PMT16-04126 City of Menifee Permit No.: PMT16-04126
29714 HAUN RD. Type: Residential Electrical
<A-CCIELX? MENIFEE, CA 92586
MENIFEE Date Issued: 0110412017
P E R M I T
Site Address: 28690 AURIGA CT, MENIFEE,CA 92586 Parcel Number: 339-211-034
Construction Cost: $1,500.00
Existing Use: Proposed Use:
Description of MAIN PANEL UPGRADE 200A
Work:
Owner Contractor
LAURIE WRIGHT AMERICAN ENERGY CONSULTANTS INC
28690 AURIGA COURT P 0 BOX 882353
MENIFEE,CA 92586 SAN DIEGO, CA 92168
Applicant Phone:7604455386
MATT LEBRUN License Number: 1011427
AMERICAN ENERGY CONSULTANTS INC
P 0 BOX 882353
SAN DIEGO, CA 92168
Fee Description City 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 cornmenced 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
CCENSED DECLARATION property who bi�flds or improves thereon,and who contracts for the projects
I hereby affirm under pen under provisions of with a licensed contmctor(s)pursuant to the Contractors State License Law).
aity ' rju 'It
Chapter9(commencing with i 2Z.7r0'C0tGh)`a 11 n 3 of the Business and o I am exempt from licensure underthe Contractor's State License Law for
Professions Code and my license is in full fo a hilpffect. the following reason:
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License Cla�s U n N �jq By my signature below I acknowledge that,except for my personal residence
ExR" '71 Signature in which I must have resided for at least one year priorta completion of
improvements covered by this permit.I cannot legally sell a structure that I
nRRER'S COMPENSATION DECLA have built as an owner-builder if it has not been constructed in Its entirety by
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
an 4ese no
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haveand will maintain a certificate of consent of self-insure for worker`5 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
this permit is Issued. www.leginfo.ca.Roy/caIaw.htmI.
Policy# 1A NWC- 6 oo 15,1- Date
in I have and will maintain workees 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 workees 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
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy# MAW C 6 0 0(54Expires (it 11-4- enter the above Identified property for inspection purposes.
(This section need not to be camp'zted is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued, �MIT46" 0'31 EM I
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#_
workees compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
sub"ect to the workees compensation provi.sions of Section 3700 of the Labor
e
ad I shall forthwith comply wilh those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Ap icant4r Otll,4dA Date amounts snAcified on the Hazardous Materials Information Guide?
0WARlINM FAR URE TO SECUREJ40RIKER'S COMPENSATION COVERAGE IS o Ye! 41c,
UNLAWFUL,AND$HALL 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 req uire a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQM D)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldeli es
CONSTRUCTION LENDING AGENCY 0 yes a
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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 boun ary of a school?
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(Section 3097 Civil Code) 0 YM E\PO
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCACJMD
p p
.,.ittino c ants under the State of
C,ld,
I hereby affirm under penalty of perjury that I am exempt from the California Health Sit Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the rdous material reporting.
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 e 0
Business and Profeolons Code).Any city or county that requires a permit to 66 W 61A Date
ROP
construct,alter,improve,demolish or repair any structure,prior to its ROPERTY qMNER OR AUTHOR
issuance,also requires the applicant for the permit to Me a signed statement '01)AGENT
that he or she is licensed pursuant to the provisions of the Contractor's State
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting RRP)Rule requires contractors
Busimess and Profosions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978
a ad the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certifted 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
ci 1,as ownerof 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 a An EPA Lead-Safe Certified Renovator will be responsible forthis 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-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this pmject because:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Profesisions
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