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PMT15-03989 City of Menifee Permit No.: PMT15-03989 29714 HAUN RD. Type: Residential Electrical <A-CCELA MENIFEE,CA 92586 MENIFEE Date Issued: 01/15/2016 PERMIT Site Address: 28561 MOON SHADOW DR, MENIFEE, Parcel Number: 364-144-004 CA 92584 Construction Cost: $1,500.00 Existing Use: Proposed Use: Description of MAIN PANEL UPGRADE 200A Work: Owner Contractor MANUEL LIMON CLEAN POWER ENGINEERING INC 28561 MOON SHADOW DRIVE 1299 COLUMBIA AVENUE#E-5,6 MENIFEE, CA 92584 RIVERSIDE,CA 92507 Applicant Phone:84470D1001 ALEX WHITING License Number: 1000575 CLEAN POWER ENGINEERING INC 1299 COLUMBIA AVENUE#E-5,6 RIVERSIDE, CA 92507 Phone:9097481300 Fee Description QQt Amount 1$1 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_Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ 1 am exempt from licensure under the Contractors'State License Law for the I hereby affirm under penalty or perjury that I licens d under provisions of following reason: Chapter 9(commencing with section 7000)o Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in Professions Code gnd'mtc.(icense is in full for a and e. L which I must have resided for at least one year prior to completion of License Class CCJJ Licens o. 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 contacted in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the WORKE NSATION DECLA TION Business and Professions Code,is available upon request when this application is submitted or at the following Web site: ❑ 1 hereby (firm under penalty of perjury one of the following declarations:I have and will maintain a certificate of consent of self-insure for workers' htto:/Mv+w.leainfo.ca.cov/calaw.html. 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 penult is issued. Property Owner or Authorized Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the property 1 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 secti 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 workers'compensatlon insurance carrierand policy number are: with all applicable city and county ordinances and state laws relating to building ��xt�' � /,, construction.I authorize representatives of this city or county to enter the above- Carrier /C r'° - W � 2 identified property for the inspection purposes. Policy# _` 'L Expires J'�Z~l'�� 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) HAZARDOUS MATERIAL DECLARATION ❑ 1 certify that in the performance of the work for which this permit is issued,I shall not emolov an ersons m any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a workers'compen 'o laws of Califomia, and agree that if I should become mixture containing a hazardous material equal to or greater that the subject to the w rkers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide? Code,I shall fo hwith on with those provisions. DYES MNO Applicant; Date; `,,,5-t�- Will 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 DYES CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS LXb ($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 j7YES ❑NO CONSTRUCTION LENDING AGENCY I have read the HQ al Information Guide and the SCAQMD I hereby affirm that under the penalty of perjury there is a construction lending permitting checldmy requirements under the State of agency for the performance of the work which this permit is issued(Section Califomia HealthSection 25505 and 25534 conceming 3097 Civil Cade) h�az"ardous maten OWNER BUILDER DECLARATIONS Z>%ES ❑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 PROPER NER 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 firths 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.govfiead 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 Finn 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 Firm Certification No.: purpose of sale). ❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Finn is required for this project because: contractors to construct the project(Section 7044,Business and Professions Code:The Contractors 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 DATE -a PERMIT/PLAN CHECK NUMBER Gj d TYPE: []COMMERCIAL RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: []ADDITION ❑ALTERATION []DEMOLITION ❑ELECTRICAL ❑MECHANICAL [-]NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 7 4 a-U R LI/ P!/ d i- /1'lflty i'/J/J/L-L U/'6% O[ cc; �fixP PROJECTADDRESS ASSESSOR'S PARCEL NUMBER 3(pLk-%LAL k• (:) L LOT TRACT PROPERTY OWNER'S NAME 4j/f 6 ADDRESS 'mil. 6Wgd _SA r✓ Z/ PHONE EMAIL APPLICANTNAME 46&3e /, 11 ,//a-- ADDRESS / tH PHONE �f09- 7y� /:30U EMAIL L"�// -iyiy/E / / ?�GC•GO CONTRACTOR'S NAME LC.9N OWNERBUILDER7 F]YES QW0 BUSINESS NAME ADDRESS 01 PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER loon ,S7S LICENSE CLASSIFICATION cic7 VALUATION$ SO FT L SQ FT APPLICANT'S SIGNATURE DATE /,2- /S DEPARTMENT DISTRIBUTION CRYF MENIFEE BU OSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP INVOICE PAIDAMOUNT //�� AMOUNT �� mq •� CLASH OCHECK# 4CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT -- CASH OCHECK# 0CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO City oFAIenijee Building& Safet Department 29714 ,4oun Rd. Menifee, CA 92586 95_-572-6777 vVwradtyofinenifee.us inspection RenuestLine 951-245-5213