PMT18-02995 City of Menifee Permit No.: PMT18-02995
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE MENIFEE Date Issued: 06/18/2018
PERMIT
Site Address: 27680 JUNIPERO RD,MENIFEE,CA Parcel Number: 333-132-004
92585 Construction Cost: $4,000.00
Existing Use: Proposed Use:
Description of INSTALL NEW OVERHEAD SERVICE CONNECTION PER ESR-2
Work:
Owner Contractor
ELSIE CHAMPION&CATHY SEGO
27680 JUNIPERO ROAD
MENIFEE, CA 92585
Applicant License Number:
, CA
Phone:9517514067
Fee Description Qtv Amount IS)
Pole or Platform Mounted Fixtures 1 183.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Electrical 1 9.15
$220.15
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 �pA 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: 110 LN J
License Class License No. B m signature below I acknowledge that,except for m y y g g p y personal residence
Expires Signature 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
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 37GO of the Labor Code,for the performance of work for which
this permit is issued. w29AQ9ginfo.ca.gov/calaw. mi.
Policy# _ - �/ Date
D I have and will maintain worker's compensation Insurance,as required by PROPERTY ER O A HO ED AGENT
section 3700 of the Labor Code,for the performance of the work for which a By nature 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
number are: application and the Information 1 have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carder building construction.I authorize representatives of this city or county to
Policy# Expires enter th bave identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred , ��> ,. - , Date Lr�6 �lJ
dollars($100)or less PROPERTY OW ER- THOR D AGENT
D I certify that in the performance of the work forwhich this permit is issued,
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if 1 should become HAZARDOUS MATERIAL DECLARATION
subject to the workers 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
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes X7 No
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 70 ONE HONORED THOUSAND DOLLARS($100,000I,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 guidelines
CONSTRUCTION LENDING AGENCY O Yes ;ONO
I hereby affirrn that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 10DO 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) Yes D No
•OWNER BUILDER DECLARATIONS 1 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
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 2SS34 concerning
checkmark(s)I have placed next to the applicable item hazardous material reporting.
(s)(Section 7031.5 f r
Business and Professions Code).Any city or county that requires a permit to Date /' 6
construct,alter,improve,demolish or repair any structure,prior to its (pROPERTYO fj AlITHO ED 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 Code)or that he or she is exempt from Iicensure
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most a RRP-cwork at ffieddistuf r paint in a comply with
residence or childcare facility to he RRP-certified firms and complywith
Applicant for a permit subjects the applicant to a civil penalty of not more than
required practices.This includes rental property owners and property
than(5500). managers who do the paint-disturbing work themselves or through their
01,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.epa.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 70",Business and Professions 1-BOD-424-LEAD(5323).
Code;The Contractors State License law does not apply to an owner of a 0 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 an 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. 0 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 fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL XRESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA O SIGN
SUBTYPE: 0 ADDITION 0 ALTERATION O DEMOLITION ELECTRICAL 0 MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK B C ,
PROJECT ADDRESS ..Z cf 6 80 :Liv1l,{,.-Qf(�( ZIP
ASSESSOR'S PARCEL NUMBER /3 3� •13� •� LOT TRACT
OWNER NAME 1 � (, kC( 0 Q 1 L 7
ADDRESS (9 oI Lle e1- ?d Sum t q 2
PHONE �7 �- /.S / „ Y 0 6 7 EMAIL ("(�-((n .SeU q ecf r/i�iu LJ ,
APPLICANT NAME 140vh
ADDRESS 7 6 8 (] v ✓1 4 ?<c7 2 s✓ v? C'_IP
PHONE �C S - 'J S / - L/ 0 6 �7 EMAIL SG`n r 4 ._>0
CONTRACTOR'S NAME OWNER BUILDER? YES 0 NO
BUSINESS NAME
ADDRESS City of Menifee
Building Dept.
PHONE EMAIL
jUN G
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$2� Q ` G D SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE -
OTYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITYU LE BUSINESS WCENSE NUMBER
BUILDING PLANNING GINEERING FIRE /{.1(TI�\
44�^
INVOICE TOTAL p•.;LO . IS` GREEN 1 SMIP
OWNER BUILDER VERIFIED OKYES 0 NO DRIVERS LICENSE# NOTARIZED LETTER O Y O
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 .
www.cityofinenifee.us
- ENIF -1
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Figure 2-15: Customer-Owned Permanent or Temporary Service Pole
Note(s):
1. The preferred location for customer-owned permanent or temporary .'
15,I service poles shall be located where the'is Company vehicle "•
access.If Company vehicle access cannot be obtained,contact the ,
` 2 local Service Planning Office for meter spot location.Service drop
1 I and wire holder or service rack shall be furnished and installed by
I 3 the Company.The Company's service drop maximum span length is
100 feet.
2. wire holder or rack furnished and installed by the customer. �
5 3. Customer's line.
4. Not less than 18 inches of wire outside service head.
4 5. Weatherproof service entrance caps. ■
6 6. Minimum 3/4-inch PVC conduit Sch.40. "e
7. A 25-foot pole with a five-inch minimum top diameter treated with a
chemical preservative.
Fasten conduit securely to pole.
8 9. For type of meter receptacle,and the number of socket terminals,
see ESR-5.
10.Meter will be furnished and installed by the Company.
Self-contained 300/400 A(Class 320)type meter panels are not
q acceptable for temporary service.Asafety socket box with factory
— installed test/bypass blocks,as detailed in ESR-5,shall be provided
for all three-phase installations.
11.Weatherproof boxes and receptacies.41
12.Armored ground wire or minimum of 1/24nch rigid conduit or wood
r molding over ground wire.
m 13.Ground wire to be#8 AWG minimum. `
14.Where customer's feeder is to be underground,install conduit as N
w indicated by dashed lines and as required by the NEC. ^
m 15.Approved ground clamp and fitting must be accessible.Conduit �..I
g must extend to ground rod to protect ground wire from mechanical fir••/
injury.
16.Ground wire from pole to electrode shall be enclosed in galvanized
X ridged conduit,or equivalent mechanical protection.If a ground rod
¢� is used,the following minimum requirements apply:
Cl Diameter of rod:3/4 inch,if iron rod or galvanized pipe 'lyV`••\/
`? 1 ❑ 112 inch,if solid rod of brass,copper,or copper-covered steel.
`O ❑ Drive to minimum depth of 8'-0-below ground surface.
❑ Refer to the local inspection agency for alternate or additional
Z requirements.
Removable 17.A 6'x 3/4"Sch.40 PVC conduit will be furnished and installed by Cap
o the customer.This conduit must be permanently secured with three
pipe straps to the butt and Bush to the bottom of the pole.The
1 bottom of the conduit must be permanently capped and the lop cap
must be removable.
18.The customer must set the service pole in natural soil.The backfill
must be tamped to a minimum compaction of 90 percent within a
two-foot radius of the pole.
City of Menifee
1 Building Dept.
IBC anent
JUN I U 9nt)
Received
v Refer to the local inspection agency and the"Califomta Electrical Safety Order'for ground fault circuit protection requirements.
ESR-2 Overhead Service Connections 0-600 V EFFECTIVE DATE
PAGE
1-2s-zgls
Electrical Service Requirements APPROVED
2-32
►SCE Pu6lict
PLOT/SITE PLAN
REAR PROPERTY LINE
V
City of Menifee `L
Building Dept.
JUN 18 201R zm e
Received o
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FRONT PROPERTY LINE
Property Owners Name �Str ( , ry q �, e�9 �� 7
Property Address 27ba v-, CAE, e9