PMT17-03946 City of Menifee Permit No.: PMT17-03946
29714 HAUN RD.
�ACCFU/ . MENIFEE,CA 92586 Type: Residential Electrical
MENIFEE Date issued: 11/02/2017
PERMIT
Site Address: 26447 LAZY CREEK RD, MENIFEE, CA Parcel Number: 338-120-003
92586 Construction Cost: $2,500.00
Existing Use: Proposed Use:
Description of CHANGEOUT 100A PANEL
Work:
Owner Contractor
CHRISTIAN ARSCOTT PALOMAR SOLAR LTD
26447 LAZY CREEK RD 1526 STERLING COURT
MENIFEE,CA 92586 ESCONDIDO, CA 92029
Applicant Phone:7605040388
DWIGHT ANDERSON License Number:945152
1526 STERLING COURT
ESCONDIDO, CA 92029
Phone:7605040388
Fee Description g,yt Amount(S)
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_Peonit 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 contractors)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 Contractors State License Law for
Professions Code and my license is in full force and effect. the fallowing reason:
License Class License No. By my signature below I acknowledge that,except for my personal residence
Expires� Signature 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 DECIA 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 of the Labor Code,for the performance of work for which
www.leginfo.ca.gov/calaw.html.
this permit is issued.
Polity#
Date
,gyWave 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 ❑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 an the property owners behalf.I have read this
number are: `A _ ' application and the information I have provided is correct I agree to comply
Carrier 4 4,r`� /Z�� `J with all applicable city and county ordinances and state laws relating to
GS �7 / building construction.I authorize representatives of this city or county to
Policy# /O��r7(�9 3 Expires 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
a 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#
workers compensation laws of California,and agree that if I should become �f1A2ARDOUS MATERIAL DECLARATION
subject to the workers compensati n�f�lvisions of Section 3700 of the Labor
Code,1 shall fart iffi coal dye use provisI ns. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 o Yes /,No
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($100,00(1),IN occupant require a permit for the 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 guidelines - -- -- - —-""—
CONSTRUCTION LENDING AGENCY ❑Yes Q 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) ❑Yes m c,
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
Contractors License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning
hazardous material reportin
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 �/
Business and Professions Code).Any city or county that requires a permit to saes Date Z/ /
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY R 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(RRPJ
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 Cade)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($500). managers who clothe paint-disturbing work themselves orthrough 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.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 ❑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 A• • •
Menifee
DATE I I Ud• 1 PERMIT/PLAN CHECK NUMBER —03" I4
TYPE: O COMMERCIAL (9 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION I&ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK l oo,4-
Panel Change coordinated with SCE
PROJECT ADDRESS 7$264471azy Creek Rd.Sun City,CA 92586
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME Christian Arscott
ADDRESS 226447lazy Creek Rd. Sun City, CA 92586
PHONE 951-623-7266 EMAIL zoozoos eta1S5@aol.Com
APPLICANT NAME PalomarSolar
ADDRESS 1126 Sterling Court Escondido CA 92029
PHONE 760-504-0388 EMAIL support@palomar.com
CONTRACTOR'S NAME Dwi ht Anderson OWNER BUILDER? O YES CKNO
BUSINESS NAME Palomar Solar
ADDRESS 1526 Sterling Court Escondido,CA 92029
PHONE 760-504-0388 EMAIL support@palomarsolar.com
CONTRACTOR'S STATE
jL'ICC NUMB 945152 LICENSE CLASSIFICATION C-10
VALUATION$ �Cl) SO Residence-1,531 sq L SQ FT
APPLICANT'S SIGNATURE DATE 111�.1'17
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS ICENSE NU BER
BUILDING PLANNING ENGINEERING FIRE GREEN $MIP
INVOICE jjt PAID AMOUNT
AMOUNT O CASH O CHECK q O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES 0 NO
rU of MAnKnA
gqI1Ir'
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-6 72-67' d'"9 Dept.
www.cityofinenifee.us Inspection Request Line 951-246-6213 NOV U Z 2017
Received