PMT18-02900 City of Menifee Permit No.: PMT18-02900
29714 HAUN RD.
MENIFEE,CA 92586 Type: Residential Electrical
MENIFEE MENIFEE Date Issued: 0 611 312 01 8
PERMIT
Site Address: 29419 PIAZZA CT, MENIFEE, CA 92584 Parcel Number: 340-560-009
Construction Cost: $500.00
Existing Use: Proposed Use:
Description of 20CAMP TO 175AMP PANEL DERATE FOR SOLAR PERMIT PMT18-02815
Work:
Owner Contractor
JOSEPH&AUDRA WOODS NB BAKER ELECTRIC INC
29419 PIAZZA CT 2140 ENTERPRISE STREET
MENIFEE,CA 92584 ESCONDIDO, CA 92029
Applicant Phone: 7605466091
RAMON LOPEZ License Number:858088
NB BAKER ELECTRIC INC
2140 ENTERPRISE STREET
ESCONDIDO,CA 92029
Fee Description City Amount r$1
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
$149.80
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_Bldg_Permit_Templale.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law),
Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Ciao CIO 'I— Cam!C License No,
S 5$U�k By my signature below 1 acknowledge that,except for mypersonal residence
Expires y'31- J 5 Stgnature in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION 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
❑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 issued. www.leetnfo.ca.eov/calaw.htmL
Policy If Date
-,Q I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
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:)am the property
this permit is issued.My workers compensation insurance carrier 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
n.J c I-H S 3o building construction.I authorize representatives of this dty or county to
✓(4
Policy 8 / Expires 3—/—/g 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 tt /
D I certify that in the performance of the workfor which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE II
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,l shall) ith comply with those provisions. Z Will the applicant or future building occupant handle hazardous material or
4
Applicant O"�l/ Date r-b-1 mixture containing a hazardous material equal to or greater that the
amounts spee'fled on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes p'No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant orfuture building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South
IN SECTION ON TO
06 OF THE
LABOR CODE,INTERTION,DAMADATTOGES AS R ATTORVIDEDNEYS
FOR Coast Air Quality Management District(SCAQMD)7See permitting checklist
IN SECTION 3706 OF7HE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguideli^}S
CONSTRUCTION LENDING AGENCY D Yes La No
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 outerbou9daryofaschool?
(Section 3097 Civil Code) o Yes No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that l 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 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to by s o Noconstruc '� ,2
(�y -� / Date
Issuance,also requires h applicshorrepairanysttofile a priosignrtpta 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($SOD). managers who do the paint-disturbing work themselves orthrough 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.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 140D-424-LEAD(5323).
Code,The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will he 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. o 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 Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please hill out the RRP
Acknowledgement