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PMT16-03377 City of Menifee Permit No.: PMT16-03377 29714 HAUN RD. Type: Residential Electrical <A—CCELA> MENIFEE,CA 92586 MENIFEE Date Issued: 10126/2016 P E R M I T Site Address: 27229 MYLES CT, MENIFEE, CA 92585 Parcel Number: 331A80-054 Construction Cost: $1,800.00 Existing Use: Proposed Use: Description of MAIN PANEL UPGRADE 200A Work: Owner Contractor TONYARCHIBOLD AMERICAN SOLAR DIRECT INC 27229 MYLES COURT 1652 WEST EMBASSY STREET MENIFEE,CA 92585 ANAHEIM,CA 92802 Applicant Phone:4242146700 TREVON WLLIAMS License Number:941069 AMERICAN SOLAR DIRECT INC 1552 WEST EMBASSY STREET ANAHEIM,CA 92802 Fee Description Ply 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 effors in the plans and specifications or from preventing building 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_Bldg_Perrnit Template.rpt Page 1 of 1 CITY OF IVIENIFEE 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 ci I am exempt from licensuTe under the Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: License Class License No. e5&i L D Cc? By my signature below I acknowledge that,exceptfor my personal residence Expires k-2- %'k Signature inwhichl musthave resided for at least one year prior to completion of improvements covered by this permit.I mnnot 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 ci 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 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 wwv,.le-info.m.gov/calaw.html. this permit Is issued. Policy# PROPERTY OWNER OR AUTHORIZED AGENT Date ahave and will maintain worker's compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which 04y'-Y signature below I certify to each of the following:I am the property this permit is Issued.My worker's dompensation 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 with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# I ac2i 16Zed I _Expires 17 enter the above identified property for inspection purposes. (This section need not to be completed is the permit Is for one-hundred Date k-e dollars($100)or less WOPERTY OWNER OR AUTHORIZED AGENT a I certify that in the performance of the work for which this permit is issued, Ishallnotemplo any persons In any 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 worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply With those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant C��— Z� Date Jc, -2-6- mixture containinga hazardous material equalto or greater that the amounts specified onthe Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKEWS COMPENSATION COVERAGE 15 ci Yes isN6 UNLAWFUL,AND SHALL SUBJECTAN EMPLOYER M CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVI L FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a pqrmit 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 SECrION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ci Yes DWo 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) 0 Yes tpAo 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 exemptfirom the California Health&Safety Code,Section 25505 and 25534 concerning contractoes License Law for the reason(s)Indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ciYes 040- Business and Professions Code).Any city or county that requires a permit to e-1 cs— Date construct,alter,improve,demolish or repair any struatire,prior to its PROPERTY OWNER OR AUTHORIZED AGENT issuance,also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisionsof 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 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing worlithemselves orthrough their ci 1,as owner of the propeft or my employee with wages astheirsole employees.For more information about EPA!s Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gay/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a u An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through em ployees'or persona I 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 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 bemuse: ci 1,as owner of the property a in 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 RRP Acknowledgement.