The URL can be used to link to this page

PMT16-03880 City of Menifee Permit No.: PMT16-03880 29714 HAUN RD. '1;kCCr-LA—> MENIFEE,CA 92586 Type: Residential Electrical MENIFEE Date Issued: 12/0112016 P E R M I T Site Address: 29806 PAINTED DESERT DR,MENIFEE, Parcel Number: 340-141-016 CA 92584 Construction Cost: $1,000.00 Existing Use: Proposed Use: Description of UPGRADE SERVICE PANEL TO 200AMPS Work: Owner Contractor CHRIS BRISSEY SMITH ELECTRICAL CONTRACTORS INC 29806 PAINTED DESERT DR 206 GREENFIELD DR STE G MENIFEE, CA 92584 EL CAJON, CA 92020 Applicant Phone:6197589829 JANE RECKTIENWALD License Number.871200 SMITH ELECTRICAL CONTRACTORS INC 206 GREENFIELD DR STE G EL CAJON, CA 92020 Fee Description QtV Amount($ 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 effors in the plans and specifications or from preventing builiding operations being carded 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 Bldg_Pemit Ternplate.rpt Page 1 of 1 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 Contractors State License Law for Professions Code and my license is In full force and effect. the following mason: License Class_CA,0 License No.S"I k D'c�c� By my signature below I acknowledge that,except for my personal residence Expires 1-3 AS 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 WORKERS COMPENSATION DECLARATION have built as an owner-builder If It has not been constructed In its entirety by cz 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 com pensation,Issued by the Director of Industria I Relations as provided for this application is submitted or at the following website: by Section 3700 of the La bor Code,for the performance of work for which www.IeRInfo.m.Rov/calaw.htmL this permit is issued. Policy# PROPERTY OWNER OR AUTHORIZED AGENT Date cz I have and will maintain worker*s compensation insumnce,as required by section 3700 of the Labor Code,for the performance of the work for which o 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 are: 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#11'00(5 to L'to Expires \0-D-7�-C-1 enter the above Identified pro y for inspection purposes. (This section need not to be completed is the permit is for one-hundred =---'—Date dollars($100)or less PROPERTY O-WWE—ROR t,1115RIZED AGENT o I certify that in the performance of the work for which this permit Is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# ac� worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensat! rovisions of Section 3700 of the Labor Code,I shall forthwith comply K ose provisi ns. 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? MIARNING.FAILURE TO SE LURF-WORKERS COMPENSATION COVERAGE IS o Yes cz No 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 them 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) uYes oNo 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 Contractor's 1.11cense 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 aYes ci 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 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 Contractoes state EPA RENOVATION,REPAIR AND PAINTING(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 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.goyllead 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 a 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 Certificartion 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 bemuse: cz 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 APPLICATI,O DATE 12-1-16 PERMIT/PLAN CHECK NUMBER 0 TYPE: ;COMMERCIAL VRESIDENTIAL :, MULTI-FAMILY -1 MOBILE HOME POOL/SPA -'SIGN SUBTYPE: 0 ADDITION ,ALTERATION '.,DEMOLITION VELECTRICAL MECHANICAL I : NEW - PLUMBING ; RE-ROOF-NUMBER OF SCLUARES DESCRIPTION OF WORK JJpqrade service panel to 200 amps PROJECTADDREss 29806 Painted Desert Dr, Menifee CA 92584 ASSESSOR'S PARCEL NUMBER 340-141-016 LOT 63L TRACT OWNER NAME Chris Brissey ADDRESS -29806 Painted Desert Dr, Menifee CA 92584 PHONE 918-6229-6223 - EMAIL APPLICANT NAM Jane Recktenwald ADDRESS PHONE 714-336-6159 EMAIL CONTRACTOR'S NAME Smith Electrical OWNER BUILDER? - YES VNO BUSINESS NAME Smith Electrical ADDRESS 206 Gr enfield Dr Ste G El Cajon, CA 92020 PHONE 619-758-9829 *AX _Busj_rLes_sjjjrense # 037694 CONTRACTOR'S STATE LIC NUMBER 871200 LICENSE CLASSIFICATION C10 VALUATION$ SQ FT L SO FT APPLICANT'S SIGNATURE 12-1-16 DEPARTME N T DISTRIBUTION IIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING _EN I E ING FIRE I GREI INVOICE 14H .WL�PAI��UNT AMOUNT I 1 1)CASH 'CHECK4 CREDIT CARD VISAIIVIC PLAN CHECK FEES PAIDAMOUNT CASH CHECK# CRIEDITCARD VISA/MC OWNER BUILDER VERIFIED - YES NO DL NUMBER NOTARIZED LETTER-- - YES , NO City of tvIejwjet� 8ujjdjI?g& Safety Departmetit 29714 Huan Rd Menifee, CA 92586 951.6174-6777 www.cityQjffl�tj;i'v0�,;J17.�lle(U00 00"95 1 621.3