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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