PMT18-02987 City of Menifee Permit No.: PMT18-02987
MENIFEE,
EE, C 92 Type: Residential Electrical
MENIFEE, CA 9258E
MENIFEE MENIFEE Date Issued: 06/15/2018
PERMIT
Site Address: 29085 STEAMBOAT DR, MENIFEE, CA Parcel Number: 333-443-009
92585 Construction Cost: $8,000.00
Existing Use: Proposed Use:
Description of INSTALL 3 OUTETS, 1 -20 AMP CIRCUIT,6 CEILING LIGHT FIXTURES IN NOOK AND LAUNDRY
Work: ROOM
Owner Contractor
KAREN KNOELLER-BROWN TARANTO CONSTRUCTION INC
29805 STEAMBOAT DR P O BOX 1857
MENIFEE, CA 92585 UPLAND,CA 91785
Applicant Phone:9099313233
JOSEPH TARANTO License Number:876297
TARANTO CONSTRUCTION INC
P 0 BOX 1857
UPLAND,CA 91785
Fee Description ply Amount!$)
Receptacle, Switch, Outlet& Fixture 9 156.00
Building Permit Issuance 1 27.00
Additional Plan Review Plumbing 1 1.00
General Plan Maintenance Fee-Electrical 1 7.80
$191.80
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_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 1 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 Ucense No. G 2 9 By my signature below I acknowledge that,except for my personal residence
Expires 2't 5i r— 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 COMPENSA N OECULRATI have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under erjury 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 Cade,for the performance of work for which www.leeinfo.ca.eov/calaw.html.
this permit Is issued.
Policy A
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 o By my signature below I 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 an the property owner's behalf.I have read this
number are: application and the information 1 have provided is correct.I agree to comply
Carrier O r-�-`- � TVA ^^�� with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Polity K do Expires i-E( 20 Y enter the above identified property for inspection purposes. /
(This section need not to be completed is the permit is for one-hundred Date ! l--3
dollars($100)or less PROPERTY OWNER ORAU HORIZEDAGENT
o I certify that in the performance of the work for which this permit is issue ,
I shall not emotov any persons in any manner so as to become subject to the USINESS LICENSE p
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 ply with those provisions. Will the applicant or future building occupant handle hazardous material or a
ant Date /9 // mixture containing a hazardous material equal to or greater that the
amounts spe ad on the Hazardous Materials Information Guide?
C
ARNING:FAIL E TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes D Ro
NLAWFUL, NO SHALLSUBIECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
ND-GINES UP TO ONE HUNDRED THOUSAND DOLLARS(5300,000),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 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidetioes
CONSTRUCrION LENDING AGENCY ❑Yes a 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 outer bo�und3rY of a school?
(Section 3097 Ovil Code) o Yes d 0
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 I am exempt from the
Contractor's License Law for the reason(s)indicated below by the hazardoulifornias
Health&Safety Code,Section 25505 and 25534 concerning
hazardo��us//��aterlal reporting.
checkmark(s)I have placed next to the applicable Rem(s)(Section 7031.5 oyes YNa
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to Its pROPERT' NER 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 Contractor's crate EP NOVATION,REPAIR AND PAINTING IRRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of he The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensu 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
o 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( I all of or( )portion of the work,and the structure is www.eoa.gov/lead or contact the National Lead Information Center at
not Intended or offered for sale.(Section 7044,Business and Professions 1-800-024-LEAD(5323).
Code;The Contractor's 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. "-ol Lead-Safe Certified Firm is required for this project because:
❑I,as owner of the property am exclusively contracting with licensed �"�`� i1 P G�-t
contractors to construct the project(Section 7D44,Business and Professions
Code:The Contractor's 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 PERN/11T/PLAN CHECK APPLICATION MENIFEE
DATE: /J�Zo/ PERMIT/PLAN CHECK NUMBER / 9
PLANNING CASE NUMBER
TYPE: 0 COMMERCIAL t RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: O ADDITION (I,ALTERATION 0- DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING v' RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK 00(G 4K.&A7 e ZAL14� n006- c,
TXIC4-c 4JaxfC - v�fcc7S .O GILGwr G 44 41-- +
PROJECTADDRESS agc,d'�- 5_jeeAoa-. l �/ 6,1.//i,.L �y�- ZIP /.ZSop
ASSESSOR'S PARCEL NUMBER 333--qqy?2W LOT TRACT /
OWNER NAME n1(1& — W
ADDRESS ZojOf� 1� .J2ifLE/�+L!/O�l-
PHONE �frl, —y� 93 EMAIL
J � �
APPLICANT NAME �vl/ /L.F?N?
ADDRES§� C / L-A
PHON&01 - EMAIL
CONTRACTOR'S NAM d L,OWNER BUILDER? 0 YES 0 4e
BUSINESS NAME
ADDRESS 1� S U/�L�}N�
I l
49
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER " LICENSE CLASSIFICATION
VALUATION$ 1, O 00 SO FT O L SQ FT
APPLI T'S SIGNATURE DATE r 2D C
OTY.%:TAFF USE ONLY
DEPART TRIB ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL GREEN SMIP
OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofinenifee.us 1
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