PMT17-00367 City of Menefee Permit No.: PMT17-00367
29714 HAUN RD. Type: Residential Electrical
9ACCEL/-> MENIFEE,CA 92586
""'""-"IRA- MENIFEE Date Issued: 0 210 812 01 7
PERMIT
Site Address: 27239 KEPLER ST,MENIFEE, CA 92584 Parcel Number: 360-401-036
Construction Cost: $2,000.00
Existing Use: Proposed Use:
Description of ELECTRICAL PANEL UPGRADE TO 225AMPS FOR SOLAR PERMIT PMT16-03855
Work:
Owner Contractor
JEFF PHILLIPS STEVE CARTER ELECTRIC
27239 KEPLER STREET 1031 CALLE RECODO UNIT F
MENIFEE, CA 92584 SAN CLEMENTE, CA 92673
Applicant phone: 9494814752
KELLY NGUYEN License Number:606687
1031 CALLE RECODO UNIT F
SAN CLEMENTE, CA 92673
Fee Description g,yl Amount 151
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 Bldg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe projects
with a licensed contractar(s)pursuantto the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effec. R the following reason:
License Class ? _ 1 V Lice s 0. tr By my signature below I acknowledge that,except far my personal residence
Expires 3 OM—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
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 self-insure forworkers 7044 of the Business and Professions Code,is available upon requestwhen
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.leainfo.ca.aov/calaw.html.
this permit is issued.
Polity Date
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 o'BY my signature below I certify to each of the following:I am the property
this permit Is Issued.My workers compensation insurance carrier and policy owner or authorized to act an the property owner's behalf.I have read this
number are: ,1 application and the information I have provided is correct.I agree to comply
�, I n �/ )I�� with all applicable city and county ordinances and state laws relating to
Cartier TL1V'/V(�7 �(IU.�r '1 building construction.l authorize representativesofthiscity orcountyto
Policy#CI yU V N 6 `t L_ Expires Z ' 1 enter t bove identify ro erty for inspection purposes. y
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less ROPERTY ER OR AU AGEM
al'certify that In the performance of the work for which this permit is issued, O�
I shall not empiov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE
worker's compensation laws of California,and agree that if I should became HAZARDOUS MATERIAL DECLARATION
subject to the workers compenss in revisions of Section 3700 of the Labor
Code,I shall rtl th comp? 44i FI sose provisions. 7 WIII the applicant or future building occupant handle hazardous material or a
O�/ U U !^a- mixture containing a hazardous material equal to or greater that the
Applicant 'r Date G // amounts spec don the Hazardous Materials Information Guide?
WARNIN :FAILURE TO SECUR O KER'S COMPENSATION COVERAGE IS D Yes r>J�
UNLAWFUL,AND SHALLSUBJECTAN EMPLOYERTO CRIMINAL PENALTIES Willthe intended use of the building bythe 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 ❑Yes ILN
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 boundayy of a school?
(Section 3097 Civil Code) Dyes ay/
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
California Health&Sa ty Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the haz rdo erial orting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 e
Business and Professions Code).Any city or county that requires a permit t0 Date 0 L V
construct,alter,improve,demolish or repair any structure,prior to its p OPE OWNER AU ORIZED 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 Contractors State EPA RENOVATIO .REPAIR AND PAINTING(RRPI
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
D 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-BOD-424-LEAD(5323).
Code,The Contractors State License Law does not apply to an owner of a D An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improvesthe
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 Na
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 Contractors 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
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
Menifee
DATE 02 08 2 U 17 // PERMIT/PLAN CHECK NUMBER 1� � -7 OO Y/✓ ,
TYPE: O COMMERCIAL Qi RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK E I6VthW I veqrmo 22-V
PROJECTADDRESS I (v/ s I MM(to cA 2.g
ASSESSOR'S PARCEL NUpMfBER b / LOT TRACT
OWNER NAME •-� T `f/ 1 hiIIf! `y
ADDRESS Z I 1� `✓�• M i eG
PHONE ( 244' 0231 ff ,A� EMAIL
APPLICANT NAME /, (A
ADDRESS r,,3 Z /,Og o # N 44/ah bl D M "IZ L3
PHONE U I4- �ul O -uj,(17—� / �A �,{� EMAIL
KK Vl T-wv W-, cim
CONTRACTOR'S NAME 1I�//,l/ Vgri I(/UI ►IU OWNERBUILDER? OYESONO
BUSINESS NAME
rM Vh�/ p'L;DI r^r�/ ��,�n �J/,I �,/p�,�,,�q f./
ADDRESS lot fVIYOI qIV Ftwav thnif F kil V(V/�IVv41
PHONE Vl 4 6 p EMAIL
CONTRACTOR'S STATE LIC NUMBER Q W 0� LICENSE CLASSIFICATION
VALUATION$ 4 3 D OU SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE UZ U p l
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN I SMIP O Q
INVOICE PAID AMOUNT
AMOUNT I • 0CASH 0CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED :'YES ^ NO DL NUMBER NOTARIZED LETTER O YES O 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