Loading...
PMT16-02694 City of Menifee Permit No. PMT16-02694 29714 HAUN RD. '5A—CCEL;F%> MENIFEE,CA 92586 Type: Residential Electrical MENIFEE Date Issued 08/2612016 P E R M I T Site Address: 27800 GROSSE POINT DR, MENIFEE, Parcel Number: 335-164-021 CA 92586 Construction Cost: $3,500.00 Existing Use: Proposed Use: Description of INSTALL PANEL UPGRADE 200A Work: Owner Contractor WILLIE HUDSON ENERGY REMODELING INC 27800 GROSSE POINT 22120 CLARENDON STREET STE 200 MENIFEE, CA 92586 WOODLAND HILLS,CA 91367 Applicant Phone:8772454672 JASON JONES License Number: 968844 ENERGY REMODELING INC 22120 CLARENDON STREET STE 200 WOODLAND HILLS, CA 91367 Fee Description Qtv Amount Services, Switchboards, Control Centers&Panels 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1.00 General Plan Maintenance Fee-Electrical 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 builicling 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 BidgPermit-Template.ript Page 1 of I CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I hereby affilmn under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing With section 7000)of Division 3 of the Business and a I am exempt from licensure under the Contractor's State License Law for Profess! s Code and my license is in full force and effect. the following reason: d %45kkrR� License No. By my signature below I acknowledge that,except for my personal residence Expires.11413biq Signature inwhich I musthave resided for atleastoneyear priorto completion of I I I — improvements covered bytbis permit.I cannot legaflysell a structurethat I WORKER'S COMPENSATION DECLARATIO have builtas an owner-builder ifithas not been constructed in its entirety by I 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 h'a'v'e 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 this permit is issued. www.IeRinIo.ca.Rcv/caIaw.htmI. Policy# o'y A Date PROPERTY OWNER OR AUTHORIZED AGENT n I have and will maintain workees compensation insurance,as required by section 3700 of the La bor Code,for the performance of the work for which a By my signature below I certify to each of the following:I am the property this permit is issued.My workees compensation Insurance carder and policy owner or authorized to act on the property ownees behalf.I have read this number are: application and the information I have provided is correct.I agree to comply with all applicable city and county ordinances and state laws relating to Carrier &rN 6 building construction.I authorize representatives of this city or county to Policy# Expire, 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, Ishallnoternal any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workees compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall fort ithoo ply 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 Date 4 amounts specified on the Hazardous M ateria Is Information Guide? ;:F LIRETO SECUREWORKER'S COMPENSATION OVE PGE I'S ci Yes KNO UNLAWFUL,AND SHALL SUBJECF 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($100,001)),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 permitting checklist IN SECHON 3706 OF TH E LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldelines CONSTRUCTION LENDING AGENCY 0yes jp�No I hereby affirm that under the penalty of pedury 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) ciYes ONO OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements underthe State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)Indicated below by the hazardous ma Business and Professions Code).Any city or county that requires a permit to tnw Date 4) checkmark(s)I have p la ced next to the applicable item(s)(Section 7031.5 oYes Kplo ri ts —a construct,alter,improve,demolish or repair any structure,p jor to I PROPERTY OWNLtR A/MORIZED 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 E R ND PAINTING(FIRM Ulcense 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 licensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the a Ileged 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 themselvesor through their o 1,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( I portion of the work,and the structure is www.epa.goy/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)6 Code,The Contractor's State License Law does not apply to an owner of a in An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or person al 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: in 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 RRY ru le please fill out the RRP Acknowledgement.