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PMT16-02927 City of Menifee Permit No.: PMT16-02927 29714 HAUN RD. Type: Residential Electrical <A—CCEL:A—> MENIFEE,CA 92586 MENIFEE Datelssued: 0911212016 P E R M I T Site Address: 28336 PANORAMA HILLS DR, MENIFEE, Parcel Number: 340-390-024 CA 92584 Construction Cost: $1,500.00 Existing Use: Proposed Use: Description of ELECTRICAL PANEL UPGRADE TO 200AMP FOR SOLAR PERMIT PMT16-02926 Work: Owner Contractor DAVID W KLUVER HOSHAW ELECTRIC 28336 PANORAMA HILLS DR 6311 PULLMAN CT MENIFEE, CA 925a4 RIVERSIDE, CA 92505 Applicant Phone:9515446574 JOSH POGUE License Number-,814080 308012TH STREET RIVERSIDE, CA 92507 Fee Description 0tv Amount Receptacle, Switch, Outlet&Fixture 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 11 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 bulliding 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.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). Chapter9(commencing with section 70DO)of Division 3 of the Business and a I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in hill force and effect. the followmg reason: License Class License No. By my signature below I acknowledge that,except for my personal residence Expires Signature in which I must haw resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder If it has not been constructed in its entirety by o 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-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 www.Ieginfo.ca.gov1cala%v.html. this permit is issued. Policy# Date PROPERTY OWNER OR AUTHORIZED AGENT ,erhave and will maintain worker's compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which ci 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 number are;n 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# AL-79—�Sw Expires enter th e above identified property for inspection purposes. (This section need not to be completed is the permit is for cme�h undred Date 011 11-6 dollars($100)or less PROPERTY OWNTR OR AUTHOMIZED AGENT o I certify that in the perform a nce of the work for which this permit is issued, Ishallnotempi any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 0501+11 worker's 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 forthwith coRlaly- �those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date 6"0 mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE 40 SECURE WORKER'S COMPENSATION COVERAGE IS 4!rYimi o 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 modiflotion from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Qua lity Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORN EYS FEES for guidelines CONSTRUCTION LENDING AGENCY crYes u No 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) arYes a No 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 License Law for the reason(s)indicated below by the checkmark(s)I hav.e placed next to the applicable Item(s)(Section 7031.5 hazardous material reporting. Business and Professions Code).Any city or county that requires a permit to Idles. o N construct,alter,improve,demolish orrepairany structure,priorto its Date issuance,also requires the applicant for the permit to file a signed statement PROPERTY OVK6 OR AUTHORIZED AGENT that he or she is licensed pursuant to the provisions of the Contractoes State EPA RENOVATION,REPAIR AND PAINTING ffiRPI 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-1979 and 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 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 u 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.ei3a.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,through employeee 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. u No EPA Lead-Safe Certified Firm is required for this project because: u 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.