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PMT16-04016 City of Menifee Permit No.: PMT16-04016 29714 HAUN RD. Type: Residential Electrical <A—CCELA—> MENIFEE, CA 92586 MENIFEE Date Issued: 12108/2016 P E R M I T Site Address: 27724 GENEVIEVE DR, MENIFEE, CA Parcel Number: 335-402-016 92586 Construction Cost: $5,832.00 Existing Use: Proposed Use: Description of UPGRADE ELECTRICAL PANEL FROM 100 TO 125 AMPS Work: Owner Contractor BARBARA TOLLIVER A R S AMERICAN RESIDENTIAL SERVICES OF 27724 GENEVIEVE DR CALIFORNIA INC M ENIFEE, CA 92586 965 RIDGE LAKE BLVD SUITE 201 Applicant Phone:9512769744 CHRISTINA CALHOUN License Number:765074 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORN]i 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS, CA 38120 Fee Description P!Y. 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 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_Permit_Temp1ate.rpt Page I of I 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 contnictor(s)pursuant to the Contractors State License Law). Chaptis-9(commencing with section 7000)of Division 3 of the Business and u I am exempt from licensure under the CDritractor's State License Law for Professions Code and my license is in full force and effect. the following mason: License class r LI 0 By my signature below I acknowledge that,except for my personal residence .,�- U._O '�P 4G& (0&6i—.'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 WORKE�S�COPAPENSATICIN DECLARATION have built as an owner-builder If it has not been constructed in its entirety by o 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 mque,st when compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website: by Section 37aO of the Labor Code,for the performance of work for which wvvw.Ieginfo.m.Rov1c;;law.htmI. this permit is issued. Policy# Date— a I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT 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 carrier and policy owner or authorized to act an the property owner's behalf.I have read this numberare: application and the information I have provided is correct.I agree to comply I with all applicable city and county ordinances and state laws relating to C;rrIerU,\,;Iu&C44 building construction.I authorize representatives of this city or county to Policy# fusm-tallod,0S Expires enterthe above identified property for Inspection purposes. (This section need not to be completed is the permit Is for one-hundred Date— dollars($200)or less PROPERTY OWNER OR AUTHORIZED AGENT ei 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 became subject to the CITY BUSINESS LICENSE$1 560-7 Lf worker's compensation laws of Ca lifamia,and agree that if I should became HAZARDOUS MATERIAL DECLARATION subject n W ons a lion 3700 ofAq Labor Will the applicant or future building occupant handle hazardous material ora Code,I Date rrfixture containing a hazardous material equal to or greater that the Applins, -5F -:ezlt L111-7 amounts specified on the Hazardous Materials Information Guide? WARN14G-,f<IL�URETOSECUREI�ORKER'SCOMPENSATIOWOD�ERAGEIS ayes �� UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Nil the Intended use of the building by the applicant or future building AN D CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($103,000),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 forguldelines CONSTRUCTION LENDING AGENCY oYes �610 I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 10130 feet of the lending agency for the performa nee of the work which this permit Is Issued outer boundary of a school? (Section 3097 Civil Code) o Yes -;Pk- OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of action 25 and 25534 concerning I hereby affirm under penalty of perjury that I am exempt train the Ca lifamia Health&Safety C�" Contractor's License Law for the reason(s)Indicated below by the hazardous material 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 permit to Date construct,alter,Improve,demolish or repair any structure,priorto Its issuance,also requires the appilont for the permit to file a signed statement &RQPWV CWhEr011 that he orshe is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI 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 orshe is exempt from ficensure 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 childnre facility to be FIRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not mom required practices.This Includes rental property owners and property than($500). managers who do the palnt-disturbing work themselves or through their ci 1,as owner of the property,or my employee with wages as their sale employees.For mom information about EPA's Renovation Program visit: compensation,will do( )all of or I I portion of the work,and the structure is ww%,.epa.gov/Iead 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 Contractorjs State License Law dam not apply to an owner of a n 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-Bullder 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 became: c 1,as owner of the property am"elusively contracting with licensed contractors to construct the project(Section 7044,Butsiness and Profeszsions Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply With EPA RRP role please fill out the RRP Acknowledgement. & SAFETY PERMIT/PLAN CHECK APPLICATION �,&'Men*fee r DATE 1Z 16116 PERMIT/PLAN CHECK NUMBER TYPE: ,COMMERCIAL )54RESIDENTIAL - MULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION �ALTERATION ODEMOLITION D41-EcTRICAL CMECHANICAL ONEW OPLUMBING C) RE-ROOF-NUMBER OF SQUARES— DESCRIPTION OF WORK 5_t�v�-CA 9ror� Oz� o _r6 PROJECTADDRESS ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME ADDRESS 4t>*,vu�a- �<X)v A-&1v-qS-b PHONE EMAIL APPLICANTNAME 0,(N &k�%wovv--) ADDRESS C_C�e-%4%&QJr01v— PHONE EMAIL CONTRACTOR'S NAME RLq"VL,.9_ OWNERBUILDER? OYES ^O BUSINESS NAME ADDRESS SO-So n6&ffACS 1!�� PHONE 80(3 &&0 0(a-7 ;;_ EMAIL CONTRACTOR'S STATE LIC NUMBER -1ta'S"0_1 LICENSE CLASSIFICATION CIO CZO Cgj�a VALLIATION $ 9-, SO F L SO FT APPLICANT'S SIGN' URE/��r_4v�/ AT DATE D BUILDING PLANNING ENGINEERING FIRE GREEN SMIP F MENIFEE BUSINESS LICENSE NUMBER EPARTMENT DISTRIBUTION 160 INVOICE PAID AMOUNT AMOUNT LM ?01 0 CASH CHECK# C CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0 CASH CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO IDL NUMBER NOTARIZED LETTER 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