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PMT17-01495 City of Menifee Permit No.: PMT17-01495 29714 HAUN RD. Type: Commercial Electrical <A—CCELf-% MENIFEE, CA 92586 MENIFEE Date Issued: 05112/2017 PERMIT Site Address: 30150 NIGHT PASSAGE PL, MENIFEE, Parcel Number: 358-500-010 CA 92584 Construction Cost: $445.00 Existing Use: Proposed Use: Description of INSTALL 50AMP SUB BREAKER WITH CONNECTION TO TRACT HOUSE LOT 2 TO LOT 10 Work: Owner Contractor RICHMOND AMERICAN HOMES TEMP POWER SYSTEMS 5171 CALIFORNIA AVE STE 120 625 S FEE ANA STREET IRVINE, CA 92617 PLACENTIA, CA 92807 Applicant Phone:7142235607 TEMP POWER SYSTEMS License Number: 696713 625 S FEE ANA STREET PLACENTIA, CA 92807 Phone: 7142235607 Fee Description Qtv Amount I$1 Services, Switchboards, Control Centers& Panels 1 183.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 GREEN FEE 1 0.00 General Plan Maintenance Fee-Electrical 1 9.15 $220.15 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 staled,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_Bidg_Permil_Templale.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 ❑I am exempt from licensure under the Contractor's State License Law for Professions Cade and my license is in full force and effect. the following reason: License Class No License No. (o By my signature below I acknowledge that,except for my personal residence Expires 01- /? Signature L in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I 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 folio in de la ations:I licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-incur rworIn 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 fallowing website: by Section 3700 of the Labor Code,for the performance of work for which www-leginfo.ca.gov/calaw.litml. this permit is issued. Policy# Date I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT e ion 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 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 94iDwErS — c, . with all applicable city and county ordinances and state laws relatingto building construction.I authorize representatives of this city or county to Policy# $n V we 0�I IF/Fy Expires i c) J) ' enter the above identified property for inspection purposes. (This section need not to be completed is the permit Is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑I certify that In the performance of the work for which this permit is issued, I shall not emolov 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 become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall tt omply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date IJ' mixture containing a hazardous material equal to or greater that the amounts s cified an the Hazardous Materials Information Guide? WARNING:FAILURE TO ECUR WORK R'S COMPENSATION COVERAGE IS ❑Yes No UNLAWFUL,AND SHALL SUBJ AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE H NDRED THOUSAND DOLLARS($100,000),IN Will the intended use of the building by the applicant or future building ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Qyyality Management District(SCAQMD)?See permitting checklist for guidelhf CONSTRUCTION LENDING AGENCY ❑Yes ❑No I hereby affirm that under the penalty of perjury there.is a construction Will the proposed building or modified facility he within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boFu9dary of a school? (Section 3097 Civil Code) ❑Yes A No 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 Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25S34 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous ial reporting. Business and Professions Code).Any city or county that requires a permit to oyes No l D Ste//2 t construct,alter,improve,demolish or repair any structure,prior to its ate PROPER WNER ED NT 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 REP RAN MiuT G RRP License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Rep)r an aiming(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from licensure receiving compensation far most work that disturbs in apre-1978 and the basis for the alleged exemption.Anyviolation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with than 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 ❑I,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.aov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 70",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. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑.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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION yXELECTRICAL OMECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Prt ,qd 9 - O TO 60N vcc rl ow1 Lo PROJECTADDRESS 3011s I -r ASS.A t w- ASSESSOR'S PARCEL NUMBER eft CFloksos}Wa IRaO(,r 3S� - SGC` - O I� LOT /D TRACT OWNER NAME 9-tCAIMbr. fZICAN ADDRESS 5 nl I C' u r-otwA Ave- -m dL ld{` lovuve c , 9du I PHONE 9qq - L4U7- .2Leoo EMAIL APPLICANT NAME JIVA nE aCO ADDRESS 09 AtiA >T 17LAceivDA e A P.P?b PHONE 71`/- 710-1- 0/99 EMAIL 71=14aPbwGe . CONTRACTOR'S NAME , S 1 OWNER BUILDER? O YES NO BUSINESS NAME ADDRESS to r1.A s-T- , Piat&r,Tiiq c-4- 9 7b PHONE 71 y- as 3 - Sac©a- EMAIL Lt.A NE pPDw6X. C O ry CONTRACTOR'S STATE LIC NUMBER W)U-2/ 7 LICENSE CLASSIFICATION C./D VALUATION$ L4 y S SQ FT L SQ FT APPLICANT'S SIGNATURE DATE 1.Z d--b/7 CITYSTAFFUSEONLY DEPARTMENT DISTRIBUTION CITY OAF MENEN`IFEE BUS IINL5� LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GRtLL EN U SMIP INVOICE PAID AMOUNT AMOUNT 0CASH 0 CHECK# LCREDIT CARD VISA/MC PLAN C AtKFE S PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of 1101611111194 City of Menifee Building& Safety Department 2971 j*iitlin§G&188"LD@Rt92586 951-672-6777 www.cityofinenifee.as Inspection RequeuAY e,9 1 �$-6213 Receoved l •CAP ' //� - `a NN �i� Np�. � I it NU ME sit im-pp Hof INN t II II �� ill q T' i►\l�/J/� 'i` �11��J .