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PMT16-02791 City of Menifee Permit No.: PMT16-02791 29714 HAUN RD- Type: Residential Electrical <;\CCELA-7? MENIFEE, CA 92586 MENIFEE Date Issued: 09108/2016 P E R M I T Site Address: 27841 FOXFIRE ST, MENIFEE,CA 92586 Parcel Number: 335-353-004 Construction Cost: $1,500.00 Existing Use: Proposed Use: Description of MAIN PANEL UPGRADE 200A Work: Owner Contractor SHARON BOND HOSHAWELECTRIC 27841 FOXFIRE STREET 6311 PULLMAN CT MENIFEE,CA 92586 RIVERSIDE, CA 92505 Applicant Phone: 9515446574 JOSH POGUE License Number.814080 HOSHAWELECTRIC 6311 PULLMAN CT RIVERSIDE, CA 92505 Fee Description Pty 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 comection of errurs 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. Akfildg_Permit-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 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 Professions Code a is in full force and effect. the following reason: License Class license No.. ;q�glq--J By my signature below I acknowledge that,except for my personal residence Expires !K30C t!Se Signature in which I must have resided for at least one year PrIOrtO COMplefiDn of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I have built as an owner-builder if it has not been constructed in its entirety by a I hereby affirm under pena Ity 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 Labor Code,for the performance of work for which this permit is issued. www.Ieglnfio.ca.goy/caIaw.htmI. Policy# Date PROPERTY OWNER OR AUTHORIZED AGENT a I have and will maintain worker's compensation insurance,as required by section 3700 ofthe Labor Code,for the performance ofthe work for which a By my signature below I certify to each ofthe following:I am the property this permit Is issued.My worker's compensation insurance carder and policy owner or authorized to act on the property owner's behalf.I have read this numberare-'.. 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 building construction.I authorize representatives of this city or county to Policy# Expires. enter the above identified property for inspection purposes. ' -Z� �—>f�7t— I (This section neaYnot to be completed Is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT a I certify that in the performance ofthe work for which this permit is issued, Ishallnotemplo any persons in any mannerso as to become subject to the CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions ofSection 3700 of the Labor Code,I shall forthwith T '4ply Ith 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 X Applicant I ed amounts specified on the Hazardous Materials Information Guide? WARNING.FAILURE�o SECURE WORKER'S COMPENSATION COVERAGE IS a Yes a No UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use ofthe 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 SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY oYes aNc, I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 100D feet of th e lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) ayes ONO OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm underpenaltV 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 material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ayes a No 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 OWN ER OR AUTHORIZED AGERT 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(RRP) License Law(Chapter 9(commencing With Section 7000)of Division 3 ofthe 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 a nd 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 Paris Ity 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 a 1,as owner ofthe property,or my employee With wages as their sole employees.For more information about EPA!s Renovation Program visit: compensation,will do( )allofor( )Portion ofthe 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,Businesis and Professions 1-800-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner Ofa a An EPA Lead-Safe Certified Renovator will be responsible for this project property who,th rough employeee or persona I effort,builds or improves the property provided that the Improvements a re not intended or offered for Certified Firm Name: sale.If,however,the building or Improvement is sold within one year of Firm Certification No.: completic, ,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sa le. a No EPA Lead-Safe Certiffied Firm is required for this project because: a 1,as owner ofthe property am exclusively contracting with licensed contractors to construct the project(Section 7W,Business a nd 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 R RP Acknowledgement.