PMT16-03237 City of Menifee Permit No.: PMT16-03237
29714 HAUN RD. Type: Commercial Electrical
4�A. CCIELA—> MENIFEE, CA 92686
MENIFEE Date Issued: 11/0712016
P E R M I T
Site Address: 30428 HAUN RD, MENIFEE, CA 92584 Parcel Number: 360-690-019
Construction Cost: $23,000.00
Existing Use; Proposed Use:
Description of REMOVE&REPLACE 400AMP SWITCH GEAR, PROVIDE&INSTALL NEW 150KVA TRANSFORMER
Work: &400AMP PANEL
Owner Contractor
DONAHUE SCHRIBER PORTERMATT ELECTRIC INC
200 BAKER ST#100 5431 PRODUCTION DRIVE
COSTA MESA, CA 92626 HUNTINGTON BEACH,CA 92649-1524
Applicant Phone:7145968788
MICHAEL BLANCO License Number: 776182
PORTERMATT ELECTRIC INC
5431 PRODUCTION DRIVE
HUNTINGTON BEACH, CA
Fee Description Qtv Amount($1
Power Apparatus 1 183.00
Services, Switchboards,Control Centers&Panels 1 183.00
Building Permit Issuance 1 27.00
Additional Plan Review Electrical 105 105.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Electrical 1 18.30
$517.30
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of enrors in the plans and
specifications or from preventing buillding 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.
AkB1dg_PeTrnR-Teo1p1ate.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 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason;
License Clam License No. By my signature below I acknowledge that,except formy personal residence
Expires Signature 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
WORKEWS 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
com pensation,issued by the Director of Industrial Relations as provided for this application Is submitted or at the following website:
by Section 3700 of the La bor Code,for the performance of work for which
this permit is issued. www.leRinfo.ca.Rov/caIaw.htmI.
Policy# 2-7-4f, Date
a 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 a 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 stale laws relating to
building construction.I authorize representatives of this city or county to
Policy# Expire _— 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 AUTHQRIZED AGENT
ci I certify that in the performance of the work for which this permit is issued, I
Ishallnotemplo any persons in any manner so as to become subject to the CITY BUSINESS LIOENSE# . %O�M 7
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 comply with S. Will the applicant or future building occupant handle hazardous material or a
Applicant Date b mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS 0yes �c!iNo
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
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FO occupant require a permit for the construction or modification from South
R Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguicheynes
CONSTRUCTION LENDING AGENCY aYes bNo
I hereby affirm that under the penalty of perjury them 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 bogiNfary of a school?
(Section 3097 Civil Code) I Yes 0
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
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have 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 Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AU111ORIZED AGENT
Issuance,a lso 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 EPA RENOVATION,REPAIR AND PAINTING IRRP)
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 r . . mpensation for most work that disturbs paint In a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving co
an Applicant for a permit subjects the applicant to a civil penalty of not more 'sidence or childcare facility to be RRP-certifled firms and comply wilth
than($500). required practices.This includes rental property owners and property
managers who do the paint-disturbing work themselves or through their
o 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 I )all of or I 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 71344,Business and Professions 1-800-424-LEAD(5323).
Code;The Contactoes State License Law does not apply to an owner of a ci An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,th rough em ployees'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 yearof Firm Certification No.:
completion,the Owner-Builder will have the burden of provingthat itwas
not built orimproved forthe purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project bemuse:
ci 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractoes 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 10-3116 PERMIT/PLAN CHE K NUMBERTMW47- 0157,�,
TYPE: IeCOMMERCIAL ORESIDENTIAL 0MULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN
SUBTYPE: 0 ADDITION 0 ALTERATION 0 DEMOLITION �eELECTRICAL 0 MECHANICAL
NEW
OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK lu-'\gIvI5 A tapv�qfr 4O()Ar 5VJ%rCj* Gleytil- I PRGVIVV
FjEW
PROJECTADDRESS —5t4lr7- %,W144, 204,
ASSESSOR'S PARCEL NUMBER d�ft�(9:00-- Qlj LOT 2A TRACT
OWNER NAME D&"Am-jv -4cAf%%OtL
ADDRESS Z&-) 51-0,6- 5-t- E;ik 10 0, COS-90-i WWSN�C"\- 916 a
PHONE '�\L\ 5<— N00 EMAIL
APPLICANT NAME ?-Nlcksw� 6vowrc>
ADDRESS (54& ?V0DVC-tj1,-,J D'?,,
PHONE q6vj, 4jo(� -t3 G6 EMAIL f-%1krC
CONTRACTOR'S NAME OWNERBUILDER? 0YES (/NO
BUSINESS NAME
ADDRESS VIM ftAP13U-ej,3j-J
PHONE EMAIL
CONTRACTOR'S STATE LIC NUM13ER LICENSE CLASSIFICATION o
VALUATION$ 2,5,000- SO FT L SO FT
��PUICANT'S SIGNATURE DATE— /
� i � ) 1 w ��MM
DEPARTMENT DISTRIBUTIO-N CITY OF ULLULLICENSE NUMBER
BUILDING PLANNING ENGINEERIWG F/tREGREEN lt4 SMIP
INVOICE PAID AMOUNT
AMOUNT I 1 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
P I MOU T
PLAN CHECK FEES PAIDAMOUNT
E I 1 0 CASH 0 CHECK# OCREDITCARD 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. IVIenij'ee, CA 92586 951-672-6777
www.cityofrnenij'ee.us Inspection Request Line 951-245-6213