PMT16-02073 City of Menifee Permit No.: PMT16-02073
29714 HAUN RD. Type: Residential Electrical
�AACCELAk�? MENIFEE, CA 92586
MENIFEE Date Issued: 07/07/2016
PERMIT
Site Address: 30324 CALLE BELCANTO, MENIFEE, CA Parcel Number: 364-103-038
92584 Construction Cost: $1.800.00
Existing Use: Proposed Use:
Description of MAIN PANEL UPGRADE TO 20DAMP FOR SOLAR PERMIT PMT16-02072
Work:
Owner Contractor
MARKBERGER HOSOPO CORPORATION
30324 CALLE BELCANTO 7100 WEST FLORIDA AVENUE
MENIFEE, CA 92584 HEMET,CA 92545
Applicant Phone:9519261176
HOLLY THOMPSON License Number: 1004233
7100 WEST FLORIDA AVENUE
HEMET, CA 92545
Fee Description City Amount(S)
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 pennit 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 IN
I hereby affirm under penalty or perjury that I am licensed under provisions of following 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 it
Professions Code a d m licen a is in full force and effm 2 which I must have resided for at least one year prior to completion o
License Class Lice n �J `'� improvements covered by this permit, I cannot legally sell a structure that I hav(
Expires .3 Signature built as an owner-building if it has not been constructed in its entirety by license(
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 it
w submitted or at the following Web site:
El hereby will under penalty of perjury one the following declarations:
I have and will maintain a certificate of consent
of self-insure far workers' htto:/Avww.leainfo.ca.aov/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
permit is issued. Property Owner or Authorized Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the property
n
//0` 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
i" see tioon3700 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'compensation insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to buildinc
/ ,,,-.construction.-- _ A I authorize representatives of this city or county to enter the above-
Carrier /1G�� nr�`Sf` !i/�CQi � �` L.C>tdentified property for the inspection purposes.
Policy# 1=1160 6piress Dale
Property Owner orAuthorized Agent
(This section need IL be completed if the permit is for City Business License#
one-hundred dollars($100)or less)
[II certify that in the performance of the work for which this permit is issued,I /HAZARDOUS MATERIAL DECLARATION
shall not emolov 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'compensation laws of California, and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor ' amour&sP'ecified on the Hazardous Materials Information Guide?
Code,I shall to comply with those provisions. ❑YES I yX0
Applicant; ate; & 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 ECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guid tins
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND pyES (1�NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS v�
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the yin,
building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundaryof school?
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES VO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirn 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 Callfomla He Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous at a reporting.
OWNER BUILDER DECLARATIONS i DYES ❑ O
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 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 fRRP)
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 RRPcertified 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 pennit 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.govAead 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( )parting 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 Finn Certification No.:
purpose of sale).
❑ 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