PMT15-02032 i
City of Menifee Permit No.: PMTIS-02032
29714 HAUN RD.
Type: Residential Electrical
MENIFEE, CA 92586 I
MENIFEE Date Issued: 07/16/2016
u
PERMIT
Site Address: 31891 HALEBLIAN RD, MENIFEE, CA Parcel Number: 372-222-017
92584 Construction Cost: $2,400.00
Existing Use: Proposed Use:
Description of MAIN PANEL UPGRADE 200A
Work:
Owner Contractor
TIMOTHY FEGEL SUNRUN INSTALLATION SERVICES INC
31891 HALEBLIAN RD 775 FIERO LANE STE 200
MENIFEE, CA 92584 SAN LUIS OBISPO, CA 93401
Applicant Phone: 8886576527
ANTHONY HERMAN License Number: 750184
SUNRUN INSTALLATION SERVICES INC
775 FIERO LANE STE 200
SAN LUIS OBISPO, CA 93401
Fee Description Qtv Amount
e ces tc bpa; , C4Il ro "n efs bane s I Q
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_Fermit_Template.rpt Page 1 of 1
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City Of Menifee #"
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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 license:
Chapter 9 (commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professlo.'
Professions Code and my license is in full force an�.effect. Code:The Contractor's License Law does not apply to an owner of a prgPa
License Class Licensee No. 1 S0 1)S who builds or Improves thereon, and who contracts for the projects wit
yes p 9
Ex U -I b Si nature C. _ licensed contractor(s)pursuant to the Contractors State License Law) g=.WORKERS'COMPENSATION DECLARATION ❑ I am exempt from licensure under the Contractors'State License Law fore ..
C7 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
compensation, issued by the Director of Industrial Relations as provided for by which must have resided for at least one year prior to completlon=,61`
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. built as an owner-building if it has not been constructed in its entirely by licensed'-{
Policy# W C U 17 (000 D contractors. I understand that a copy of the applicable law, Section 7044 of tlie'`I
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:http'llwm.leginfo ca Qov/calaw.html.
permit is issued.My(workers'compensation Insurance carrier and policy number are:
Carrier LU✓LI�`^ r� / Property Owner or Aut onzed Agent pate
t^r
Expires - �' j ) Policy# �J 1'('�60D J a�
1 M 6 1 N_Phone# �I/yjd
d J�� n170O ❑ my Signature below, certify to each of the following: am the property
rr-k ;
Name of Agent([ N�h owner
r 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-
:1 1 certify that in the performance of the work for which this permit is issued, I ide9tifigd 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 \ l ?" .I 7
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 isi ns.
^� I 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, DYES 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 fl0 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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address _ ,IeTNO 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 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, 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 d BYES 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 ($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole H5CD,1U`S0gWJ
IAL REPORTING,
compensation, will do ( ) all of or ( ) porting of the work, and the structure is PIORAUTHORIZED AGENT
not intended or offered for sale.(Section 7044, Business and Professions Code,The Contractor's State License Law does not apply to an owner of a property 'l —
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale, If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
A., Menifee
DATE -7- 1 PERMIT/PLAN CHECK NUMBER
TYPE: ") COMMERCIAL '. RESIDENTIAL 0 MULTI-FAMILY 01 MOBILE HOME C) POOL/SPA C) SIGN
SUBTYPE: C'ADDITION (' ALTERATION () DEMOLITION ELECTRICAL '.' MECHANICAL
C% NEW PLUMBING " RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS '3 .,leHi1, , ^�l•
ASSESSOR'S PARCEL NUMBER 3 7 Z •Z?Z- o I -7 LOT - TRACT CRY
OWNER NAME? T r,O TL Building & Safety Dept.
ADDRESS 7 l gci 66, JUL 16 2015
PHONE EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME Suh YLVn OWNERBUILDER? 0YESSrP0
BUSINESS NAME SVvl avU
ADDRESS c�/y SU_7 5
PHONE GS7 EMAIL
CONTRACTOR'S STATE LIC NUMBER 7 SO It y" LICENSE CLASSIFICATION C
VALUATION$ Z (JV SQ FT L SO FT
APPLICANT'S SIGNATURE DATEDEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP 777
INVOICE
AMOUNT U PAID AMOUNTCASH ,)CHECK# )CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNTCASH '.)CHECK# CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED C)YES C" NO DL NUMBER NOTARIZED LETTER C YES D NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213