PMT18-03093 City of Menifee Permit No.: PMT18-03093
D.
MENIFEE,
EE, C 92 Type: Residential Electrical
MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 0 612 012 01 8
PERMIT
Site Address: 29497 OAKBRIDGE,MENIFEE,CA 92586 Parcel Number: 338-213-006
Construction Cost: $1,500.00
Existing Use: Proposed Use:
Description of PANEL CHANGEOUT-SAME SIZE(100A)AND LOCATION
Work:
Owner Contractor
JOHN ANTHONY VALENZUELA JR ,
29497 OAKBRIDGE DR
MENIFEE,CA 92586
Applicant License Number.
JOHN ANTHONY VALENZUELA JR
29497 OAKBRIDGE DR
MENIFEE,CA 92586
Fee Description C& Amount f$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 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 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
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 ❑I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the fallowing reason:
License Class License No. By my signature below I acknowledge that,except for my personal residence
Expires Signature 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
O I hereby affirm under penalty of perjury one of the fallowing 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 Rcifessi ns Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application is submitt or /.the fo wing website:
by Section 3700 of the Labor Code,for the performance of work for which -
this permit is issued. www.le inf .c . ov c w.h Policy# r- Date to 0 'DQ
PROPE OWNER OR ALIT ORRED AGENT
o I have and will maintain workers compensation insurance,as required by
section 3700 of the labor Code,for the performance of the work for which o B y signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation Insurance carrier and policy ow er ,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 coun ordinances and state laws relating to
building con intiction.I audlocile r resentatives of this city or county to
Policy# Expires enter the o e p identi p far inspection purposes.l,,
(This section need not to be completed is the permit Is for one-hundred Date W 2 0
dollars($100)or less PR ER OWNER OR AJITHORIZED AGENT
o 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 ITy BUSINESS LICENSE#
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,1 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 sp}cified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes dNo
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
AODITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECNON 37060F THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguide�lif'�s
CONSTRUCTION LENDING AGENCY ❑Yes dyNo
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 bou9dary of a school?
(Section 3097 Civil Code) ❑Yes No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMO M
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I/fetyC
d y requirements under the State of
California Health e ' n ZSSOS and 25534 concerning
Contractors License Law far the reason(s)Indicated below by the hazardou ater re
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes No
Business and Professions Code).Any city or county that requires a permit to Date Off? M
construct,alter,improve,demolish or repair any structure,prior to its PROPE WNERORA RIZEDAGENT
issuance,also requires the applicant for the permit to file a signed statement O
that he or she Is licensed pursuant to the provisions of the Contractors State EPA OVATION REPAIR AND PAINTING IRRPJ
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
o 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.epa.aov/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 Contractors State License Law does not apply to an owner of a o 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. 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
Cade: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
,ilk
DATE: o PERMIT/PLAN CHECK NUMBER PEW
GRADING/PLANNING CASE NUMBERR�/OTHER RELATED CASES
TYPE: O COMMERCIAL aYRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: OADDITION 'ALTERATION O DEMOLITION VELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK m
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS O YES O NO
PROJECTADDRESS Z4 91 00L ' Dr. o,, ZIP Ali`✓" b
ASSESSOR'S PARCEL NUMBER ^ LOT TRACT
OWNER NAME r, rity of Menifee
ADDRESS jjq,jj S A Building Dept.
PHONE _(q5j) 4jq- EMAIL JUN 20 2018
APPLICANT NAME 4 (.,
ADDRESS 2qqqj "41-%
PHONE (R51) EMAIL Ivel CL 21Q141Ab1QQ-CO
CONTRACTOR'S NAME OWNER BUILDER? O YES O NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ SO FT L SQ FT
APPLICANT'S SIGNATURE to DATE o Zo)
DEPARTMENT DISTRIBUTION ACCEPTED BY. /n\ CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL 1 I4 GREEN SMIP -'—
OWNER BUILDER VERIFIED YES O NO DRIVERS LICENSE H NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofmenifee.us
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PLOT/SITE PLAN
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City of Menifee Q
Building Dept.
JUN 2 0 2018
Received
FRONT PROPERTY LINE I� -
Property Owners Name .14,6 Ay4bnv '�nlojjziw\LA Tr
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Property Address 2gyq-1 W/—br-aIn—
City of Menifee Building&Safety Department 29714 Haun Rd.Menifee,04 92586951-677-672-677
wwwcityofinenifee.us