PMT17-03680 City of Menifee Permit No.: PMT17-03680
29714 HAUN RD,
"�CCELA? MENIFEE,CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 10/1312017
PERMIT
Site Address: 26299 COLUMBUS DR, MENIFEE, CA Parcel Number: 338-192-023
92586 Construction Cost: $1,500.00
Existing Use: Proposed Use:
Description of ELECTRICAL PANEL UPGRADE TO 200AMP FOR SOLAR PERMIT PMT17-03436
Work:
Owner Contractor
PEGGY SMITH&JAMES MAGOON SEMPER SOLARIS CONSTRUCTION INC
26299 COLUMBUS DRIVE 1805 JOHN TOWERS AVENUE
MENIFEE,CA 92586 EL CAJON, CA 92020
Applicant Phone:6197154054
ALICIA ANDREWS License Number: 978152
1805 JOHN TOWERS AVENUE
EL CAJON, CA 92020
Fee Description C,]yt Amount($1
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 carved 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_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 hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State Ucense Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o 1 am exempt from licensure under the Contractors5tate License Law for
Professions Code and my license is in full force and effect. the following reason:
License Cl as G�� (.f V Ucense No. _ 97 By my signature below I acknowledge that,except for my personal residence
Expires 31 (Y Signature in which I must have resided for at least one year priorto completion of
improvements covered bythis permit.I cannot legallysell 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 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 of the Labor Code,for the performance of work for which
this permit is issued. www.leginfo.ca.eov/calaw.html.
Policy II Date
trl have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
se Lion 3700 of the Labor Code,for the performance of the work for which o By my signature below 1 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: nn �n application and the information I have provided is correct.I agree to comply
✓I V`T N� . P with all applicable city and county ordinances and state laws relating to
Carrier //�� �f �4 �f building construction.I authorize representatives of this city or county to
Policy N_01a 07"M Expires (d 1 l 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
o 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 If ✓ r
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 forthw'h comply with those provisions Will the applicant or future building occupant handle hazardous material or a
Applicant Date I -/ mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE W 'S COMPENSATIO COVERAGE IS o Yes gpv0
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($100,000I,IN occupant require a permitforthe 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 guideli es
CONSTRUCTION LENDING AGENCY oyes [�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 school?
(Section 3097 Civil Code) o Yes 110
OWNER BUILDER DECLARATIONS 1 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 perjurysn(s)in I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License law for the reason(s)indicated below by the f/''checkmark(s)I have placed next to the applicable item hazardous material reporting.
s)(Section 7031.5 oyes oryo
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its p TY OWNER OR AUT 0 GENT
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(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 orchildcarefacilitytobeork that
painicomre-197ply h
than
Applicant for a permit subjects the appliant to o civil penalTy of not more required practices.This includes rental property ownersand 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.eoa.aov/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 o 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. o No EPA Lead-Safe Certified Firm is required for this project beause:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct the pmject(Section 7044,Business and Professions
Code:The Contactors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please RII out the RRP
Acknowledgement.