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PMT16-00736 City of Menifee Permit No.: PMT16-00736 29714 HAUN RD. 'rACCELAI MENIFEE, CA 92586 Type: Residential Electrical MENIFEE Date Issued: 0 312 512 01 6 PERMIT Site Address: 27520 CAMDEN WAY, MENIFEE, CA Parcel Number: 335-232-014 92586 Construction Cost: $1,800.00 Existing Use: Proposed Use: Description of MAIN PANEL UPGRADE 200A Work: Owner Contractor KIM CURCI MYERS ELECTRIC CO 27520 CAMDEN WAY 5815 CYNTHIA STREET MENIFEE, CA 92586 SAN BERNARDINO, CA 92407 Applicant Phone:5516628769 HOLLY THOMPSON License Number: 972274 MYERS ELECTRIC CO 5815 CYNTHIA STREET SAN BERNARDINO, CA 92407 Fee Description Dry Amount(SI 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 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_Permil_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I hereby affirm under penalty of perjury that I am under provisions of with a licensed cantractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from ficensure under the Contractor's State License Law for Professions Code and my license is in full force andoect. the following reason: License Class-a —I Q Limnse No"-� By my signature below I acknowledge that,except for my personal residence Expires �?�- Signatu in which I m ust have resided for at least one year prior to completion of relb improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by o I hereby affim under penalty of perju ry one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which wwvrleRinfo.ca.gov/ca1aw.htmI. this permit is issued. Policy# Date PROPERTY OWNER OR AUTHORIZED AGENT o I have and will maintain worker's compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which E3 By my signature below I certify to each of the following:I am the property this permit is issued.my worker's compensation insunance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: application and the information I have provided is correct.I agree to comply CarrierS with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this City or county to Policy# Explresj�j ( J&nci enter the above Identified property for inspection purposes. (This section need not to be completed Is the per�lt is�or one-hundred Date /) dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT `�Iul certify that in the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSI NIFSS LICENSE# worker's compensation laws of California,and agree that if I should become 14AZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I-s�ll fbrthyvith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to or greater that the nt Da.�4'95)& amounts specified an the Hazardous Materials Information Guide? 1-1h ,ING:IJURE TO SECURE WORKEWS COMPENSATION COVERAGE 15 0 Yes UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the bulldf ng by the applica or or future building AND CIVIL FINES UP TO ON E HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See pemitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguideLnes CONSTRUCrION LENDING AGENCY oYes; "a I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) 0 Yes �.No OWNER BUILDER DECLARATIONS I have readthe Hazardous Material Information Guideand theSCAQMD permitting checklist I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Cade,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicated below by I'he hazardou%.naterial ryporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 0yes 0 Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER bR AUTHORIZED AGENT 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 EPA RENOVATION,REPAIR AND PAINTING IRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from 11censum receiving compensation for most work that disturbs paint in a pre-1979 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childure facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing Work themselves or through their E3 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renowition Program Visit: compensation,will do I I all of or I )portion of the work,and the structure is www.epa.pow'lead or contact the National Lead In I formation Center at not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323). Code,The Contractor's State License Law does not apply to an owner of a 0 An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.if,however,the building or improvement is sold within one year of Firm Certirication No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required forthis project bemuse: o 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RAP rule please fill out the RRP Acknowledgement.