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PMT16-03537 City of Menifee Permit No.: PMT16-03537 29714 HAUN RD- Type: Residential Electrical <A—CCEL:A—> MENIFEE, CA 92586 MENIFEE Date Issued: 11101/2016 P E R M I T Site Address: 28243 RUSTLING WIND CIR, MENIFEE, Parcel Number: 333-612-029 CA 92585 Construction Cost: $1,200.00 Existing Use; Proposed Use: Description of INSTALL(2) 110 ELECTRICAL OUTLETS,(1)220 OUTLET PER PLAN Work: Owner Contractor JAMES GLEASON INTEGRITY LANDSCAPE CONSTRUCTION 28243 RUSTLING WIND CIR 31916 SEA GREEN COURT MENIFEE,CA 92585 MENIFEE, CA 92584 Applicant Phone:9514436067 INTEGRITY LANDSCAPE CONSTRUCTION License Number: 1011384 31916 SEA GREEN COURT MENIFEE,CA 92584 Fee Description QtV Amount I$ Receptacle, Switch,Outlet&Fixture 3 126.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Electrical 1 6.30 $160.30 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 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 commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA.B1dg_PeniLTemp1ate.rpt Page I of I 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 Class 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 WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by a 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 req uest 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 wvvw.Ieainfo.ca,aov/caIaw.htmI. this permit is issued. Policy# I c Date ROPERTY OWNER OR AUTHORIZED AGEN I )Wi` o I have and will maintain worker's compensation insurance,as required by section 3700 of the Labor Code,forthe performance of the work for which By my signature below I certify to each of the folloving:I am the property this permit is issued.My worker's Compensation insurance carrier and policy -1 1 —.— - 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 building construction.I authorize representatives of this city or county to Policy# Expires 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 AUTHORIZED AGENT ci I certify that In the performance of the work for which this permit is issued, Ishalinotemolo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workees 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 Date mixture containing a hazardous material equal to orgreater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS uYes oNo 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 TOONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit 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 SECTION 3706 OF THE LABOR CODE,INTEREST�AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGEN uYes ciNo 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) o Yes ci No OWNER BUILDER DECLARATIONS I haw read the Hazardous Material Information Guide a nd th e SCAQMD permitting checklist I understand my requirements under the State of I hereby affirm under penalty of perjury that I a in exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)[have placed next to the applicable item(s)(Section 7031.5 uYes a No 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 OWN ER OR AUTHORIZED AGENT issue nce,also requires the applica nt for the perm it 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 a nd Painting(RRP)Rule requires contractors Business a nd Professions Code)or that he or she is exempt from licensure receivmg compensation for most work that disturbs paint in a pre-1978 and the basis for the a IlEged exem ption.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 pinictices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their a 1,as owner of the property,or my employee with wages as their sole employees.For mom information about EPA's Renovation Program visit; compensation,will do( )all of or I )portion of the work,and the structure is www.eva.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contmctoes State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.It however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because: ;4/ls owner of the property a in exclusively contracting with licensed �ontractors to construct the project(Section 70",Business and Professions Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. city of Menifee Buildjqq.&Safety DepL. NOV 0 1 2016 Menifee PQ laived DATF PSWITIPLANaECKNUMBER 'eirtflO - TYPE ElaommiarIALbaimax [�un-FmLY [�OEILEHOME EjbWTA [�GN aimy3E [�Du�� [jkTmA, -noN ElhwouTiON )4kB7RcAL [3iI83-IANICAL CRJEWE�11JMEIING EjkK)ORNUMBEROFMLIA�. DBM-IPInONOFWOW --�2— // 0 PRaIECIFADDREBS ASSIMMSW4M-NUMBE163 3 0 11- LOT LAP TFACI- (2Ak-Jhle ADMM /V PHONE EMAIL APPLICANTNAM ADMM eV 61-71;ve PHONE -7/q EMAIL ODNTPAGIFOR RNAM E—TA�1�,,>i IA C�,tr & 4� 2�MERBUILQER? [�ffigk 4 BUSINESSNAME ADDFUS _,�Jj ::;ov i PHONE EMAIL ampAcroRssrATELICNUMEER UC3=NSEaAS3RCA-nON VAWATON$ 14/";0 C) MFr La)Fr APPU CANT S SIGNATURFzQg. DATE f DEPARWENT[)ISTRBACI�NG FIFE GIL I —7CF�IFEEWSNESSUCNTNUMBER BUILEM R-ANNING ESIGI SWIP = J, 1�0,50 I PRDAMOUNT MmTcam \ASVMC RAN CHECKFEES I PAJDAMOJNT MHXTGMD Msvmc— OM4ERBLJILDERVERFIED MES MQ DLNUMBER NOTAMEDMITER MES MID aty of Menifee Building&Safety Department 29714 Haun M. Menifee, CA 92586 951-672-6777 www.cjtyofmenifee.us Inspection Request Line 951-246-6213 — ---------- 301M 07VA Ag a3NIVINNY th ———————————7z 7, 456 1 �3 r"-' , BW .,:m Ln NIM 0 L N1 :3Z co .14 aam= WIN %0'1 .0e '19 'NMV-ZO G Ln CD CD Z. c.).1, I coj 00 C3, CD l< CD 11 -my cr) V7 611 'Nln�g zi Z9,.q -1i AT'K. r Ol