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PMT17-00727 City of Menifee Permit No.: PMT17-00727 29714 HAUN RD. Type: Residential Electrical �-1-�CCEL/� MENIFEE,CA 92586 MENIFEE Date Issued: 03/10/2017 PERMIT Site Address: 31765 DEBORAH LN, MENIFEE, CA Parcel Number: 358-240-002 92584 Construction Cost $8,930.00 Existing Use: Proposed Use: Description of PEDESTAL&SUBPANEL CHANGE OUT 100AMP DUE TO DAMAGE Work: Owner Contractor TIM&PATRICIA VIOLETT A R S AMERICAN RESIDENTIAL SERVICES OF 31765 DEBORAH LN CALIFORNIA INC MENIFEE, CA 92584 965 RIDGE LAKE BLVD SUITE 201 Applicant Phone:9512769744 KENNY PEERY License Number:765074 A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNI) 965 RIDGE LAKE BLVD SUITE 201 MEMPHIS,CA 38120 Fee Description OQt Amount t51 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 carded on thereunder when in violation of the Building Code or of any other ordinance of City of Men'Ifee.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_Pennit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I herebyaffirm under penalty of with a licensed mntrader(s)pursuant to the Contractors State License Law). p ty perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and O I am exempt from licensure under the Contractors State License taw for Professions Code and my license is in full force and effect. the following reason: License Cl License CZ0/C 3ee License No. L(o_� /J -7 Y m B signature belowiacknowled acknowledge except Y g g p y personal residence Expires 4 - C ,i Signature in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit 1 cannot legally sell a structure that i have built as an owner-builder if it has not been constructed in its entirety by jo wi t hereby affirm under penalty of perjury one of the fallong 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 ofthe 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. wvnv.leeinfo.ca.eov/calaw.htmL Policy# Date D I have and will maintain workers 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 l 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 owners behalf.I have read this number are: application and the information I have provided is correct I agree to comply Carrier �� with all applicable city and county ordinances and state laws relating to . i building construction.I authorize representatives of this city orcounty to Policy#ZQ50S(aU /U Expi 0.-17 enter the above identified property for inspection purposes. (ibis section need not to be completed is the permit R for one-hundred Dale dollars(%GO)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑1 certify that in the performance of the work for which this permit is issued, © �Cam- ? C� 1 shall not employ any persons in any manner w as to become subject to the CITY BUSINESS LICENSE# r worker's compensation laws of California,and agree that if should become K6ARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthw th comply with those provisions. �\\ Ill the applicant or future building occupant handle hazardous material or Applicant Date .0 I121_ jre containing a hazardous material equal to or greater that the �'f" amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO REWORK SCOMPENSATIONCOVERAGEIS ayes .� UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended useaf the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant requireapermit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast quality Management District(SO4QMD)?See permitting checklist IN SECTION 37060FTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY oyes i 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 boundary of a school? (Section 3097 Civil Code) Dyes Ci OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that l am exempt from the permitting checklist l understand my requirements under the State of Contractor's License Law for the mason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable items)(Section 70315 hazardous material reporting. Business and Professions Code).Any city or county that requires a permit to Ely ❑No construct,alter,improve,demolish or repair any structure,prior to its �/Lir1 Date 10-17 issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER OR OR EDAGERr- thatheorsheislicensedpursuanttotheprovisionsof the ContractprsState EPA RENOVATION,REPAIR AND PAINTING(RRP) 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 recefvingcompensationformostworktha[disturbs paint inapre-1978 and the basis for the alleged exemption.Any violation of5ectiuq 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 pemalWornot more required ractices.This includes rental property than($500). eq P P P rty owners and property managers who do the paint-disturbing work themselves or through their OI,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( Iall ofor( )portion of the work,and the structure is www.epa.env/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-SOD-424-LEAD(5323). Code,The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will he 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. 0 No EPA Lead-Safe Certified Firm is required for this project because: o I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7D44,Business and Professions Code:The Contractors State License law does notapply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement BUILDING : SAFETY PERMIT/PLAN CHECK APPLICATION kn Mefee DATE Jf7l PERMIT/PLAN CHECK NUMBER HT(* DO 7p5 TYPE: ❑COMMERCIAL ✓❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA []SIGN SUBTYPE: [—]ADDITION ❑ALTERATION [-]DEMOLITION �ELECiRICAL ❑MECHANICAL [:]NEW ❑PLUMBING ❑RE-ROOFF-NNUMBER OF SQUARES DESCRIPTION OF WORK IC'0 — DA*Y19L PROJECTADDRESS - 5 ee a ASSESSOR'S PARCEL NUMBER Z;YSO '--14D>0Q-;L TRACT v - -y- PROPERTYOWNER'SNAME /' ^ /e 16Z� / e /f/C/,AVlalzj� Z ;A'-A,4 � A- ADDRESS.��� f ` - PHONE r;2l')3�J y EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME RIGHTIME OWNER BUILDER? ❑YES❑✓NO BUSINESS NAME ADDRESS 3030 MYERS ST RIVERSIDE CA.92503 PHONE (800)660-0675 EMAIL CONTRACTOR'S STATE LIC NUMBER 765074 LICENSE CLASSIFICATION C10, C20,C36 VALUATION$ ( SO FT LSO FT �t APPLICANT'S SIGNATURE LI- DATE , ;rn' ;,:( DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP INVOICE PAID AMOUNT LAWMOUNT ' UCASH OCHECK# OCREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH OCHECK# OCREDITCARD VISA/MC NER BUILDERVERIFIED OYES 0 NO DLNUMBER NOTARIZEDLETTER 0 YES 0 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