PMT16-01941 City of Menifee Permit No.: PMT16-01941
29714 HAUN RD. Type: Residential Electrical
�J-�CCELA—> MENIFEE, CA 92586
MENIFEE Date Issued: 06/23/2016
PERMIT
Site Address: 28604 AMBORELLA WAY, MENIFEE, CA Parcel Number: 364-213-005
92584 Construction Cost: $2,500.00
Existing Use: Proposed Use:
Description of INSTALL NEW 125A SUBPANEL
Work:
Owner Contractor
WENDY BRITTO SOLARCITY
28604 AMBORELLA WAY 3055 CLEARVIEW WAY
MENIFEE,CA 92584 SAN MATEO, CA 94402
Applicant License Number.888104
ASHLEIGH TYLER
SOLARCITY
3055 CLEARVIEW WAY
SAN MATEO, CA 94402
Fee Description Owl 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 carded an 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_Pe"it_Templale.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 contractar(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 licensure under the Contractor's State License Law for
Professions Code and�my��licel!nL�se is in full force and effect. the following reason:
License Classl.({�06.Iv1 v C se Z9 By my signature below l acknowledge that,except for my personal residence
Expiresla&-- u Signature in which lmust have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constmcted In Its entirety by
o I hereby affirm under penalty of perjury 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 La bar Code,for the performance of work for whichwivi,,leeinfo.ca.eav/calaw.html.
this permit is issued.
Policy#
Date
have and will maintain workers compensation Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
numberare: application and the information I have provided is correct.I agree to comply
Carrier
zuQ�&, Ay%�I Cp l 'nf-;1A 4-'1Gt✓ with all applicable city and county ordinances and state laws relating to
\ ff .�, building construction.I authorize representatives of this city or county to
Policy#IaGfD I{`�ZDIQ-�I9OS�xpires Q—� _ �-C� enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that In the performance of the work for which this permit is issued,
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if should become HAZARDOUS MATERIAL DECLARATION
subject to the workers co rq ensation provisions of Section 3700 of the Labor
Cade,Isha a hwit a�i ly wi r as provi ns. Will the applicant or future building occupant handle hazardous material or
Applicant Date mixture containing a hazardous material equal to or greater thatthe
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURETO � E WORK R'S COMPENSATION COVERAGE IS Dyes JAD
UNLAWFUL,AND SHALL`Sf1BJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE 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(SCAQM D)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldelfnes
CONSTRUCTION LENDING AGENCY oyes 1940
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility he within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer bounphiry,of a school?
(Section 3097 Civil Code) Dyes JiNo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
hereby affirm under penalty of perjurythatlam exempt from the permitting checklist l understand my requirements underthe State of
California Health al Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the
hazardous material r g.
checkmark(s)I have placed nextto the applicable Item ce s)(Section 7031.5 (e s o No Qb
Business and Professions Code).Any city or county that requires a permit to �/e
Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER ORA ORIZED ENT
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 Contractors State EPA RENOVATION.RE AIR AND P INTING(RRP)
License Law(Chapter9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)orthat he or she is exempt from licensure receiving compensation for most work that disturbs paint In a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare 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
D I,as owner of the property;or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.epa.aov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code,The Contractors State License Law does not apply to an owner of a D 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.It,however,the building or improvement is sold within one year of Firm Certification No:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. D No EPA Lead-Safe Certified Firm is required forthis project because:
D I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement