PMT16-03726 City of Menifee Permit No.: PMT16-03726
29714 HAUN RD. Type: Residential Electrical
'5ACCIELA-> MENIFEE,CA 92586
MENIFEE Date Issued: 11/1812.016
P E R M I T
Site Address: 25040 SHERMAN RD, MENIFEE, CA Parcel Number: 329-270-013
92585 Construction Cost: $2,000.00
Existing Use: Proposed Use:
Description of ELECTRICAL PANEL UPGRADE TO 200 AMP FOR SOLAR PERMIT PMT16-03567
Work:
Owner Contractor
JOSE SEVILLA W C HEATING&AIR CONDITIONING INC
25040 SHERMAN ROAD 41085 GOLDEN GATE CIR
MENIFEE, CA 92585 MURRIETA, CA 92562
Applicant Phone:9516000700
RALPH BARRON License Number.779604
41085 GOLDEN GATE CIR
MURRIETA, CA 92562
Fee Description QtV Amount($1
Receptacle, Switch,Outlet&Fixture 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 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 pennit 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 Bidg_Permit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I herebyaffirm under penalty of perjury that I am under provisions of With a licensed contmctor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ri I am exempt from licensure under the Contractoes State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class Ulcense No T?9(roel 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
WORKER'S COMPENSATION DECLAFJ�KON improvements covered by this permit.I cannot legally sell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
a 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 wifll maintain a certificate of consent of self-insure for workees 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. www.Ieglnfo.ca.Rov/caIaw.IitmI,
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
ci 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 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 ca rrier a ad policy owner or authorized to act on the property owner's beha If.I have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier P—��r4eli 7(-5VMkCr- with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or muntyto
Policy# t�/(- Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is forone-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
I certify that in the performance of the work for which this permit is issued,
Ishalinotemplo 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 workees compensation provisions of Section 3700 of the Labor
Code,I shall forthwifth comply With those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applica nt �7 �44eP"de�14C/- 'Date amounts specified an the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS ciYes NNo
UNLAWFUL,AND SHALL SUBJECTAN 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($200,000),IN occupant require a permit for the construction or modifintion 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 %RYm 0 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) 0 Yes q 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 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
Business and Professions Code).Any city or county that requires a permitto Date
construct,alter,improve,demolish or repair any structure,prior to its "WOPERTY OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed staitement
that he or she is licensed pursuant to the provisions of the Contractor's State I�ZEPA RENOVATION,REPAIR AND PAINTING MRPI
License Law(Chapter9(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 childca re fa cility 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
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( )all of or( )portion of the work,and the structure is www.epa.goy/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 dam 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.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 because:
a 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 dam not comply with EPA RRP rule please fill out the RRP
Acknowledgement.