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PMT16-02892 City of Menifee Permit No.: PMT16-02892 29714 HAUN RD- Type: Residential Electrical <A-CCE�CA�.' MENIFEE,CA 92586 MENIFEE Date Issued: 08131/2016 P E R M I T Site Address: 31497 MURRIETA RD. MENIFEE,CA Parcel Number: 358-210-037 92584 Construction Cost: $1,000.00 Existing Use: Proposed Use: Description of REPLACE EXISTING 100AMP PANEL WINEW 200 AMP PANEL Work: Owner Contractor LARRY&PATRICIA ENGLEHART 31497 MURRIETA RD MENIFEE, CA 92584 Applicant License Number LARRY&PATRICIA ENGLEHART 31497 MURRIETA RD MENIFEE, CA 92584 Phone:9516723442 Fee Description QtV Amount($ 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 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 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. AALBldg_Permll-Template.rpt Page I 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). Chapter!)(commencing with section 7000)of Division 3 of the Business and a I am exempt from Ncensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: License Clam License No. By my signature below I acknowledge that except for my personal residence Expires_Signature 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 I WORKEWS COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by a 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-imure 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 "w.IegImFo.ca.Rov/caIaw.htmI. this permit is issued. Policy# PROPERTY OWNER OR AUTHORIZED AGENT Date— o I have and will maintain worker's compensation insurance,as required by PROPERT section 3700 of the Labor 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 worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this n umber a re: application and the Information I have provided is correcL I agree to comply with all applicable city and county ordinances and state laws relating to Carrier (buildin construction.I authorize representatives of this city or county to Policy# Expires ante above ifie p party or inspection purposqS1 (This section need not to be completed is the permit is for one-hundred Date 6r-_ dollars($100)or less If R—eOPEP'f'DWI�'Ellbfl AUTHORIZED AGENT o I certify that in the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS UCENSE# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's com pensation provislo ns 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 mixture containing a hazardous material equal to or greater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes o No UNLAWFUL,AND SHALL SUBJECr 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(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidellnes CONSTRUCTION LENDING AGENCY oYes� uNo 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) oYes 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 under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractor's Uicense 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 oYes u No Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,priorto Its PROPERTY OWNER OR AUTHORIZED AGENT issuance,also requires the applicant for the permittofile a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRPI 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 licensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exam ptilon.Any violation of Section 7031.5 by residence or childcare facility to be RRP-cerfified 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 a 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPXs Renovation Program visit: compensation,will do( )all of or( )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). Code,The Contractor's State License Law does not apply to an owner of a a An EPA Lead-Safe Certified Renovator will be responsible for this project property who,th nough 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: ci 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 RRP rule please fill out the RRP Acknowledgement. & SAFETY PERM IT/PLAN CHECK APPLICATION Wenifee DATE PERMIT/PLAN CHECK NUMBER TYPE: 0 COMMERCIAL A�ESIDENTIAL 0MULTI-FAMILY CMOBILEHOME OPOOL/SPA CSIGN SUBTYPE: OADDITION OALTERATION C)DEMOLITION XfLEcrRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES- DESCRIPTION OF WORK ZWA-k1 ,?j1, IdO 74 e) PROJECTADDRESS � Wb) , lee- CA Ld;jk ASSESSOR'S PARCEL NUMBER 6 LOT TRACT OWNER NAME Z] 6-44AY ACDRESS �M� N.("LL 4 PHONE (722— '2, EMAIL �.�Ar :�/V-;:60/WPWOLIJ Glml Q APPLICANT NAME le-44 )>j ADDRESS PHONE &-77-- C/- gd-A� z- CONTRACTOR'S NAME oWNERBUILDER? OYESONO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ 1 ot� L SQ FT APPLICANT'S SIGNATURE ?�� i�� DATE wkkoafm"i � AIN& IA6- DEPARTMENT DISTRIBUTION too CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE PAID AMOUNT AMOUNT Ll� -w I I � 0 CASH 0 CHECK# CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK N 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building&Safety Oepartment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee.us inspection Request Line 951-246-6213