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PMT16-03181 City of Menifee Permit No.: PMT16-03181 29714 HAUN RD. Type: Residential Electrical <A-CCELA> MENIFEE, CA 92586 MENIFEE Date Issued: 09/26/2016 P E R M I T Site Address: 27695 BLUE DIAMOND LN, MENIFEE,CA Parcel Number: 329-290-030 92585 Construction Cost: $2,000.00 Existing Use: Proposed Use: Description of 200 AMP PANEL UPGRADE FOR FUTURE SOLAR Work: Owner Contractor DANIELMOLINA JPE ENTERPRISES INC 27695 BLUE DIAMOND LN 4634 VIA LA QUINTA MENIFEE, CA 92585 YORBA LINDA, CA 92886 Applicant Phone:7142349040 RAFAEL CABRAL License Number!633319 JPE ENTERPRISES INC 4634 VIA LA QUINTA YORBA LINDA, CA 92886 Fee Description ON Amount($) 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 requinng the correction of effors 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. AA.B[dg_Pe"r1-TeMpIate.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 u nder 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 o I am exempt from ficensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: License Class r C-) License No. G 5 �5 Z I q By my signature below I acknowledge that,except for my personal residence Expires Signature X� in which I must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legallysell 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 followilng 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 vivimleginfo.ca.aary/calaw.htmi. this permit is issued. Policy# PROPERTY OWNER OR AUTHORIZED AGENT Date ,t r1have and will maintain worker's compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which in 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 numberare: application and the information I have provided Is correct.I agree to comply T_ with all applicable city and county ordinances and state laws relating to Carrier (A�V (--? f/I building construction.I authorize representatives of this city or county to Policy t C.Z L?J Expires 0 . 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 u I certify that in the performance of the work for which this permit is issued, I shall not employ any persons in a ny manner so 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 workees compensation provisions of Section 3700 of the Labor Code,I shall fin ith am with ose provis' ns. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to or greater that the D Date amountssp -fled on the Hazardous Materials Information Guide? 'a I' am w h as prov's s� T P i�:F URE TO MECUREaWOR�KEWSCOMPENSATIONI COVERAGE IS a Yes X, 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 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 for guidet' CONSTRUCTION LENDING AGENCY 0 Yes rN. 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) rz Yes n4iloi 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 perju ry 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 pord checkmark(s)I have placed next to the applicable Itern(s)(Section 7031.5 9Y6 0 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 OW OR AUfK6Rl7ED AGENT issuance,also requires the applicant for the pennit to file a signed statement I YK 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 a lleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be FUIP-certified firms and comply with an Applica at for a permit subjects the applica nt to a civil'penalty of not more required practices.This includes rental property owners a nd 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 sale employees.For more information about EPA's Renovation Program visit: compensation,will do I I all of or( I portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions I-BOD-424-LEAD(5323). Code,The Contractor's State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements am 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. ci No EPA Lead-Safe Certified Firm Is required for this project became: 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 RRIP Acknowledgement BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION "Menifee DATE PERMITIPLAN CHECK NU kp� 007)1151 TYPE: OCOMMERCIAL eRESIDENTIAL CMULTI-FAMILY OMOBILEHOME O— POOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION ODEMOLITION 61EI.EcTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES— DESCRIPTION OF WORK 411t, (2 "C_�p &jj J-0k AC I I PROJECTADDRESS ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME ADDRESS Qia mnjn_,� La 14 PHONE ?0�_ 22 ZZL� EMAIL - T�CAPPLICANLT NAME ADDRESS �&JV L C�c,,rll 6� PHONE j(L(. 2- qo,-(6 - EMAIL CONTRACTOR'S NAME Ev) fe, r -se-s .1 c OWNERBUILDER? OYESONO BUSINESS NAME ADDRESS Q6 3q llr'c,\ La (;��,,�vi+rx VLA� L'vi,,4� , CX 9 �7&3�0- PHONE '10L(L7 EMAIL CONTRACrOWS STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ DOC2 LSQFT Lam Z7--e,1�=DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITYOFME IFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE � GREEN SMIP INVOICE I 14M VD pAIDAMOUNT AMOUNT I OCASH OCHECK# OCREDITCARD, VISA/MC PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISAtMC OWNER BUILDER VERIFIED 0 YES 0 NO DLNUMBER NOTARIZED LETTER 0 YES —_ NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92595 951-672-6777 www.cityoflmenifee.us Inspection RequestLine 951-246-6213