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PMT17-03234 City of Menifee Permit No.: PMT17-03234 29714 HAUN RD. Type: Residential Electrical <;XCCEL^-> MENIFEE,CA 92586 "-' MENIFEE Date Issued: 0 9/1 412 01 7 PERMIT Site Address: 28490 PORTSMOUTH DR, MENIFEE, CA Parcel Number: 339-182-006 92586 Construction Cost: $4,000.00 Existing Use: Proposed Use: Description of MAIN PANEL UPGRADE TO 200A Work: Owner Contractor JUAN VALDEZ MELLOR ELECTRIC INC 28490 PORTSMOUTH DRIVE 108 QUARTZ LANE MENIFEE, CA 92586 PERRIS, CA 92570 Applicant Phone:9517194294 CHRISTOPHER MELLOR License Number:905077 MELLOR ELECTRIC INC 108 QUARTZ LANE PERRIS, CA 92570 Fee Description -ty 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 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 Code and my license is in full force and effect. the following reason: License Class C_-1 V License No V05 U77 By my signature below I acknowledge that,except for m r '_ g p y personal residence Expires '-(�'�Ci�1`7 Signature( Zzl 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 ❑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 workers 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 ofthe Labor Code,for the performance of work for which www.leQinfo.ca.aov/calaw.htm 1, this permit is issued. Policy# Date ❑I 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 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 e;^-z�-� with all applicable city and county ordinances and state laws relating to Carrier building construction.I authorize representatives of this city or county to Policy# L�wZ � �0 Expires ��Z"� IU enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, Ishallnotemolov any persons in any manner so 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 sh a comp ly ply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applica Date V� mixture containing a hazardous material equal to or greater that the�� �I amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes .,fNo 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($300,000),IN occupant require a permitfor the construction or modification from South ADDITION 70 THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes `"o I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Cade) in Yes +No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjurythat I am exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item hazardous material reporting.$)(Section 7031.5 ..d7 Y�e _ No Business and Professions Code).Any city or county that requires a permit to C �6 -/Yi Mi,Qi Date 7�I�1 �r' construct,alter,Improve,demolish or repair any structure,prior to its PROPERTY OWNER OR ALIT RIZED 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 Contractor's State EPA RENOVATION,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 apre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be work that disturbs ified firms and comply with than Applicant fora permit subjects the applicant too 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 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 LALw%v.epa.gov/Iead 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 ❑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. APPLICATION& SAFETY PERMIT/PLAN CHECK M.?nifpP I � DATE: <p/lq 1-7 PERMIT/PLAN CHECK NUMBER TYPE: O.COMMERCIAL C. RESIDENTIAL C MULTI-FAMILY O MOBILE HOME 0 POOL/SPA O SIGN SUBTYPE: CADDITION OALTERATION ODEMOLITION 4;i-ELECTRICAL O,MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK I`l A l N L•Z,.L L-j TZ C-A-t_ A-1uZZ_ `- 12`i PROJECTADDRESS Gf3AI3o :B 2- '-i S YLityTi-t orz. ZIP ASSESSOR'S PARCEL NUMBER 13P - 1 {iOL-0QD LOT TRACT OWNER NAME yRTV - ADDRESS f%,lZvv_7 rC CA PHONE 2 a, EMAIL Of MenI1BB Clt Bul ng APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME C_ ✓\ ( LZ OWNER BUILDER? O YES 4*0 BUSINESS NAME JM[ iINC a ADDRESS O U (-Z a L_,pkN - PC`. ZeI S' C H 9Z .5 ' PHONE EMAIL n'1&1 lov-e eci `0- rti ! a CnyN, CONTRACTOR'S STATE LIC NUMBER 905a'/CENSE CLASSIFICATION , VALUATION $ CL�-C�� SO FT L SO FT APPLICANT'S SIG NATUR -L DATE - SLQFF_LagOlva DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE PERMIT FEE 14CISMIP !C GREEN PLAN CHECK FEE r INVOICE TOTAL ' OWNER BUILDER VERIFIED OYES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES NO