PMT18-02743 City of Menifee Permit No.: PMT18-02743
29714 HAUN RD. Type: Residential Electrical
11� MENIFEE,CA 92586
MENIFEE MENIFEE Date Issued: 0610612018
PERMIT
Site Address: 31043 TIVERTON RD,MENIFEE,CA Parcel Number: 372-470-004
92584 Construction Cost: $7,488.00
Existing Use: Proposed Use:
Description of MAIN PANEL CHANGE OUT 200A TO 200A
Work:
Owner Contractor
MEKKIQ DESANCHFZ A R S AMERICAN RESIDENTIAL SERVICES OF
31043 TIVERTON ROAD CALIFORNIA INC
MENIFEE,CA 92584 965 RIDGE LAKE BLVD.#201
Applicant Phone:9512769744
CHRISTINA CALHOUN License Number: 765074
A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIi
965 RIDGE LAKE BLVD.#201
MEMPHIS, CA 38120
Phone:8006600675
Fee Description Oft Amount I$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 slated,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_Bidg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractols)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and a I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force a ffect. he following reason:
License Class ( C�� U s 0.-7( By my signature below I acknowledge that,except for my personal residence
Expires Signature y in which l 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 DECLA TIO 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 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.govifcalaw.html.
this permit is issued.
Policy q Date
PROPERTY OWNER OR AUTHORIZED AGENT
vlitrdve and will maintain workers compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which o 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
numberare` application and the information I have provided is correct.I agree to comply
Carrier L,l rd with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy 0 11p�uISC)NoVOl�j x Pis res enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is orone-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, O -)LA
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 0 ✓w
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the war e{s compeoealibnpJ�vislNtI of s 3700 of the Labor
Code,I shall f "th co pl r Z Yiose ; Will the applicant or future building ocal equ l to or hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applican Dale 6 amounts specified on the Hazardous Materials Information Guide?
WAR N ILURETOSEC WORKER'SCOMPENSATI COVE GE IS oyes VNO
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)?See permitting checklist
IN SECTION 370E OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY oyes *OAG
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) ayes %r4o
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 4RENOVATION,
AREPAIRAND
equire under the State of
ion nd 25534 tooter ing
Contractors License Law for the reason(s)indicated below by the
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 yBusiness and Professions Code).Any city car county that requires a permit to Date L ` le
construct,alter,improve,demolish or repair any structure,prior to its 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 NTING(RRP)
License Law(Chapter9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RAP)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
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.eovAead 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 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-Builderwill have the burden of proving that it was
not built or improved for the purpose of sale. a No EPA Lead-Safe Certified Firm is required for this project because:
D 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.
BUILDINGAPPLICATIONf
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Menifee
DATE: L04511 a PERMIT/PLAN CHECK NUMBER QS '1
TYPE: 0 COMMERCIAL CI RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION 0 ALTERATION O DEMOLITION t,E' LECTRICAL O MECHANICAL
-----------------
O NEW O DPLUMBING O RE-ROOF NUMBEROFSO•UARES
DESCRIPTION OF WORK t�.I{ P(rc- .� QG yn .�
Zob
PROJECfADDRESS 16{Qc('2 -UT,ry}.�j,�1 P-a. ZIP `zs-,j
ASSESSOR'S PARCEL NUMBER LOT TRACLjty at menifee
OWNER NAME �rjp, C.r�•2.Z /nu°.1��.L Q Building 0130
ADDRESS
PHONE w ZOI S'�� / EMAIL
APPUCANTN�A/M�E Y't 6 VV� ecel
vuu
ADDRESStJLJ
PHONE 80 C) U Q O OCv-11 � EMAIL
CONTRACTOR'S NAME %� Ivilo%
U-,-2- OWNER BUILDER? O YES ONO
BUSINESS NAI -6 .
ADDRE
PHONE I50() ( a pp (7(-,2 EMAIL n
CONTRAGTOR'S STATE LIC66NUMBER 7Ip510?y UCENSECLASSIFICATION (210 CZO C$(p
VALUATION 5R FT SQ Ff
APPLICANT'S SIGNATURE DATE 0
DEPARTMENT DISTRIBUTION ,^ CITY OF MENIFEE BUSINESS UCENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: 1LI�IKI/./�
PERMIT FEE 1 -� SMIP )e GREEN _
PLAN CHECK FEE INVOICE TOTAL
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE It NOTARIZED LETTER O YES 0 NO
City of Menifee Building&Safety Department29714 Haun Rd, Menifee, CA 92586 951-672-6777
www.cityofmenifee.us