PMT16-03825 City of Menifee Permit No.: PMT16-03825
29714 HAUN RD. Type: Residential Electrical
<A—CCEL:A—> MENIFEE. CA 92586
MENIFEE Date Issued: 11130/2016
P E R M I T
SiteAddress: 28700 THORNHILL DR,MENIFEE, CA Parcel Number: 337-353-017
92586 Construction Cost: $2,000.00
Existing Use: Proposed Use:
Description of MAIN PANEL UPGRADE 200A
Work:
Owner Contractor
CHRISTOPHER ROSE SUNRUN INSTALLATION SERVICES INC
28700 THORNHILL DRIVE 775 FIERO LANE STE 200
MENIFEE, CA 92586 SAN LUIS OBISPO,CA 93401
Applicant Phone:4155806900
JORDAN AUDIFFEREN License Number.750184
SUNRUN INSTALLATION SERVICES INC
775 FIERO LANE STE 200
SAN LUIS OBISPO,CA 93401
Fee Description ON 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 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.B1dg_Pemft—TeM;p1ate.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION 13 1 am exempt from ficensure under the Contraclors'Slate License Law for the
I hereby affirm under penalty or perjury that I am licensed under provisions of following reason:
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that,except for my personal residence in
Professions Code and my license is in full force and effect. which I must have resided for at least one year prior to completion of
License Class 6—10 __-Use improvements covered by this permilit,I cannot legally sell a structure that I have
Expires(y*,930-IN Signatu built as an owner-buildfng if it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law.Section 7044 of the
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is
submitted or at the following Web site:
0 1 hereby affirm under penalty of pedury one of the following declarations
I have and will maintain a certificate of consent of self-iinsure for workers: hff P.,/Iwww.leginfo.ca.gov/mlaw.html.
compensation,issued by the Director of Industrial Relations as provided for by Date
Section 370D of the Labor Code, for the performance of work for which this
permit is issued. Property Owner orAuthoflzed Agent
Policy# 0 By my Signature below, I certify to each of the following:I am the property
0 1 have and will maintain workers' compensation insurance. as required by owner or authorized to act on the property owners behalf. I have read this
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided Is correct I agree to comply
permit is Issued.Myworkers'compensation Insurance carder and policy number are: with all applicable city and county ordinances and slate laws relating to building
construction.I authorize representatives of this cilyor county to enter the above-
Carriera,wfal AmRi-ir identified property for the inspection purposes.
PoIiry#Wr_0(*3A(P0J1 Expires 10*1'1(P Property Owner orAuthorized Agent —Date
(This section need not be completed if the permit is for City Business License# 0;557 10
one-hundred dollats-(_$1 00)or less)
HAZARDOUS MATERIAL DECLARATION
0 1 certify that in the performance of the work for which this permit is issued,I
shall not emol any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers'compensation laws of California,and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts S
Code,I shall fbrthwfth��Ilth those provisions. 'pecified on the Hazardous Materials Information Guide?
OYES YNO
Appfilc:�� Date; .(S*kf Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast AJr Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidefirles
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 0 YES C9N0
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary f h I?
LABOR CODE, INTEREST,AND ATTORNEYS FEES OYES Aaosc 00
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous material reporting.
OWNER BUILDER DECLARATIONS ?§�(ES D NO
I hereby affirm under penalty of pinjury that I am exempt from the Contractors Date Hsl(&
License Law for the resson(s)indicated below by the checkmark(s)I have placed PR6�RETY OWN�IT®R AUTHORIZED AGENT
next to the applicable item(s)(Section 7031.5.Business and Professions Code:
Any city or county that requires a permit to construct,alter improve,demolish, EPA RENOVATION,REPAIR AND PAINTING(RRP)
or repair any structure.prior to its issuance. also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law(Chapter 9 (commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare fadlity to be RRP-cerfified firms and comply with
she is exempt from ficensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by anyApplicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees.For more Information about EPXs Renovation Prograrrivisit:
www.epa.govfiead or contact the National Lead Information Center at
0 1, as owner of the propertA or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the work,and the structure Is
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property D An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort, builds or improves the propertA
provided that the improvements are not intended or offered for sale.If,however Certified Firm Name:
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the Firm Certification No.:
purpose of sale).
11 1, as owner of the property an exclusively contracting with licensed 0 No EPA Lead-Safe Certified Firm Is required for this project because:
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
who builds or impmves thereon, and who contracts for the projects with a
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
-S
Menifee
DATE PERMIT/PLAN CHECK NUMBER f
TYPE: ()COMMERCIAL )PRESIDENTIAL -) MULTI-FAMILY - MOBILEHOME 0 POOL/SPA 0 SIGN
SUBTYPE: "DADDITION OALTERATION ODEMOLITION XELECTRICAL MECHANICAL
ONEW OPLUMBING 0. RE-ROOF-NUMBER OF SQUARES—
DESCRIPTION OF WORK Md�tj pa"I 11gradjI, "jS�-jVJ8 10() A +0 �)_WA
PROJECTADDRESS 1,170o lbornh;l) 12r. 0GO&P
ASSESSOR'S PARCEL NUMBER 33 1) 14 LOT TRACT
OWNERNAME C41riS+j.rhw Rj�-�
ADDRESS -M riqNtu D�. �LAi4 Ury (0
PHONE CT S; I - '776 - L1511 EMAIL
APPLICANT NAME��Or
da&j :6 q h',Af IC41M
ADDRESS �:�;Fd-O �]Ckje (j)- /�j VI-Vj-e+a CA 40,� Ijo
PHONE 7(po - ]61? LP�Sq8 EMAIL-Jdrd".
CONTRAcroWSNAME (-ii1btkt OWNER BUILDER? YES Q NO
BUSINESS NAME SaPrIW -F
ADDRESS Lwis jbl�go C4 01-440)
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION C- 10
VALUATION $ _10_�o SO FT L SO FT
APPLICANT'S SIGNATURE �
DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIF,
INVOICE PAID AMOUNT OCASH
AMOUNT LACI .80 1 C,CHECK 9 OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0 CASH CHECK# C'CREDITCARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 No DL NUMBER NOTARIZED LETTER G YESO' NO
City of Menifee Building&Safety Department 29714 HGUn Rd. Menifee, CA 92586 951-672-6777
www.citvofmenifee.us Inspection Request Line 951-246-6213