PMT16-02393 City of Menifee Permit No.: PMT 16-02393
29714 HAUN RD. Type: Residential Electrical
<A- CEL/l7. MENIFEE,CA 92586
MENIFEE Date Issued: 0 712 612 01 6
(PERMIT
Site Address: 30162 VIA PALERMO, MENIFEE, CA Parcel Number: 36"95-006
92584 Construction Cost: $2,000.00
Existing Use: Proposed Use:
Descrlptton of REMOVE FLORECENT LIGHTS AND INSTALL 6 CAN LIGHTS
Work:
Owner Contractor
KIM THOMAS A A A RESTORATION INC
30162 VIA PALERMO 29850 2ND STREET
MENIFEE,CA 92584 LAKE ELSINORE, CA 92532-2420
Applicant Phone:9514715828
KIRK MUNIO License Number:834839
A A A RESTORATION INC
29860 2ND STREET
LAKE ELSINORE,CA
Fee Description O_yt Amount I$)
Receptacle, Switch, outlet& Fixture 6 141.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Electrical 1 7.05
$176.06
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a pennit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_eldg_Permit_Template.rpl Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from llcensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect the following reason:
License Class Cam$ �.A3 Ucens b• y y g g p y personal residence
s � B m signature below I acknowledge that,except
Expires 3,1;5)/20 S Stgnatis w in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that
WORKER'S COMPENSATION DECLARATION
have built as an owner-builder if it has not been constructed in its entirety by
o l hereby affirm under penalty of perjury one of the following declarations:) 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 7D44 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
this permit is issued, www.leeinfo.ca.gov/calaw.html.
Policy fl Date
D I 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 forwhich ❑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
number are:: application and the information I have provided is correct.I agree to comply
Carrier_A wi�rfsy5aJe with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy p Expires N1 f12x f 7 enter the above identified property for inspection purposes.
(This section need not to he 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,
1 shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE It
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes <No
UNLAWFUL,AND SHALL SUBJECT 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(SC tion or See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines
Qua
CONSTRUCTION LENDING AGENCY D Yes 5mo
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) ❑Yes -(No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5
hazardous materiat repSIrtiling.
Business and Professions Code).Any city or county that requires a permit to Mies
a Date .7 !o
construct,after,Improve,demolish or repair any structure,prior to its ROPERTY 04(INER9 AUTHORIZED AT
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,REPAIR AND PAINTING IRRP)
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 Iicensure receiving compensation for most work that disturbs paint in apre-1978
and the basis for the alleged exemption.Any violation of Section 703L5 by residence or childcare facility to be work
that disturbs
ified firms and comply with
than
Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($SOIL). managers who do the paint-disturbing work themselves or through their
o 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.eov/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 o 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 Certification 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 for this project because:
a 1,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.
BUILDING i SAFETY PERMIT/PLANAPPLICATION
2 6 2016
Menifee
DATE :UQe,, PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL A RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION 0 ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK AL�k/ k C:L
PROJECTADDRESS 301GQ /,� yv�ryv,,
ASSESSOR'S PARCEL NUMBER *jt4 `( 001 t^- (��L+LOT l 3 $ TRACT -12 1 *5 0
OWNER NAME I1',
ADDRESS c�6
PHONE EMAIL
APPLICANT NAME
ADDRESS
PHONE YS} -�g� -C71 S� EMAIL
CONTRACTOR'S NAME i OWNERBUILDER? CYES )(NO
BUSINESS NAME f 1;A A l�
ADDRESS C.q
PHONE 'jr51 -'L{-j 1 - Va g lg EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION {-
VALUATION$ SO FT L SO FT
APPLICANT'S SIGNATURE n1 DATE `71azo%;26) SO
( 'IY':9F,
DEPARTMENT DISTRIBUTION GRIN
OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GRIN SMIP
INVOICE PAID AMOUNT
AMOUNT { 1� • O� OCASH CCHECKp OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NU.MBER NOTARIZED LETTER O YES O NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
i
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JUL 2 6 2016
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Product Information
ODescription
• Utilitech Pro Retro-fit 5-in or 6-in LED Recessed
Downlight Kit
• Produces 700 lumens of brightness using only
10.5 watts
• 5000K color temperature
• White trim with frosted diffuser
• Fully dimmable 10%to 100%
• Provides 50,000 hours of maintenance free
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• CUL Rated for Damp Locations
• 5-year limited warranty
Specifications
Power Source Screw-in Lighting Technology Integrated LED
Manufacturer White Depth-Adjustable X
Color/Finish Socket
Color/Finish Family White Diameter(Inches) 7.32
Light Color Emitted Daylight Package Quantity 1
Color Temperature 5000 UL Safety Listing ✓
(Kelvins)
CSA Safety Listing X
Wattage 10.5
ETL Safety Listing X
Wattage Equivalent 65
Collection Name N/A
Lumens 700
Retrofit ✓
Dimmable ✓
Fits Housing 5-in or 6-in
Bulb Base Type Medium base (E-26) Diameter
ENERGY STAR ✓ Junction Box X
Qualified Compatible
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