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PMT15-01894 i City of Menifee Permit No.: PMT16-01894 29714 HAUN RD.4�CCEL MENIFEE, CA 92586 Type: Residential Electrical c'"`""`""wt.� MENIFEE Date Issued: 07/16/2015 PERMIT Site Address: 27498 EMBASSY ST, MENIFEE, CA Parcel Number: 335-323-015 92586 Construction Cost: $1,000.00 Existing Use: Proposed Use: Description of MAIN PANEL UPGRADE 200A '.. Work: Owner Contractor JAMES ADAMS SUNRUN INSTALLATION SERVICES INC 27498 EMBASSY STREET 775 FIERO LANE STE 200 MENIFEE,CA 92586 SAN LUIS OBISPO, CA 93401 Applicant Phone: 8886576527 - DULCE CORREA License Number: 750184 SUNRUN INSTALLATION SERVICES INC - 775 FIERO LANE STE 200 - SAN LUIS OBISPO, CA 93401 Phone: 9095873825 Fee Description ON Amount isl 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 4 fr, City Of Menifee ' LICENSED DECLARATION ' hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with license-�- Chapter 9 (commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professl'' Professions Code and my license is in full force anti effect Code:The Contractor's License Law does not apply to an owner of a propee' License Class C Licens/ee,,N,o.�Ir-�S0 It r}- who builds or improves thereon, and who contracts for the projects withF.a Expires - )d -I b Signature l/°`"J'�'"'-'-- licensed contractor(s)pursuant to the Contractors State License Law) t .. WORKERS'COMPENSATION DECLARATION ElI am exempt from licensure under the Contractors'State License Law for U7e; /hereby affirm under penalty of perjury one of the following declarations: following reason: ; have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that, except for my personal residencei n,its: 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 Issued. W C 0 1 e5 Gh 6000 built as an owner-building If It has not been constructed in Its entirety by licensed 'v Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the Ali I have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is s section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site.http/Iwww leginfo ca.gov/calaw.htmi permit is issued.My workers'compensation Insurance carrier and policy number are: Carrier Zl/Y�16rn Property Owner or Authorized Agent Date Expires Jib - I- I Policy# Wl 1 00 1 //yy CI By my Signature below, I certify to each of the following: I am the property Name of Agent A fAvn 6A41�r ,_Phone# "fIS 6 9j 70p 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- ❑ I certify that in the performance of the work for which this permit is issued,I ide9tti9d 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 became 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 p.o isi ns. -'ry City Business License# _ Date; ( - �� - � Applicant __-��� 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 OR A DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST, AND ATTORNEYS FEES pzNO 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 ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address 2 NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR GUIDE LINES OWNER BUILDER DECLARATIONS I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME: License Law for the reasons)indicated below by the checkmark(s)I have placed 11YES 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, O 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 �yE3 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 S 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 ❑ I, as owner of the property, or my employees with wages as their sole HAZARD US MAT 1Eg) AL REPORTING. compensation, will do ( ) all of or( ) porting of the work, and the structure is PROP/Ey2/TY OW'ER 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).