PMT16-03906 City of Menifee Permit No.: PMT16-03906
29714 HAUN RD. Type: Residential Electrical
<ACC1RLA—> MENIFEE, CA 92586
MENIFEE Date Issued: 1210212016
P E R M I T
Site Address: 27080 PRESELY ST, MENIFEE, CA 92586 Parcel Number: 335-305-014
Construction Cost: $800.00
Existing Use: Proposed Use:
Description of PANEL UPGRADE 125 MAIN TO 225 BOSS
Work:
Owner Contractor
DELIA DE LA ROCHA SOLCIUS LLC
27080 PRESLEY ST 1145 SOUTH 800 EAST SUITE 201
MENIFEE, CA 92586 OREM, UT 84097
Applicant Phone: 8018994541
CRISTIAN OSORIO License Number:976336
SOLCIUS LLC
1145 SOUTH 800 EAST SUITE 201
OREM, CA 84097
Fee Description Y. Amount 1$)
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_Bldg_Pemit Template,rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of n I a m exem pt from licensure under the Contractor's State License Law for
Chapter9(commencing With section 7000)of Division 3 of the Business and
Professions Code and my license is in full force and effect. the following reason:
License Class C—10 —License No. 17?�30 By my signature below I acknowledge that except for my personal residence
Expires Cl (Zl_-Signature in which I must have resided for at least one year prior to 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
ri 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 www.leginfo.ca.go-vLm-Iaw-IitmI
this permit is issued. Date
Policy# PROPERTY OWN ER OR AUTHORIZED AGENT
A-<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 o By my signature below I certify to each of the following:I am the property
this permit is issued.My workees compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
application and the information I have provided is correct.I agree to comply
number are: county ordinance&and state laws relating to
'fiei n C�() 14ebl!4 with all applicable city and
Carrier building construction.I authorize representatilves of this City or county to
Policy# 56YX &OV110 Expires ti i 7, 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 Ins PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued, CITY BUSINESS LICENSE# 05805(o
1 shall not emoloy any persons in any manner so as to become subject to the
worker's compensafion laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compenr6ion provisions of Section 3700 f the abor
Code,I shall fort>ith compi ' those provisions. Will the applicant or future building occupant handle hazardous material or a
&- �� It 7.4,1 1 mi.xture containing a hazardous material equal to or greater that the
Applicant :-09py amounts specified on the Hazardous Materials Information Guii
WARNING: AILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS 0 Yes U-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 constructlion 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 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES lorguidelines
CONSTRUCTION LENDING AGENCY 0 Yes 1;114C
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
lendinj agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) 0 Yes 4X6�
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checkfisL I understand my requirements underthe 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 he ardous material reportiov
checkma rk(s)I have pla ced next to the applicable item(s)(Section 7031.5 N ///� /1 16
Business and Professions Code).Any city or county that requires a permit to 2f Date 61
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 EPA REN ON,REPAIR AND PAINTING(RRPI
that he or she is licensed pursuant to the provisions of the Contmctoes State
License Law(Chapter 9(commeneing 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][censure receiviing 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
a n Applicant for a permit subjects th e 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 propeft or my employee with wages as their sole employees.For more information about EPA!s Renovation Program visit:
compensation,will do( )all of or( I portion of the work,and the structure is wwvV I pamoyllead 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 u 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,ciffered 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 o No EPA Lead-Safe Certified Firm is required for this project because:
not built or improved for the purpose of sale.
a 1,as owner of the property am exclusively contracting With licensed
contractors to construct the project(Section 71144,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.
UETY PERMIT/PLAN CHECK APPLICATION
Wenifee
DATE PERMIT/PLAN CHECK NUMBER dol
TYPE: OCOMMERCIAL ORESIDENTIAL OMULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN
SUBTYPE: OADDITION OALTERATION ODEMOLITION CNELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
-Z'5 )
DESCRIPTION OF WORK PC44 OK62� 12-S I'Atir) 2' AP
f L/
PROJECTADDRESS -n-nt�
ASSESSOR'S PARCEL NUMBER .5w, 0144 LOT TRACT
OWNER NAME e�k I r, a LC4 CIVA
ADDRESS S� (-)'60 Nebl?-k�
PHONE (,611 4M Lj�'31 EMAIL
APPLICANT NAME 0-Y&JKly) osiotlo
ADDRESS
PHONE EMAIL
CONTRACrOWS NAME /C I'u t) OWNEE-BUILDER? OYESONO
BUSINESS NAME 5e)jc'1&5
ADDRESS 1?-1 '55 kw/1C, 4 , Avllyr-';�o G�+ f
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER q76�53 6 LICENSE CLASSIFICATION
S
VALUATION $ L SQ FT
LAP,PLICANT'S SIGNATURE DATE 621
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER_
BUILDING PLANNING ENG;INEERING FIRE GIEN SMIP
INVOI E PAID AMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC
'C
AMOUNT
I M 0 C S OC it
PLAN CHECK FEES P:1 A,I I III A I I,I 10 1 U I IN,I IT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDERVERIFIED 0 YES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building& Safety Department 29714 Haun Rd. Menfee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213