt"ute 46 0
>:.
Building Permit Issuance 1 27.00
$174.00
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
ll
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 U License No. 931113q who builds or improves thereon, and who contracts for the projects with a
Expires 31 l(o Signature.Cg 4/ licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ 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' 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, cannot legally sell a structure that have
permit is issued. built as an owner-building if it has not been constructed in its entire b licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
Poll y# entirety Y
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 submitte or at the following Web site:h-ttp://www.leginfo.ca.gov/calaw.html,
permit Is issued.My workers'compensation insurance carrier and policy number are: I °� '�_
Carrier p'{ryteYiSpJ'v Property Owner or Authorized Agent r
Date
Expires q'1 -1h Policy# CST y 0012
❑ By my Signature below, I certify to each of the following: I am the property
Name of Agent JaC ) WTI Phone# tj00- qZ —W hp owner or authorized to act on the property owner's behalf. I have read this
(This section need riot 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' spection 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 becomeL
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. t p2�q
(` # �'J 1 �✓J 9
Date; `5 Applicant; JC)r( qyU.yvra"T& 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, DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑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 WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name EYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
❑NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
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 pYES 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 ❑YES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from icensure 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 IT NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE SECTION 25505, 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do( )all of or( )porting of the work, and the structure is PROPER TN OWWNF 'OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code; �' .,�,.(-j
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
Lam'
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
DATE PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL GeRkESIDENTIAL O MULTI-FAMILY MOBILE HOME 1 POOL/SPA •O SIGN
BI/
SUBTYPE: O ADDITION ^.:ALTERATION O DEMOLITION &"ELECTRICAL O MECHANICAL
NEW O PLUMBING ORE-ROOF
APPLICATION NAME .J'Sri �./
DESCRIPTION OF WORK A j2 / L19/1 LI hT'S• vn / /JI%n�.+¢i/' , -�-�q�
opt a IJlm✓nar v✓tr 5'1n K
PROIECTADDRESS -W/7 691tt Eftihkbo ^ e
ASSESSOR'S PARCEL NUMBER 51*0-p1$O-Q�_1 LOT aI TRACT o�-Rk-7
OWNER NAME
ADDRESS Z6s17" CNl/t E il,knd SK.A CGh ZS 5--
PHONE EMAIL
APPLICANT NAME del j
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME X It n7 Uh,-0 OWNER BUILDER? O YES O NO
BUSINESSNAME .29' 4-0 anl7 57— L¢/LG / --H 9'?-:5 �
ADDRESS /44-f tee/_MO-, +7/A,?
PHONE qh1 V7/',/p21 EMAIL
CONTRACTOR'S STATE LIC NUMBER Y3�/6`39 LICENSE CLASSIFICATION
�{VALUATION$ /Z pal SO FT L SO FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUST S LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE SMIP I GREEN
INVOICE /� PAID AMOUNT
AMOUNT `� OCASH OCHECK# CCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT CJ CASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES NO LICENSE NUMBER NOTARIZED LETTER O YES '% NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-5213
Em( f/4�nC--�
city of Menifee
j( Building & Safety Dept.
i APR 13 2015
Received
3 - _rl /z
L
f� Off,
31
�t r
AoD S cgn l.�gbiS
"iTY OF MENIFEE l
IILDING AND SAFETY DEPART ENT R Dimmer
% APPROVAL 4
Q
rr ,'IEWEll BY
DATE
al of these plans shall not be construed to be a permit for,or an
Of,any violation of any provisions of the federal,state or city
e= is and ordinances. This set of approved plans must be kept on the
ail completion,