PMT18-01208 City of Menifee Permit No.: PMT18-01208
29714 HAUN RD.
'--A =L A? MENIFEE,CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 03/16/2018
PERMIT
Site Address: 29581 ACADIA CT, MENIFEE, CA 92585 Parcel Number: 333-770-007
Construction Cost: $400.00
Existing Use: Proposed Use:
Description of UNDERGROUND 3/4"ELECTRIC CONDUIT TO BBQ
Work:
Owner Contractor
PAUL FAUSTINO BILL& DAVE'S LANDSCAPE MAINTENANCE INC
29581 ACADIA COURT 1153 HARLEY KNOX BLVD
MENIFEE, CA 92585 PERRIS,CA 92571
Applicant Phone:9519436455
BILL& DAVE'S LANDSCAPE MAINTENANCE INC License Number: 751707
1153 HARLEY KNOX BLVD
PERRIS, CA 92571
Phone:9519436455
Fee Description ON Amount($)
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 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 Rldo Permit TemnlalPmt Panc 1 of'I
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 7DOD)of Division 3 of the Business and n l am exempt from licensure under the Contractor's State License Law for
Professions Code and m1 y license is in full force and effect. V the following reason:
License Class C—J ) License No.� s ) By my signature below 1 acknowledge that,except for my personal residence
Expires Signature L �� _ in which l must have resided for at least one year priorto completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I
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 copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's 71344 of the Business and Professions Cade,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.gJcalaw.html.
this permit is Issued. l
Policyg 6 L �-� l L��! L� Date
n 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 forwhich D By my signature below l certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance caller and policy owneror authorized to act an the property owner's behalf.I have read this
number are: I applimilon and the information I have provided is correct.I agree to comply
'/t
Carrier J��c. I` V �- rI L.'✓`r �i C with all applicable city and county ordinances and state laws relating to
1 building construction.I authorize representatives of this city or county to
Policy K 7 U/YJ j j'I Expires C I I \ enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars tS100)or less
PROPERTY OWNER OR AUTHORIZEDAGENT
❑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 became subject to the CITY BUSINESS LICENSE p a•�� �
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 shaftfortq t,h comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
` - V 1S ( 7 mixture containing a hazardous material equal to or greater that the
Applicant_ Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS Dyes iO 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 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)7 See permitting checklist
IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines_
CONSTRUCTION LENDING AGENCY oYes o.NS
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) a Yes ,a No
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 lam exempt from the
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
hazaurdordoatedal reporting.
cherkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 Oyu--O No (\ Q
Business and Professions Cade).Any city or county that requires a permit to a\ jJ 7
�—�� ^ate V
construct,alter,improve,demolish or repair any structure,prior to its PR PERTY OWNR-At1TROM—ED 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 IRRPI
License Law(Chapter9(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 Iicensure 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 fora 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
D I,as owner of the property,or my employee with wages as their sole employees.For mare 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 Contractor's State License Law does not apply to an owner of a oAn 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-Bullderwill have the burden of proving that it was
not built or Improved for the purpose of sale. D No EPA Lead-Safe Certified Firm is required for this project because:
D 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State Ucense 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 -
. �`
MENIFEE
DATE: 3 z l Y—) PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION J?'ELECTRiCAL O MECHANICAL
O NEWS' O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK CS 1 �Izz,
PROJECTADDRESS 2-SS ( ALA LA D I /H-- C44" /�S �S
ASSESSOR'S PARCEL NUMBER son'-m' cV I LOT TRACT
OWNER NAME L_ 'FA &I I q
ADDRESS ;"v S "C.•'7-Y,/ `/�-- '}— y S
PHONE �7(s U --75 9 - 13S I SEMAIL I '
APPLICANT NAME CJ r {�� C^ /
ADDRESS C �^ t S ^
PHONE I J q y 3 6 �j f EMAIL
CONTRACTOR'S NAME I 1 �J V�V' t/ A - OWNER BUILDER? O YES 0440-
BUSINESSNAME } \ 1j.n�kL
_�I��I�,S 1. ,/W S [`
ADDRESS AAU Jj �)
PHONE 9-s ! L ^EMAIL ajQ C S
CONTRACTOR'S STATE LIC NUMBER ZS J G / LICENSE CLASSIFICATION C _i)
VALUATION$ Q SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE 11
CJTYSTAFf USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE � 4-
INVOICETOTAL I GR N SMIP
OWNER BUILDER VERIFIED OYES 0 NO DRIVERS LICENSE H NOTARIZED LETTER 0 YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., MC*#a0,,Idd111k1Fi86 (951)672-6777
www.cityofinenifee.us BulldIN Dept
MAR 16 2018 ENIFE
Received
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MAR 16 2018 I
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