PMT16-03186 City of Menifee Permit No.; PMT16-03186
29714 HAUN RD. Type: Residential Electrical
<A-CCr=CA—> MENIFEE,CA 92586
MENIFEE Date IssuLd: 09/27/2016
P E R M I T
Site Address: 27815 FOXFIRE ST, MENIFEE,CA 92586 Parcel Number: 335-353-002
Construction Cost: $700.00
Existing Use: Proposed Use:
Description of MAIN PANEL UPGRADE 125A
Work:
Owner Contractor
JOHN WADE SOLCIUS LLC
27815 FOXFIRE STREET 1145 SOUTH 800 EAST SUITE 201
MENIFEE, CA 92586 OREM, UT 84097
Applicant Phone:8018994541
CHRISTIAN OSORIO License Number:976336
SOLCIUS U-C
12155 MAGNOLIA AVE
RIVERSIDE, CA 92503
Fee Description city 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 correction of errors in the plans and
specifications or from preventing builiding operations being carded 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.B1dg_Perrnit-TeMplate.rpt Page I of 1
City Of Menifee
LICENSED DECLARATION
I hereby affirm under penalty or pedury that I am licensed under provisions of El 1, as owner of the property an exclusively contracting with licensed
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044.Business and Professions
Professions Code and my license is in full force and effect. Code:The Contractors License Law does not apply to an owner of a property
Ulcense Class C--10 UcenseNo. q7, .,,,536 who builds or improves thereon, and who contracts for the projects with a
Expires,,?A o 71-6-- licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION 0 1 am exempt from licensure under the Contractors'State License Law for the
0 1 hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and Will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that.except for my personal residence in
compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of
Section 3700 of the Labor Code, for the performance of work for which this improvements covered by this perimIL I cannot legally sell a structure that I have
permit is issued. built as an owner-building K it has not been constructed in its entirety by licensed
Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the
AI have and will maintain workers' compensation insurance. as required by Business and Professions Code,is available upon request when this application is
se,tion 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http�//�.leoinfo.m.00v/calaw.html.
permit Is Issued.My workers'compensation insurance carder and policy number am:
Carrierc Property Owner orAuthodzLd Agent
jxt2w-65 bis 60 Date
Expires It /z// 1-5 P'licyit 5ax gotclot
Name of Agent Phone# 0 By my Signature below, I certify to each of the following: I am the property
owner or authorized to act on the property owners behalf. I have read this
(This section need figl:be completed if the permit is for application and the information I have provided Is orrect. I agree to comply
one-hundred dollars(S100)or less) with all applicable city and county ordinances and state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
0 1 certify that in the performance of the work for which this perrnit is issued,I identified 5pRerty for the 1 7 action purposes.
shall not employ any persons in any manner so as to become subject to the
workers'compensation laws of California,and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the LdUUI Property Owner orAuthorized Ag�ant Date
Code,I shall forthwith comply with those provisions. b5ono City Business License#— (93--o-7,6
Data; ?//7/1 �5- Applicant; L-V[�,kpq
WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000). IN ADDITION TO THE COST OF COMPENSATION, E]YES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES XNO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of pedury there is a construction lending INFORMATION GUIDE?
agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE 13UILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address tONO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reason(s)indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5.Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter,improve, demolish, XNO SCHOOL?
or repair any structure, prior to its 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 License Law(Chapter 9(commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or "OES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from ficensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS
Violation of Section 7031.5 by any Applicant for a permit subjects the applicant to oNO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE,SECTION 25505. 25533,AND 25534 CONCERNING
0 1. as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORI ING.
compensation, will do( )all of or( )porting of the work,and the structure is PROPERTY NER R IEDAGEN
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or Improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or Improved for the
purpose of sale).
BUILDING & SAFETY PERM IT/PLAN CHECK APPLICATION
-Wenifee
DATE q1-z? PERMIT/PLAN CHECK NUMBER 9mw - cz%st 0
TYPE: OCOMMERCIAL ORESIDENTIAL OMULTI-FAMILY OMOBILEHOME C) POOL/SPA OSIGN
SUBTYPE: OADDITION OALTERATION 0DEMOUTION OELECTRICAL CIMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES—
DESCRIPTION OF WORK /9Phd ,I, Bo�)b
PROJECTADDRESS '7,7 '6 rox 'Rlle, 51 501 C14 9 2"S q�
city at menilloo
ASSESSOR'S PARCEL NUMBER 3W -36 S- (OC)a LOT TRACT ssinty DOW
OWNER NAME J061 Ode
ADDRESS 2? '615- For, ()'re, lb�
PHONEO!�'51 2?q *27 11 EMAIL
,celved
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME _'5f)jC('0_D OWNERBUILDER? OYESOINO
BUSINESS NAME
ADDRESS 1 IZ 1'5*5 /`4o�poho Aw&Y54 o4 qz'!503
PHONE fi�Y �'5_7 ZZ 4�"X EMAIL 501(4�OgLMO'b 9 501CI'U5- CDWI
CONTRACTOR'S STATE LIC NUMBER OP,6336 LICENSE CLASSIFICATION
VALUATION$ t -7)00 SO FT L SO IT
APPLICANT'S SIGNATURE —DATE 9
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAIDAMOUNT
AMOUNT 1�qq - w � 0 CASH 0 CHECK N OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT I I OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDERVERIFIED 0 YES 0 No DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityof,menifee.us inspection Request Line 951-246-6213