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PMT16-03784 City of Menifee Permit No.: PMT16-03784 29714 HAUN RD. Type: Residential Electrical <A—CCX--L:A—> MENIFEE, CA 92586 MENIFEE Date Issued 1112312016 P E R M I T Site Address: 25627 SOLELL CIR,MENIFEE, CA 92584 Parcel Number: 329-380-028 Construction Cost: $450.00 Existing Use: Proposed Use: Description of 50 AMP GFCI SUBPANEL FOR ABOVE GROUND SPA Work: Owner Contractor STEVE STEFCHAK S A E BUILDERS 25627 SOLIELL CIR 28810 BROKEN ARROW CIRCLE MENIFEE, CA 92585 MENIFEE, CA 92584 Applicant Phone:9516585807 SCOTT EGBERT License Number.625328 S A E BUILDERS 28810 BROKEN ARROW CIRCLE MENIFEE, CA 92584 Fee Description ON Amount Receptacle, Switch,Outlet&Fixture 1 116.00 Building Permit Issuance 1 27.00 Inspections not specified 129 129.07 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 6.45 General Plan Maintenance Fee-Electrical 1 5.80 $285.32 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 builiding 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.8k1g_Perrnft—Template.rpt Page 1 of 1 I —_ CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the pil with a licensed contractor(s)pu rsuant 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 o I am exempt from licensure under the Contractor's State License Law for Professions Code an my license is in full force and effect the following reason: LicenseClass Licen 8 By my signature below I acknowledge that,except for my personal residence e in which I must have resided forat least oneyear prilortocompletion of Expir s 7 Signature improvements covered bythis permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DIEC"OQ�)� have built as an owner-builder if it has not been constructed in its entirety by ci I hereby affirm under penalty or—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 www.IeRinfo.ca.Kov/calaw.htmI. this permit is issued. Date PROPERTY OWNER ORAUTHORIZED AGENT I�h�ave and will maintain worker's compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which ci 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 a utharlize representatives of this city or county to Policy# Ys/��Xpires 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 o I certify that in the performance of the work for which this permit is issued, I shall not ermiloy a ny persons in any manner so as to becom a subject to the CITY BUSINESS LICENSE# 0 worker's com pensatl�o!n�lffornia,a nd agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the vierte—r's cam pe!�sa`tioap�ons of Section 3700 of the Labor Code,I shall for�wfth cpiii,15�'W�those provisions. Will the applicant or future build Ing accu pa nt hand le hazardous m aterial or a mixture containing a hazardous material equal to or greater that the Annficant Date amounts specified on the Hazardous Materials Information Guide? JARN] :F RE TO SECURE WORKER'S COMPENSATION COVERAGE IS 0 Yes /oINO U W ,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building IVIIL�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)?Sea permitting checklist IN SECTION 3706 OF THE LABOR CODEO INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY a Yes 0/40 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 0 OWNER BUILDER DECLARATIONS I have Cd the Hazardous Material Information Guide and the SCACMD 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 Contractor's License Law for the reason(s)indicated below by the hazardous mated 0 checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes Business and Professions Code).Any city or county that requires a permit to It construct,alter,Improve,demolish or repair any structure,prior to its �PROPOW RPAUTHORIZED ATGJEN�T OW U 0 'Z"' T issuance,also requires the applicant for the permittafilea signedstatement P E N that he or she is licensed pursuant to the provisions of the Contractor's State P VAT�IONREPAIR AND�PAINTIN i 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 FIRF-certified firms and comply with a n Applicant for a perm it subjects the applica nt to a civil pena Ity 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 ci 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.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 Contractor's 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 whoo through emplayeee 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-3uilder 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 does not comply with EPA RRP rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION A Men'fee - k DATE PERMIT/PLAN CHECK NUMBER Oppmfo, ov>l*+ /07-3zl 6- TYPE: OCOMMERCIAL PRESIDENTIAL 0MULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION ODEMOLITION /eELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 07zrev�,,ee-1 C5-0 441-� st-,J4.-de4- e 4� PROJECTADDRESS 50 Ze ZLI r,,12 C44 ASSESSOR'S PARCEL NUMBER —?,>IP 9 LOT TRACT OWNER NAME L5-7/�- /"-o"16 ADDRESS ? C56 er 4'e, PHONE 0 EMAIL APPLICANT NAME ADDRESS 0?08/0 6:�76116e� 4 PHONE EMAIL CONTRACTOR'S NAME C�JOF7 ao" 40df�-t OWNERBUILDER? OYE5,erNO BUSINESS NAME ADDRESS 02e?81C) If"11C lep ll�etver-g2 PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION _AP VALUATION$ L SO FT APPLICANT'S SIGNATURE DAT - ---- - m- OTYSTAFFUSEONLY DEPARTMENT 015TRIBUTION CIIYUFMI, IFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT AMOUNT A1,5- 7��] 1 1 OCASH OCHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES I PAID AMOUNT I I OCASH OCHECK# OCREDITCARD VISA/MC_ H OWNER BUILDER VERIFIED C)YES 0 NO DL NUMBER NOTARIZED LEff ER 0 YES 0 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