PMT18-02243 City of Menifee Permit No.: PMT18-02243
29714 HAUN RD. Type: Residential Electrical
<A—CCEL:A—> MENIFEE,CA 92586
MENIFEE . Date Issued: 05/0712018
PERMIT
Site Address: 26050 PINE VALLEY RD, MENIFEE, CA Parcel Number: 337-021-030
92586 Construction Cost: $2,200.00
Existing Use: Proposed Use:
Description of ELECTRICAL SERVICE UPGRADE FROM 100 AMP TO 225AMP FOR FUTURE SOLAR
Work:
Owner Contractor
ROBERT EKMAN KENNETH DOYLE
26050 PINE VALLEY RD 26100 NEWPORT ROAD
MENIFEE,CA 92586 SUITE Al2-128
Applicant Phone:6613095016
KEN DOYLE License Number:655852
KENNETH DOYLE .
26100 NEWPORT ROAD
SUITE Al2-128 '
SUN CITY, CA 92586
Fee Description 9S]r Amount(Sl
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—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 License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from Iicensure under the Contractors State License Law for
Professions Code and my license Is In full force and effect. the following reason:
License Class C- O Lice se No. to 5Sg6-2 B m signature below I acknowledge that,except for m
y y g g p y personal residence
Expires 1 1-3 0—1 al Signature in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATIO improvements covered by this permit.I cannot legally sell 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 a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure forworkers 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.leeinfo.ca.eov/calaw.html.
Policy K Date
o l have and will maintain workers compensator Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which D By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance artier and policy owner or authorized to act on the property owners behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy N Expires enter the above identified property for inspection purposes.
(This section need not to he completed is the permit is for one-hundred Date
dollars($100)or less
PROPERTY OWNER OR AUTHORIZED AGENT
e11certify that in the performance of the work for which this permit is Issued,
I shall not emolov any persons In any manner so as to become subject to the CITY BUSINESS LICENSE g
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall fo hwith compl with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant mixture containing a hazardous material equal to orgreaterthat the
PP Date .$ -1 ^ 1 It' amounts sp}}tined on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes dN0
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 Duality a permiment.District contSCADMDrmodiSee permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATFORNEYSFEES Coast Airlin
CONSTRUCTION LENDING AGENCY ❑Yes
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 boun of a school?
(Section 3097 Civil Code) o Yes Ao
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCADMD
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&Safety Code,Section 25505 and 25534 conceming
checkmark(s)I have placed next to the applicable ttem(s)(Section 7031.5 �haCn_ rdous mated I reporting.
Business and Professions Code).Any city or county that requires a permit to ➢'Cs o No
Date rj =1—IY
construct,alter,improve,demolish or repair any structure,signets its PROPERTY OWN R OR AlfTHO IZ 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 IRRPI
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 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 car childcare facility to be work
that distuified rbs
and complypre-19th
than
Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($SfJO). 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 more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80G424-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:
in 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 APPLICATION MENIFEE
--
DATE: _ Z019 PERMIT/PLAN CHECK NUMBER O�
PLANNING CASE NUMBER
TYPE: " COMMERCIAL `!' RESIDENTIAL MULTI-FAMILY C MOBILE HOME O POOL/SPA SIGN
SUBTYPE: '-- ADDITION "ALTERATION O DEMOLITION `c'ELECTRICAL 0 MECHANICAL
O NEW C PLUMBING C RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK Se ` c.c.
00
PROJECTADDRESS 2—(,C75 2_2Pj!14 ZIP �/,,
ASSESSOR'S PARCEL NUMBER 33� ' I-O3jO LOT 7" 1 TRACT �/��
4-5
OWNER NAME u h ,,//��
ADDRESS IG GI
PHONE EMAIL r
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? 0 YES ✓NO
BUSINESS NAME a
ADDRESS
PHONE ��s1, �09 -C'd/ EMAIL
CONTRACTOR'S STATE LIC NUMBER (p�Sg S 2. LICENSE CLASSIFICATION
VALUATION o SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE
CITYSTAFFUSEONL
DEPARTMENT DISTRIBUTION ACCEPTED 8Y: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL I I a-I-3 GREEN SMIP
OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER ` YES 0 NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6*77
www.cityofmenifee.us