PMT16-03001 City of Menifee Permit No.: PMT16-03001
29714 HAUN RD. Type: Residential Electrical
<A-ccELA-> MENIFEE,CA 92586
4--t Wq-- MENIFEE Date Issued: 09/0912016
P E R M I T
Site Address: 27144 MONK ST,MENIFEE, CA 92586 Parcel Number: 335-314-001
Construction Cost: $1,200.00
Existing Use: Proposed Use:
Description of 225 AMP PANEL UPGRADE FOR FUTURE SOLAR
Work:
Owner Contractor
ATHENE SPARKS JOE ANTHONY FLORES
27147 MONK ST 27902 JOHN F KENNEDY STE C
MENIFEE,CA 92686 MORENO VALLEY,CA 92555
Applicant Phone: 9519034731
JOE FLORES License Number. 987341
JOE ANTHONY FLORES
27902 JOHN F KENNEDY STE C
MORENO VALLEY,CA 92555
Fee Description QtV Amount($1
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 emors 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.Exoept 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.Bidg_Permit Ternplate.ript Page 1 of I
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under pena Ity 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 o I am exempt from licensure underthe Contractor's State License Law for
Professions Code and my license is In full force and effect. the following reason:
License By my signature below I acknowledge that,except for my personal residence
Expires 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
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 clei:laratlons:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-hisure for worker's 7044 of the Business and Professions Code,is awila ble 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.IegInlo.ca.goy/caIaw.html.
Policy# Date
o I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
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; application and the information I have provided is correct.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# Expires enter the above identified property for inspection purposes.
(This section need not to be completed Is the perm it is for one-h undred Date
dollars($100)or less PROPERTY OWN ER OR AUTHORIZED AGENT
34 certify that in the perfornna nce of the work for which this permit is issued,
(halinotemyl any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
�orker's compensation laws of California,and agree that If I should become HAZARDOUS MATERIAL DECLARATION
subject to the wcrele's am ation provisions of Section 3700 of the bar
mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
Code,I shall fortl' ithc ly ith those provisions. Yq S Will the applicant or future building occupant handlehazardous material ora
Applicant_P\ —Date q
WARNING:FAILUR SECURE WORKER'S COMPENSATION V RAGE I ci Yes "a
L SI
UNLAWFUL,AND fALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the build Ing by the a pplicant or future building
PTO O�
ANDCIVILFINESI PTO ONE HUNDRED THOUSAND DOLLARS($100,000),IN
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
for guidelines
CONSTRUCTION LENDING AGENCY a Yes ea
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 2000 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) 0yes /"a
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
California He I h&Saf�el Code,Section 25505 and 25534 conc
Contractoes License Law for the reason(s)indicated below by the hazardous m:t`11riai 't
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Dyes
Business and Professions Code).Any city or county that requires a permit to 40 Date-9 Tf 71,
construct,alter,improve,demolish or repair any structure,prior to Its PROPERTY OWN ERrUTh6AIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement
. Ep�
that he or she is licensed pursuant to the provisions of the Contnctor's State EPA RENO , EPAIR AND PAINTING(RRP)
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 exemption.Any violation of Section 7031.S by residence or childmre facility to be RRP-certifled firms and comply with
a n 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
ci 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( )portion of the work,and the structure is www.epa.govIlead 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 Removatorwill be responsible forthis project
propertywho,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:
o 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 PERMIT/PLAN CHECK APPLICATION
-Menifee
DATE 7z? PERMIT/PLAN CHECK NUMBER PKI 0MI
TYPE: OCOMMERCIAL )CRESIDENTIAL 0MULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN
SUBTYPE: OADDITION OALTERATION ODEMOLITION OWLECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJEcTADDRESS (r- 9J. 5 C-i A"
ASSESSOR'S PARCEL NUMBER !Y555 IN400( LOT TRACT (o
OWNER NAME 04-f#t^.rc- .5.0.4 - -- C
ADDRESS le 5"op C ,,�'y
PHONE -7-99 EMAIL
APPLICANT NAME J0,6-
ADDRESS J ()
PHONE 9TI 7,13 z1-7 3e> EMAIL �—y J--�LZ�
CONTRACTOR'S NAME OWNER BUILDER? 0 YES --,NO
BUSINESS NAME I f L" C-
ADDRESS -2-�7 cr j re, (z VA*-lle .;e C,;i 5�7 4�Z-�
PHONE
I " EMAIL
CONTRACTOR'S STATE LIC NUMBER t&*�--5-4 1 LICENSE CLASSIFICATION
VALUATION$ SO FT L SQ FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION OF 6N�4SZ14CENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP I F� I
INVOICE PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
AMOUNT I I
PLAN CHECK FEES PAIDAMOUNT I I OCASH OCHECK# 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 Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213