PMT17-00339 City of Menifee Permit No.: PMT17-00339
29714 HAUN RD. Type: Residential Electrical
S�CCli MENIFEE,CA 92586
MENIFEE Date Issued: 0 210 6/2 01 7
PERMIT
Site Address: 29630 CADENA DR, MENIFEE,CA 92585 Parcel Number: 327410-020
Construction Cost: $1,800.00
Existing Use: Proposed Use:
Description of MAIN PANEL UPGRADE 225A
Work:
Owner Contractor
JAVIER ARVIZO MYERS ELECTRIC CO
29630 CADENA DRIVE 425 W LA CADENA DR#21
MENIFEE, CA 92585 RIVERSIDE, CA 92501
Applicant Phone: 9516628769
HOLLY THOMPSON License Number:972274
MYERS ELECTRIC CO
425 W LA CADENA DR#21
RIVERSIDE,CA 92501
Fee Description Q1lr Amount!$)
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_Bldg_Permit 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).
1 hereby affirm under penalty of perjury that 1 am under provisions of
Chapter9(commencing with section 7000).of Division 3 of the Business and D 1 am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class, Jes,t4i C_it-1 (.O License No.,I O 0 y Z3 By my signature below I acknowledge that,except for my personal residence
Expires (,.3 Z,W_TSignature 9&�_ A ,b a_ ce=: 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
D 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 selfinsure 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 wvww.leginfo.ca.Rov/calaw.html.
this permit is issued. Z �O ff o� 1
1 Policy# C UI QD„ Q Z Date
I- - PROPERTY OWNER OR AUTHORIZED AGENT
o I have and will maintain worker's compensation Insurance,as required by
section 3700 of the labor Code,for the performance of the work forwhich D 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 ` t-3� �ri 0 �s q , with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# 6W G-n C_12.0O 07�Exp��ir��es enter the above identified property for inspection purposes.
(This section need not to be completed istTie�"it 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, ins5q �
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# O�'��
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant 4A. 4 , (Y", 0 mixture containing a hazardous material equal to or greater that the
amounts spa*fled on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes � .
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 forguidelin s
CONSTRUCTION LENDING AGENCY o Yes o
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 boundp&Y of a school?
(Section 3097 Civil Code) D Yes Wo
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 perjurythat I am exempt from the
Contractor's License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed nextto the applicable item(s)(Section 7031.5 hazardous material reporting.
oyes D No rr
Business and Professions Code).Any city or county that requires a permRto �� � _ ����� �Date
construct,alter,improve,demolish or repair any structure,prior to its PRRO RTY OWNER OR AUTHORIZEDAGEr1T
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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRP)
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.eov/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 ❑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-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. D No EPA Lead-Safe Certified Firm is required for this project because:
D I,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 RRP rule please fill out the RRP
Acknowledgement.
BUILDING • PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 2/3/17 PERMIT/PLAN CHECK NUMBER �� -W✓
TYPE: O COMMERCIAL 1 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: 0 ADDITION O ALTERATION 0 DEMOLITION CK ELECTRICAL O MECHANICAL
O NEW 0 PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK (N) 225A Main Panel
PROIECTADDRESS 29630 Cadena Dr.
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME JavierArvizo
ADDRESS 29630 Cadena Dr.
PHONE EMAIL
APPLICANT NAME Holly Thompson
ADDRESS 7100 W Florida Ave
PHONE 951-537-6859 EMAIL holly.thompson@horizonsolarpower.com
CONTRACTOR'S NAME OWNER BUILDER? 0 YES 0 NO
BUSINESS NAME Myers Electric
ADDRESS 425 W La Cadena Dr#21
PHONE 951-662-8769 EMAIL
CONTRACTOR'S STATE LIC NUMBER 977274 LICENSE CLASSIFICATION C-10
VALUATION$ 1,800.00 SQ FT L SO FT
APPLICANT'S SIGNATURE a",v Y 74—,&mW DATE 2/3/17
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN 5MIP
INVOICE PAID AMOUNT :,,
AMOUNT 0CASH G�CHECKR CREDIT CARD VISA/MC
L
N CHECK FEES PAID AMOUNT 1; CASH CCHECKp 'CREDITCARD VISA/MC
UILDER VERIFIED '0 YES NO DL NUMBER NOTARIZED LETTER •`' YES ii NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213