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PMT17-01440 City of Menifee Permit No.: PMT17-01440 29714 HAUN RD. �!-�CCEL i> MENIFEE,CA 92586 Type: Residential Electrical MENIFEE Date Issued: 05/04/2017 PERMIT Site Address: 27720 GOETZ RD, MENIFEE, CA 92587 Parcel Number: 335-040-018 Construction Cost $1,800.00 Existing Use: Proposed Use: Description of MAIN PANEL UPGRADE FROM 225AMP TO 400AMP FOR SOLAR PERMIT PMT17-01421 Work: Owner Contractor DALE MCKENZIE MYERS ELECTRIC CO 27720 GOETZ RD 425 W LA CADENA DR#21 MENIFEE, CA 92587 RIVERSIDE, CA 92501 Applicant Phone:9516628769 HOLLY THOMPSON License Number:972274 425 W LA CADENA DR#21 RIVERSIDE,CA 92501 Fee Description Qtv Amount ISI 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 $149.30 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_Permil_Template.rpt Page 1 of 1 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 contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contmctors5tate License Law for Professions Code and.my license is in full force and effect. p the following reason: License Class^ I I gti License No. /•� /`-1�t/(i�� By mysignature below l acknowledge that,except formy personal residence Expiresio -17 Signature E'(i—'A'CLX � U0�—a� in which l must have resided for at least one year priorto 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 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 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 ,A„Nw.leeinFo.ca.eov/calaw.lstml. this permit is issued. Policy# Date 0 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 ❑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 on the property owners behalf.I have read this number are: I ,, /l /� application and the information I have provided is correct.I agree to comply CarriernL� -l��Vdll (11�()l �l`sL.. with all applicable city and county ordinances and state laws relating to ,,(( Y �y •� building construction.I authorize representatives of this city or county to Policy#ku Y,C'�xr`�;1 �4l xpires/� ��`-'� C enter the above iden ified roperrtty for inspection purposes. (This section need not to be corsl'pteted is the permit is for one-hundred i �G7N��G`l�il Date dollars($100)or less PROPERTY OWNER OR AUTHORI2 DAGENT o I certify that in the performance of the work for which this permit is issued, IshallnotemolaV any persons in any mannerso as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers 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 /��J // '7 / mixture containing a hazardous material equal to orgreater that the Applicant i�2. ./� // Date �. —/— Jo amounts specified on the Hazardous Materials Information Guide? WARNING:FAIL E TO SECURE WORK 5 COMPENSATION COVERAGE IS o Yes o No UNLAWFUL,AND SHALL SUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant orfuture building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modirication from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECFION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY o Yes o No 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) o Yes o No 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 perjury that I am exempt from the Contractors License Law for the reason(s)indicated below by the California HealthalSafety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)1 have placed next to the applicable item(s)(Section 7031.5 oyes o No /, Business and Professions Code).Any city or county that requires a permit to U(f Date a —l6 construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OWNER OR AUTHORIZED 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 RENOVATION,REPAIR AND PAINTING(RRP) License Law(Chapter9(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($SOD). managers who do the paint-disturbing work themselves orthrough their ol,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.eoa.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 Contractors State License Law does not apply to an owner of a aAn 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. o No EPA Lead-Safe Certified Firm is required for this project because: cz 1,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. BUILDING • SAFETY PERMIT/PLAN APPLICATION � Menifee DATE 5/3/17 PERMIT/PLAN CHECK NUMBER � ' O ('1 1O TYPE: O COMMERCIAL CIJ RESIDENTIAL O MULTI—FAMILY 0 MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION Oc ELECTRICAL O MECHANICAL O NEW O PLUMBING 0 RE—ROOF—NUMBER OF SQUARES DESCRIPTION OF WORK (N) 400A Main Panel PROJECTADDRESS 27720 Goetz Rd ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME Dale McKenzie ADDRESS 27720 Goetz Rd 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? O YES 0 NO BUSINESS NAME Myers Electric ADDRESS 425 W La Cadena Dr#21 PHONE 951-662-8769 q—, EMAIL CONTRACTOR'S STATE LIC NUMBER ' ` ��yya 17 -7lj LICENSE CLASSIFICATION C-10 VALUATION$ 1,800.00 SO FT L SQ FT APPLICANT'S SIGNATURE ��/ - °a'H°aO� DATE 5/3/17 LRTI(45TAFF USE ONLY. DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN ' SMIP INVOICE ' PAID AMOUNT AMOUNT CASH `.%CHECK# -'CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT CCASH CHECK# ✓CREDITCARD VISA/MC OWNER BUILDER VERIFIED n YES O NO DL NUMBER NOTARIZED LETTER YES C NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-5213