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PMT18-03147 City of Menifee Permit No.: PMT18-03147 29714 HAUN RD. MENIFEE,CA 92586 Type: Residential Electrical MENIFEE MENIFEE Date Issued: 0 6/2 21201 8 PERMIT Site Address: 28229 WINDSAIL CT, MENIFEE,CA Parcel Number: 364-043-014 92584 construction Cost: $1,200.00 Existing Use: Proposed Use: Description of DERATE CENTERFED MAIN BREAKER 100A Work: Owner Contractor BARRY FRENCH HOSOPO CORPORATION 28229 WINDSAIL COURT 7100 WEST FLORIDA AVE MENIFEE, CA 92584 HEMET,CA 92545 Applicant phone: 9519261176 HOLLY THOMPSON License Number: 1004233 HOSOPO CORPORATION 7100 WEST FLORIDA AVE HEMET, CA 92545 Fee Description Oft Amount iEl 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 staled,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 I 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 Cla $A-Ku)Q�U J n tense No. By my signature below 1 acknowledge that,except for my personal residence P �_&-_"I `l g t` Ex ire' Si natu- , 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 DECLARATION have built as an owner-builder if it has not been constructed in its entirety by fhereby affirm under penalty of perjury one of the fallowing declarations:l licensed contractors.I understand that a copy of the applicable law,Section ve and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Cade,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 sysvw.leeinfa.ca.eov/calaw.html. ��{�� PolicywAd4a4aY t k= Date D 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 D 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 on the property owner's behalf.I have read this number are: /] application and the information I have provided is correct.I agree to comply Carrier/ �L 06%,L with all applicable city and county ordinances and stale laws relating to 2 building construction.I authorize representatives of this city or county to Policy O flx/I/♦��oo 00 Expires(y—��f 9 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 D 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 CITY BUSINESS 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 s all rthlin comply with those provisions. WIII the applicant or future building occupant handle hazardous material or a Appli 1 ,U)'3fA G� 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 ❑Yes ❑No UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant urfuture building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,0001,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 construction t(SCtionor modification permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines Qua CONSTRUCTION LENDING AGENCY oYes DNo I hereby affirm that under the penalty of perjury there is a construction WIII 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) O Yes o No 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 permitting checklist.I understand my requirements under the State of Contractor's License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning hazardous material reporting. 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 construct,alter,improve,demolish or repair any structure,prior to its 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 Contractor's 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 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 fora 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 n 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.flov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323). Code;The Contractors State License Lawdoes 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. D 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 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. i 1 & SAFETY • IT/PLAN • • 1 , • ::t t,/lenifee DATE: PERMIT/PLAN CHECK NUMBER-pM I18- n PLANNING CASE NUMBER TYPE: efo-MMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: "AADDp�7ION 0 ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL 'NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORKF Jr.4m)& ) - Sgszje� PROJECT ADDRESS 9(/,j n),6W{��. ZIP j ASSESSOR'S PARCEL NUMBER 3(4,C)--nK(o -QZj LOT TRACT OWNER NAME J41Fk)p _ LE ADDRESS / Q - Q o PHONE - ,3 EMAIL ""� APPLICANT NAME /J y ADDRESS 4a 22120 PHONE $,`)�' 99T - � � EMAIL Dn)90 G d CONTRACTOR'S NAME J.a OWNER BUILDER? O YES O NO BUSINESS NAME Kg (jEg ADDRESS JD 1// P4 so ex Q PHONE S(�-�, jD- Q() �� EMAIL c ZX1 cJ 0 Cd CONTRACTOR'S STATE LIC NUMBER . zz ! LICENSE CLASSIFICATION14 VALUATION SO FT L SO FT �X APPLICANT'S SIGNATURE DATE !�� .CITYSTAFF USE ONLY _ DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY:� /�� PERMIT FEE �� GREEN SMIP PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED OYES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES O NO City of Menifee Building& Sofety Deportm_nt 29714 Houn Rd. Menifee, CA 92586 951-672-6777 w,,vw.citvo fineni fee.us