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PMT15-03467
City of Menifee Permit No.: PMT15-03467 29714 HAUN RD. Type: Residential Electrical �CCEILA> MENIFEE, CA 92586 MENIFEE Date Issued: 11/05/2015 PERMIT Site Address: 28461 MARCALOPE LN, MENIFEE, CA Parcel Number: 388-051-012 92584 Construction Cost: $1,400.00 Existing Use: Proposed Use: Description of ELECTRICAL PANEL UPGRADE TO 225 AMPS FOR SOLAR PERMIT PMT15-02587 Work: Owner Contractor MICHAEL HAMKER SMITH ELECTRICAL CONTRACTORS INC 28461 MARCALOPE LN 206 GREENFIELD DR STE G MENIFEE, CA 92584 EL CAJON, CA 92020 Applicant Phone:6197589829 SASHA PETERSON License Number:871200 SMITH ELECTRICAL CONTRACTORS INC 206 GREENFIELD DR STE G EL CAJON, CA 92020 Fee Description Q_yt Amount($) Receptacle, Switch, Outlet&Fixture 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 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 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 ❑ lam exempt from licensure under the Contractors'State License Law for the I hereby affirm under penalty or perjury that I am licensed under provisions of following reason: Chapter 9(comm ncing with section 7000)o Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in Professions Cod n license is in full for effe ( which I must have resided for at least one year prior to completion of License Class U17 Licen l improvements covered by this permit, I cannot legally sell a structure that I have Expires Signature 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 WORKERS'COMPENSATION DECLA TI N Business and Professions Code,is available upon request when this application is submitted or at the following Web site: ❑ I hereby affirm under penalty of perjury one of the following declarations: submitted or t the hftp://www.leginfo.ca.gov/calaw.htmi. site: I have and will maintain a certificate of consent of self-insure for workers' compensation,issued by the Director of Industrial Relations as provided for by Date 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 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 ction 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' u ry ris'c p nsatio insurance carrier and policy number are: 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- Carrier O identified property for the inspection purposes. Policy# 4n I I Expires IDMII� 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) ❑ I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION shall not em to 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' om sation laws of California, and agree that if I should become mixture c�NFO ing a hazardous material equal to or greater that the subject t th r 'compensation provisions of Section 3700 of the Labor amountsfied on the Hazardous Materials Information Guide? Code,I f i o ly with those provision . ❑YES Applican Date; Will the intended use of the building by the applicant or future building occupant require a permit for the construction or modification from South WARNI G: FAILURE TO SECURE WORKERS' Coast Air Q ity Management District(SCAQMD)?See permitting checklist COMPE SATION COVERAGE IS UNLAWFUL, AND SHALL for guideli s SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS El YES ❑NO ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the prop9sed building or modified facility be within 1000 feet of the outer DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary a school? LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑YES NO CONSTRUCTION LENDING AGENCY I have read the Ha rdous Material Information Guide and the SCAQMD I hereby affirm that under the penalty of perjury there is a construction lending permitting checklis. un r tand my requirements under the State of agency for the performance of the work which this permit is issued (Section California Hea h�S f Section 25505 and 25534 co cerning 3097 Civil Code) hazardous tedal n . OWNER BUILDER DECLARATIONS ❑YES NO I( J I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date ` J License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNEI OR HORIZED AGENT next to the applicable item(s)(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: www.epa.gov/lead or contact the National Lead Information Center at ❑ 1, as owner of the property, or my employees with wages as their sole 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 BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ,Y. Menifee DATE l II I� PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL " RESIDENTIAL C) MULTI-FAMILY -) MOBILE HOME 0 POOL/SPA (I SIGN SUBTYPE: 0 ADDITION 0 ALTERATION O DEMOLITION yXELECTRICAL 0 MECHANICAL C) NEW (D PLUMBING C) RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Cl ne— PROJECT ADDRESS !� lC l 1�rC�I /I � ) I I Lk ASSESSOR'S PARCEL NUMBER LOT > TRACT OWNER NAME ADDRESS PHONE 111115I" 1� VW , L EMAIL APPLICANT NAME ADDRESS Mon CL 92,0-2-0 PHONE �Q�Gi-15�-� ��9 Q�j EMAIL e S ., cvn CONTRACTOR'S NAME V S � OWNER BUILDER? C)YES s�'ANO BUSINESSNAME S h E-Ifdfr�Cal l,nF�( )) i'G Qt-0T nc• ADDRESS ZU Lo 6rre-enfieid D(• (Ckj on cr+ c)e2dZQ PHONE (P1 01 gZq EMAIL ddV\OSmi+�ft 141p,Ile0_Y)C.Sd (zM CONTRACTOR'S STATE LIC NUMBER l 12©O LICENSE CLASSIFICATION C—10 I n VALUATION$ I+0 0 I FT L SQ FT APPLICANTS SIGNATURE I DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION f/U CITY OF MENIFEE BUSINESS L17SE NUMBER , c t� BUILDING PLANNING ENGINEERING FIRE GREEN SMIP ��' 7 INVOICE r G1 PAID AMOUNT I (] �� O CASH C '`CHECK# AMOUNT 1 `' ('U" ?CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT U CASH O CHECK# -)CREDIT CARD VISA/MC OWNER BUILDER VERIFIED C)YES J NO DL NUMBER NOTARIZED LETTER C' YES NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213