PMT15-01019 City of Menifee Permit No.: PMTIS-01019
29714 HAUN RD.
CCC_i..h?' MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 0 6/0 712 01 6
PERMIT
Site Address: 29424 SPRINGSIDE DR, MENIFEE, CA Parcel Number: 340-240-034
92584 Construction Cost: $5,000.00
Existing Use: Proposed Use:
Description of INSTALL WHOLE HOUSE BACK-UP 20kW GENERATOR, TRANSFER SWITCH&250 GAL PROPANE
Work: TANK
Owner Contractor
ROBERT LEANZA ROSS POWER SOLUTIONS
29424 SPRINGSIDE DRIVE 3507 WEST STETSON#125
MENIFEE, CA 92584 HEMET, CA 92545
Applicant Phone: 9517510782
AARON ROSS License Number: 932885
ROSS POWER SOLUTIONS
3507 WEST STETSON#125
HEMET, CA 92545
Fee Description Oitr \ Amount is
Services, Switchboards, Control Centers&Panels 1 116.00
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Building Permit Issuance 1 27.00
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GREEN FEE 1 1.00
$485.18
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 force and effect. Code:The Contractor's License Law does not apply to an owner of a properly
License Class G—10 License No93 .S who builds or improves thereon, and who contracts for the projects with a
Expires l_3 _2 o1Jgnatur</2� 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
❑ 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 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
permit is isTb r0-s q Q(- f
Policy;, J _I 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
❑ 1 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.leciinfo.ca.goyLcalaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier t7 e co U A 1Y Property Owner or Authorized Agent Date
Q Expires � � V ^zy(� Policy#(—IqoS�¢o C
❑ By 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 stale 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 emolov 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 Date
Code, I shall forthwith comply with those provisi ns.Date;
7 .-2qS Applica ' City Business License# 0_25�y a 39 p
S
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 11�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 AYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address ( O FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
DISTRICT(SCA MD) SEE PERMI GG 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: `� BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, y�N0 SCHOOL?
or repair any structure, prior to its Issuance, also requires the applicant for the t/ `
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 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
p❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation,will do( )all of or( )porting of the work, and the structure is PROPE N 6 D NIT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
��- Menifee
DATE ��— 2 t— Za QS PERMIT/PLAN CHECK NUMBER r
TYPE: ") COMMERCIAL . RESIDENTIAL (D MULTI-FAMILY Q MOBILE HOME POOL/SPA C)SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION XELECTRICAL C MECHANICAL
C. NNEW C PLLUUMBII,NG 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 2 (AP✓�cor ��TLt,S'�-(�5 Wl� i�,�.Sf/�,
rn u t City of Me Ifee
PROJECTADDRESS Z T� Z-1 P1k 51� �` �� q2 �d / 9 a ,ty Dept.
ASSESSOR'S PARCEL NUMBER � � M0 —�j LOT TRACT Z 2015
OWNERNAMEE 9.06 CZ-Z�4Ztk ' ed
ADDRESS Z I �'{T�N J�7'J(" Side d r e�/I�fie G 11 4 2-�5'8'�/ U
PHONE q�j I—L'I q'�'S f y(� q� ,s, I� CEMAIL
APPLICANT NAME
fO./w�vl JO L��6 -S �J
ADDRESS 3 6-0 VVP,S Y sI 0� Oue- HeG%� L�f 9ZS�
PHONE 451- 75/-078'2 EMAIL
CONTRACTOR'S NAME V C >5'S OWNER BUILDER? iCl YES)0NO
BUSINESS NAME
EE Z W Y SO�rt��Ga K,
ADDRESS S-4t4 j(/ad.,o (Zf /fe"te--#L C6� 4 2�51'KS
PHONE "I,Cj 1-751-07 p Z EMAIL 12 Gve.(�SO/w�, LIS• C ki
CONTRACTOR'S STATE LIC NUMBER Ct&Z ` LICENSE CLASSIFICATION C �(
VALUATION$ SO FT L SO FT
APPLICANT'S SIGNATURE DATE �d IJ
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT CASH %CHECK# )CREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT GCASH i.)CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED YES C) NO DL NUMBER NOTARIZED LETTER =) YES NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-245-5213
Building & Safety
ENIF
...... Internal Route Sheet
Date: 4/21/15
Permit #: PMT15-01019
Address: 29424 SPRINGSIDE DRIVE
Contact Person: AARON ROSS Phone #: 951-751-0782
Planning 11
Routed Date: 4/21/115 Date Recv'd: Date Cleared: 4A 1 S
Planner Initials: �i� Project #:
Notes: PLEASE RETURN APPROVED PLANS
❑ Engineering
Routed Date: Date Recv'd: Date Cleared:
Engineer Initials: Plan #:
Transp. Clearance Received":
Notes:
Notes:
*If Applicable \�