PMT16-03331 City of Menifee Permit No.: PMT16-03331
29714 HAUN RD. Type: Residential Electrical
<A-CCIELA> MENIFEE,CA92586
MENIFEE Date Issued: 1011212016
P E R M I T
Site Address: 25039 CRESTPEAK CT,MENIFEE,CA Parcel Number: 339-432-026
92584 Construction Cost: $2,000.00
Existing Use: Proposed Use:
Description of MSP UPGRADE TO 225AMP FOR SOLAR PERMIT PMT16-03326
Work:
Owner Contractor
MICHAEL FORNAROTTO HOSHAW ELECTRIC
25039 CRESTPEAK CT 6311 PULLMAN CT
MENIFEE,CA 92584 RIVERSIDE, CA 92505
Applicant Phone:9515446574
JOSH POGUE License Number.,814080
HOSHAW ELECTRIC
6311 PULLMAN CT
RIVERSIDE,CA 92505
Fee Description City 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 6.80
$149.80
The issuance of this permit shall not prevent the building official from thereafter requiiing the correction of errors in the plans and
specifications or from preventing builicling 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 commenoad is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA BldgPemit-Templaterpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and ci I am exempt from Hcensure under the Contractor's State Uicense Law for
Professions Code is in full force and effect. the following reason:
License Class 7;v License No. firIM1040.0 By my signature below I acknowledge that,except for my personal residence
Expires A/
&e?J�Z2! _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
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 pena Ity 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 Professlans Code,is available upon request when
com pensation,issued by the Director of Inclustrila I 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 www.Ieginfo.ca.gov1caIaw.htmI.
this permit is issued.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
a I have and will maintain worker's compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which cr By my signature below I certify to each of the following:I a on the property
this permit is issued.My workerrs compensation insurance ca rcler 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
with all applicable city and county ordinances and state laws relating to
Carrier 22�-P— 7 building construction.I authorize representatives of this city or county to
Policy# / enter the above identified property for inspection purposes.
I r Expires s!��/ —
(This section need not to be completed is the permit is for onehundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
a I certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in a ny me nner so as to becom e 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 worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwithvomply with those provisions. Will the applicant or future building occupant handle hazardous material or a
App I im at —Date mixture containing a hazardous material equal to or greater that the
am�o�specified on the Hazardous Materials Information Guide?
WARNING:FAILL14 TO SECURE WORKER'S COMPENSATION COVERAGE IS goTes ci No
UNLAWFUL,AND SHALLSUBJECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building bythe 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 COSTOF 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 forguidelines
CONSTRUCTION LENDING AGENCY m Yes a No
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) a Yes o No
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 perjury that I am exempt from the California Health&Safety Code,Section 2S505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the h
.�;�zar usmaterial reporting.
e, ,
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es o No
Business and Professions Code).Any city or county that requires a permit to 4Z06E=�;� Date
construct,alter,Improve,demolish or repair any structure,prior to its PROPERTY OWNERTWAIDTHORIZED AGENT
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 EPA RENOVATION,REPAIR 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
a nd the basis for the a Ileged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRPcertified firms and comply with
an Applicant for a permit subjects the applicant to a civil pena Ity of not more required practices.This includes renta I property owners and property
than($500). managers who clothe paint-clisturbing work themselves orthrough 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 all of or( )portion of the work,and the structure is www.epagov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80G-424-LEAD(5323).
Code;The Contractor's 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,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,howeverthe building or Improvement issold within oneyearof 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. cr No EPA Lead-Safe Certified Firm is required for this project bemuse:
a 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contoctoes 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.