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PMT18-01080 City of Menifee Permit No.: PMT18-01080 29714 HAUN RD. �lAC]CELA�. MENIFEE, CA 92586 Type: Residential Electrical ewin�''�wk-. MENIFEE Date Issued: 03/09/2018 PERMIT Site Address: 27872 JEFFERSON AVE, MENIFEE, CA Parcel Number: 329-194-020 92585 Construction Cost: $2,000.00 Existing Use: Proposed Use: Description of MAIN PANEL UPGRADE FROM 100 AMPS TO 200 AMPS Work: Owner Contractor RAMON GARCIA CLEAN ENERGY SOLUTIONS INC SAME 27872 JEFFERSON AVE 417 W ALLEN AVENUE STE 105 MENIFEE,CA 92585 STE 105 Applicant Phone:8009941134 CLEAN ENERGY SOLUTIONS INC License Number.998787 417 W ALLEN AVENUE STE 105 SAN DIMAS, CA 91773 Phone:8009941134 Fee Description 9tY Amount($1 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_Permt_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 perjurythat 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 Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Class V License No. / // C (/ By my signature below I acknowledge that,except for m g p my personal residence Expires s r l�ignature in which I must have resided far at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATIO 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 this permit is'ssued. www.leginfo.ca.gov/calaw.html. Polity Date have and will maintain workerscompensatton 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 owner's behalf.I have read this number are application and the information I have provided is correct.I agree to comply Carrier J7/ with all applicable city and county ordinances and state laws relating to � building construction.I authorize representatives of this city or county to Policy#� ��L Expires ;2 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 employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of Cali rnia,and agree that if I should become (vIAZARDOU5 MATERIAL DECLARATION subject to the workers[ ab Provisions of Section 37 th Labor ,1 Code,I shall forthwith c with t se provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date / mixturecontal ing a hazardous material equal to or greater that the amounts sp died on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATIO VERAGE 15 ❑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($100,000),IN occupant requil a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Q dlity Management District(SCAQMD)?See permitting checklist IN SECTION.3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS_FEES. forguide nes CONSTRUCTION LENDING AGENCY ❑Yes ❑No I hereby affirm that under the penalty of perjury there is a construction Will the prcipcsjediuilding or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boun ry of a school? (Section 3097 Civil Code) ❑Yes p 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 Califor ialHealth&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the ha dpus serial re n . 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 es Date construct,alter,improve,demolish or repair any structure,prior to 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(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 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 do the paint-disturbing work themselves or through their ❑1,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 forthis 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 4Mty of Menefee not built or improved for the purpose of sale. Building D.c V 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 ProfessI Code:The Contractors State License Law does not apply to an owner of BAR 0 9 2 If your project does not comply with EPA RRP rule please fill out the RRP AcknowI d ment. Received BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE AJL DATE: PERMIT/PLAN CHECK NUMBER PLANNING CASE NUMBER TYPE: COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION LECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK p 4— PROJECTADDRESS ZIP ASSESSOR'S PARCEL NUMBER CQLT TRACT OWNER NAME ,57,V K � ADDRESS S PHONE / q EMAIL / APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES ONO BUSINESS NAME ADDRESS PHONE CONTRACTOR'S STATE LIC NUMBER l8T7 LICENSE CLASSIFICATION (J VALUATION$ DcPv. SQ FT L SQ FT APPLICANT'S SIGNATURE DATE OTYSTAFFUSEONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: yCITY OFF (M�ENNIFFEEEE WSINESS LLIIC 4SEE NIJWIBER BUILDING PLANNING EN NEERING FIREINVOICE TOTAL I ,qv GREEN , SMIP OWNER BUILDER VERIFIED OYES Q NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., M&%%U86 (951)672-6777 www.cityofinenifee.us Building Dept MAR 0 q 2018 NIR Received