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PMT16-03564 City of Menifee Permit No.: PMT16-03664 29714 HAUIN RD. Type: Residential Electrical -(�kccEO� MENIFEE,CA 92586 MENIFEE Date issued: 1110312016 P E R M I T Site Address: 25598 TROY LN, MENIFIEE, CA 92587 Parcel Number: 330-240-04B Construction Cost: $800.00 Existing Use: Proposed Use: Description of MAIN PANEL UPGRADE 200A Work: Owner Contractor VICKIE GLANCY 25598 TROY LANE MENIFEE,CA 92587 Applicant License Number VICKIE GLANCY 25598 TROY LANE MENIFEE, CA 92587 Phone:9516721090 Fee Description Qtv Amount($1 Services, Switchboards, Control Centers&Panels 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1.00 General Plan Maintenance Fee-Electrical 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 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. Page I of 1 AA.Bldg_PerrrR_Template.rpt 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). Chapter!)(commeneing with section 7000)of Division 3 of the Business and ci 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 for my personal residence Expires_Signature in which I must have resided for at least one year priorto 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 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 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 this permit is Issued. Policy# Date PROPERTY OWNER OR AUTHORIZED AdF ci I have and will maintain worker's compensation insurance,as required by 7-NT section 3700 of the Labor Code,forthe 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 am: application and the information I have provided is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# Expires enter the abov identified fo—I ertyfor inspection purposes. -hundred (This section need not to be completed is the permit is for one Date .TH.RIZE. dollars($100)or less PROPERTY OWNE 'G "T 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 Date 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 ciYes ciNo 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 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 AGENCY oYes oNo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 100D 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) oYes oNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirmi 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 hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ciYes ci No Business and Professions Code).Any city or county that requires a permit to Date construct,alter,Improve,demolish or repair any slorticture,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 provisions of the Contractors 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 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 work themselves or through their &I, sawnerofthepr rty,o my employee with wages as their sole 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.eva-goyllead or contact the National Lead Information Center at not Intended or oftere 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 ci An EPA Lead-Safe Certified Renovator will be responsible forthis project property who,through employees'or personal effort,builds or improves the propertV.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. a No EPA Lead-Safe Certified Firm is required for this project bemuse: in 1,as owner of the property am 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 RAP rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION kMenifee v`v DATE 10/25/2016 PERMIT/PLAN CHECK NUMBER TYPE: F—ICOMMERCIAL FZIRESIDENTIAL E]MULTI-FAMILY FZ]MOBILEHOME F]POOL/SPA [:]SIGN SUBTYPE: E]ADDITIONE]ALTERATION []DEMOLITION [Z]EUECTRICAL []MECHANICAL F]NEWE]PLUMBING [I RE-ROOF-NUMBER OF SQUARES— City of Menifee DESCRIPTION OF WORK Electrical Panel Upgrade on 11/7 with SCE from a 100 amp 200 amp Building & Safety Dept. N.ov g i 9n16 PROJECTADDRESS 25598TroyLane SunCity, CA92587 ASSESSOR'S PARCEL NUMBER :3-30-94C)-C�A% LOT TRACT Received PROPERTY OWNER'S NAME VickieM.Glancy ADDRESS 2559BTroyLane SunCity,CA92587 PHONE (951)672-1090 EMAIL vickiedg53@gmaii.com APPLICANTNAME same ADDRESS PHONE EMAIL CONTRACIFOWS NAME OWNER BUILDER? 2jYESF]NO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ Sj L SO FT J1 ,-7 AT APPLICANT'S SIGNATURE / E 11102112016 1W W "Ism DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP )e I INVOICE PAIDAMOUNT \LA01_SDI OCASH OCHECK# OCREDITCARD VISA/MC AMOUNT 0AC-i-so I PLAN CHECK FEES I PAIDAMOUNT 0 CASH --CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED C YES 0 No DLNUMBER NOTARIZED LE17ER --, YES :' NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee.us Inspection Request Line 951-246-6213