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PMT18-02316 City of Menifee Permit No.: PMT18-02316 29714 HAUN RD. <A-CCEL/> MENIFEE,CA 92586 Type: Residential Electrical MENIFEE Date Issued: 0 511 512 01 8 PERMIT Site Address: 29020 AVENIDA DE LAS FLORES, Parcel Number: 341-142-021 MENIFEE, CA 92587 Construction Cost: $2,000.00 Existing Use: Proposed Use: Description of UPGRADE MAIN PANEL TO 200 AMP Work: Owner Contractor KEITH&DEBRA HOFFMAN JPE ENTERPRISES INC 29020 AVENIDA DE LAS FLORES 4634 VIA LA QUINTA MENIFEE, CA 92587 YORBA LINDA,CA 92886 Applicant Phone:7142349040 4634 VIA LA QUINTA License Number:633319 YORBA LINDA, CA 92886 Phone:7142349040 Fee Description gyt Amount(81 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 specificetions 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 nldg_Permit_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 D I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: License Class 4n License No. (A3 B m signature below I acknowledge that,except for m y y g g p y personal residence Expines_�/ZJL707,0 Signature g� — �_ 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 DECLARATION have built as an owner-builder if it has not been constructed in its entirety by �d 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 worker's 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 wvnv.leeinfo.ca.eov/calaw.html. this permit is issued. Policy g Date ❑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 for which D By my signature below 1 certify to each of the following:I am the property this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: Av�'' application and the information I have provided is correct.I agree to comply Carrier (t Arc i d T �/ I 0 t N I� with all applicable city and county ordinances and state laws relating to —r building construction.I authorize representatives of this city or county to Policy ft/fo Wf4elZ-5:Lq:Z L Expires 1 D l enter the above identified property for inspection purposes. (This section need not to he completed is the permit is for one-hundred Date dollars($SOD)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 emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE K 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 shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applican _� �� - Date ( .S $- mixture containing a hazardous material equal to or greater that the amounts sppecified on the Hazardous Materials Information Guide? WARNING: AILURETO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes /SNo UNLAWFUL,AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES Will the intended use ofthe building bythe applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TOTHE COST OF COMPENSATION,DAMAGES A5 PROVIDED FOR occupant require a permit for the construction or modification from South IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist for guidelines CONSTRUCTION LENDING AGENCY oYes d1ko I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 2000 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) 0 Yes D-No 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 Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable Items)(Section 7031.5 oyes d/ J` Business and Professions Code).Any city or county that requires a permit to Date — f r r G DAGENT construct alter,improve,demolish or repair any structure,prior to its pR EFig 0� AI� UTL�4 RIZ 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(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 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 7032.5 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 D 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.ena.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 ContractoYs State License Law does not apply to an owner of a D 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. D No EPA Lead-Safe Certified Firm is required for this project because: o I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractoes 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. F77777777 ~� x pA DATE: 5 I('I I PERMIT/PLAN CHECK NUMBER TYPE: COMMERCIAL 'liESIDENTIAL MULTI-FAMILY <. MOBILE HOME POOL/SPA SIGN SUBTYPE: ADDITION I ALTERATION DEMOLITION t-'fLECTRICAL > MECHANICAL -: NEW PLUMBING RE ROOFNUMBER OF SQUARES I of ae AA DESCRIPTION Of WORK ea,jU Building Dot MAY 2 8 PROJECT ADDRESS �p c. '11V?:ntn, `.s F1 2n� IP 2. ✓ ASSESSOR'S PARCEL NUMBER 541•�'L. D Z I __ LOT TRACT ecei_ ed OWNER NAM �7g EK � }1n I� VV)Onx �� L a,� ADDRESS to?_ J+Vt+y L IiC. SIC C A cf 7 Clx r PHONE IS] - Z4y-H504 EMAIL _ APPLICANT NAME .16M. 3E Sn✓i ADDRESS 4��L U10. Lr� 111c� I.—lf2f Un _ Z��o PHONL fly-7� -�O�I C� EMAIL CONTRACTOR'S NAME _'�-Q�K � {� � _ OWNER-BUILDER? OYES NO BUSINESS NAME EI v q ADDRESS `Iy� �� uy i(j�, I)i✓I�-An 2 PHONE 1_��J.=I_Q.y.C� F.MAIL �A1Qlai.�� CONTRACTOR'S STATE LIC NUMI3ER ��1 � LICENSE CLASSIFICATION VALUATIONS �J SO FT L SO FT '- - 1-u-Ems'✓-- ----- _ I, APPLICANT'S SIGNATURE -CITY STAFF USE ONLY N I DI7RIBUl ION CI I Y OF MF.NIP[F BUSINESS LICENSE NUMBER n'U11DWG PLANNING - ACCEPTED BY —1 PERMIT FEE `� ,� SMIP �/ GREEN PLAN CHECK FEE INVOICE TOTAL OWNER BU ILDER VERIFIED —� -_-� -_ -_— —Dom'YES T NO DRIVERS LICENSE# NOTARIZED LETTER YES O NO ...... Iu:;ar Rd, MI'mice. CA 92586 951-L^72-677i IwovlRr.�:rbv/?neni(ee.us