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PMT15-03473 City of Menifee Permit No.: PMT15-03473 29714 HAUN RD. �CCEL/h> MENIFEE, CA 92586 Type: Residential Electrical MENIFEE Date Issued: 11/05/2015 PERMIT Site Address: 27159 CELTIC CIR, MENIFEE, CA 92585 Parcel Number: 331461-027 Construction Cost: $3,000.00 Existing Use: Proposed Use: Description of MAIN PANEL UPGRADE 200A Work: Owner Contractor CHUCK COBB CURRENT POWER ELECTRIC INC 27159 CELTIC CIRCLE 36884 RED OAK STREET MENIFEE, CA 92585 WINCHESTER, CA 92596 Applicant Phone: 9514402441 GABRIELA SALGADO License Number: 993291 CURRENT POWER ELECTRIC INC 36884 RED OAK STREET WINCHESTER, CA 92596 Fee Description Qtv Amount($) Services, Switchboards, Control Centers&Panels 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_Templatexpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ I am 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 fallowing reason: 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 icense is in full force and eff t which I must have resided for at least one year prior to completion of License C ass LicenseN 9 improvements covered by this permit, I cannot legally sell a structure that I have Expires ��3 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 DECLARATION 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 htti)://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 W/ 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.My work s compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to building V y construction.I authorize representatives of this city or county to enter the above- Carrier—7 f 1 identified property for the inspection purposes. Policy# IJLL )&7Expires I� t2oI`� Date Property Owner or Authorized Agent (This section need not be completed if the permit is r City Business License# one-hundred dollars($100)or less) HAZARDOUS MATERIAL DECLARATION ❑ I certify that in the performance of the work f hich this permit is issued,I shall not employ any persons in any manner s s to b come subject to the Will the applicant or future building occupant handle hazardous material or a workers'compensation laws of California, an ree t t if I should ecome mixture containing a hazardous material equal to or greater that the subject to the worors'compensation provisi s of Se ion 3700 of th the amounts specified on the Hazardous Materials Information Guide? Code,I shall forthkith c mply with those p i i ns. ❑YES ❑ NO Applicant; I I Date i intended use of the building by the applicant or future building occupant require a permit for the construction or modification from South WARNING: FAILURE O ECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist COMPENSATION COVERAGE IS U LAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER TO INAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ❑YES ❑ NO ($100,000), IN ADDITION TO THE CO � OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer DAMAGES AS PROVIDED FOR IN ECTION 3706 OF THE boundary of a school? LABOR CODE, INTEREST,AND ATTO„ NEYS FEES DYES ❑ NO CONSTRUCTION LENDING AGENCY II 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 DYES ❑NO I hereby affirm under penalty 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 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 ❑ I, 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.: ❑ I, 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 A,.1,.,,.,.,1 a..,....,.... BUILDING & SAFETY PERMIT/'PERMIT/PLAN CHECK APPLICATION 4iM ' r Menifee DATE PERMIT/PLAN CHECK NUMBER TYPE: ❑COMMERCIAL RESIDENTIAL MULTI-FAMILY MOBILE HOME POOL/SPA SIGN SUBTYPE: FIADDITION ALTERATION DEMOLITION ELECTRICAL MECHANICAL W PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 2-F�IJ PROJECT ADDRESS L C r •r Building c? Safeiy Dell'(, ASSESSOR'S PARCEL NUMBER .L4LQ� •CQ-1 LOT TRACT PROPERTY OWNER'S NAME C VC 0 NOV 0 5 2015 ADDRESS __� �. l..( 1 a E PHONE EMAIL APPLICANT NAME CU` '(�,e,�v � � ul e— ADDRESS PHONE ' u EMAIL CONTRACTOR'S NAME l /H a-0 z_ OWNER BUILDER? YES At� BUSINESS NAME L)Urd �' r E lX C. J� /�� ADDRESS o2�� CQ \-�)( 4�_240 PHONE51 � �'L� I EMAILJUL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION v VALUATION$ �U SQQFFT� L SQ FT APPLICANT'S SIGNATUR L—Ci� DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP k INVOICE I PAID AMOUNT AMOUNT 'D(� 1 CASH C CHECK# O CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT CASH u CHECK# C CREDITCARD VISA/MC OWNER BUILDER VERIFIED -0 YES CD NO DL NUMBER NOTARIZED LETTER Q YES C, 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