PMT15-02811 City of Menifee Permit No.: PMT15-02811
29714 HAUN RD. Type: Residential Electrical !
MENIFEE, CA 92586
MENIFEE Date Issued: 0911012015
PERMIT
Site Address: 26954 CANBERRA ST, MENIFEE, CA Parcel Number: 360-480-060
92584 Construction Cost: $1,400.00
Existing Use: Proposed Use:
Description of MAIN PANEL UPGRADE 200A
Work:
Owner Contractor
WILLIAM HAVERS SMITH ELECTRICAL CONTRACTORS INC
26954 CANBERRA ST 8733 N MAGNOLIA AVE 112
MENIFEE, CA 92584 SANTEE, CA 92071
Applicant Phone: 6197589829
EMILY FOSTER License Number: 871200
SMITH ELECTRICAL CONTRACTORS INC
8733 N MAGNOLIA AVE 112
SANTEE, CA 92071
Fee Description fah[ Amount($1
s. b
Building Permit Issuance 1 27.00
General Plan Maintenance Fee-Electrical 1 5.80
$149.80
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 slated,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
i
City Of Menifee
LICENSED DECLARATION ❑ 1 am exempt from licensors under the Contractors'State License Law for the1,
following reason:
I hereby affirm under penalty or perjury that I am licensed under provisions of
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in
Professions Code and my license is in full force and effect. which i must have resided for of least one year prior to completion of
License Cl s �"' d License N improvements covered by this permit, I cannot legally sell a structure that I have
Expires�1 0 Signature POE built as an owner-building if it has not been constructed in its entirety by licensed
(/ V contractors. I understand that a copy of the applicable law, Section 7044 of the
WORKERS'COMPENSATION DECLARATION Business and Professions Code,Is available upon request when this application is
submitted or at the following Web site:
Elhereby affirm under penalty of perjury one the following declarations: htto7//www leoinfo ca aov/calaw html.
I have and will maintain a certificate of consentt of self-insure for workers'
compensation,issued by the Director of Industrial Relations as provided for by Dale
Section 3700 of the Labor Code, for the performance of work for which this
permit Is issued. Property Owner or Authorized Agent -
Policy# ❑ By my Signature below, I certify to each of the following: I am the property
n4 I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comply
permit is issued.Myworkers'compensation Insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to building
,f,. construction. I authorize representatives of this city or county to enter the above-
Carrier EVCfifS+ N a-I/O nct-1 identified,property for the inspection purposes.
Policy#!lnbD(7 _C)_ 4013i Expires_Io `Z3^ire _Date
Property Owner or Authorized Agent
(This section need not be completed if the permit is for City Business License#
one-hundred dollars($100)or less) y
[II certify that In the performance of the work for which this permit is Issued,I HAZARDOUS MATERIAL DECLARATION
shall not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a -
workers' compensation laws of California, and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide?
Code,.I shall forthwith corn y ith those provisions. ❑YES "0
Applicant; � Date; / 1 dS WIII the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS 'UNLAWFUL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ❑YES ENO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN :SECTION 3706 OF THE boundary of a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES ,ENO
CONSTRUCTION LENDING AGENCY _ I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous material reporting.
OWNER BUILDER DECLARATIONS IFWES El NO
I hereby affirm under penally of perjury that I am exempt from the Contractor's , Date
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable items)(Section 7031.5. Business and Professions Code:
Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION REPAIR AND PAINTING(RRP)
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 The EPA Renovation, Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law(Chapter 9 (commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than ($500).) employees.For more information about EPA's Renovation Program visit:
❑ I, as owner of the property, or my employees with wages as their sole www.epa.gov/lead or contact the National Lead Information Center at
1-800-424-LEAD(5323).
compensation, will do ( )all of or( ) porting of the work,and the structure is
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 ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not Intended or offered for sale.If,however, Certified Firm Name:
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), Firm Certification No.:
❑ 1, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044, Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
Ii.
DATE a 110 1143 PERMIT/PLAN CHECK NUMBER g�
TYPE: -C COMMERCIAL x RESIDENTIAL G MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: OADDITION O ALTERATION O DEMOLITION Cx ELECTRICAL O MECHANICAL
ONEW PLUMBING C RE-ROOF-N UMBER OF SQUARES
DESCRIPTION OF WORK EXISTING ELECTRICAL PANEL UPGRADE TO"LOP AMPS
City of Menife
Buildina & Safet ept.
PROJECTADDRESS 2jpq64 C0j()bPf(R S+. e Cb JI Gy-f
ASSESSOR'S PARCEL NUMBER (,QC)- N50 - eXGt) LOT TRACT
OWNER NAMEIffiQXY1 ho I
je/r'S //�°' //�� deceive
ADDRESS a54 -t-c
a- 61. Q g2.554
PHONE q5r - . 22 - 3,-04 EMAIL
APPLICANT NAME SMITH ELECTRICAL CONTRACTORS,INC
ADDRESS 206 GREENFIELD DR#G,EL CAJON,CA 92020
PHONE 619-758-9829 X101 EMAIL perrnitupdates@smithelectricsd.com
CONTRACTOR'S NAME SMITH ELECTRICAL CONTRACTORS,INC OWNER BUILDER? O YES)NO
BUSINESS NAME SAME
ADDRESS SAME AS ABOVE
PHONE SAME EMAIL SAME
CONTRACTOR'S STATE LIC NUMBER 871200 LICENSE CLASSIFICATION C-10
VALUATION$ 1400.00 SO FT L SQ FT/
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT ��yy//�•�
AMOU •yt/ '"CASH +'.`CHECK# OCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0 CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Maun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us inspection Request Line 951-246-6213