PMT18-03534 City of Menifee Permit No.: PMT18-03534
Ar 29714 HAUN RD.® MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE MENIFEE Date Issued: 07/17/2018
PERMIT
Site Address: 29555 AVIDA DR, MENIFEE,CA 92584 Parcel Number: 339-222-009
Construction Cost: $1,800.00
Existing Use: Proposed Use:
Description of MAIN PANEL UPGRADE 125A
Work:
Owner Contractor
TAMRA IRWIN COMPLETE SOLAR INC
29555 AVIDA DRIVE 1850 GATEWAY DRIVE SUITE 450
MENIFEE, CA 92584 SAN MATEO, CA 94404
Applicant Phone:8772994943
ERNESTO MADRIGAL License Number:961988
COMPLETE SOLAR INC
1850 GATEWAY DRIVE SUITE 450
SAN MATEO, CA 94404
Fee Descrlotlon Rbf Amount 1$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 carded 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 perjurythat 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 in I am exemptfrom 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 C 10 License No. 01 By my signature below I acknowledge that,except for my personal residence
Expires 10 / 31 /ZQI%ignature 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
❑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 3700 of the Labor Code,for the performance of work forwhich www,leeinfo.ca.gov/calaw.htmL
this permit is issued.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
❑I have and will maintain worker's compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which ❑By my signature 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: 1 r_ /p� application and the information I have provided is correct.I agree to comply
Carrier IT Y1n4,Y t Cot n t lU 1'Vt-P— rT $U 6ad1�- with all applicable city and county ordinances and state laws relating to
N building construction.I authorize representatives of this city or county to
Policy# WCO4 �-Q JOL/F-Expires —+—I— I "I 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
❑I certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS.LICENSE If
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,I shall forthwith amply h those provisions. v Will the applicant or future building occupant handle hazardous material or a
Applicant Date J / ' O 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 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
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 ❑Yes ❑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 boundary of a school?
(Section 3097 Civil Code) ❑Yes ❑No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
hereby affirm under penalty of perjury that am exempt from the permitting checklist.I understand my requirements under the State of
California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the 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,priorto 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING(FIRM
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($500). managers who do the paint-disturbing work themselves or through their
❑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.gov/lead or contact the National Lead Information Center at
not intended or offered forsale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a ❑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. ❑No EPA Lead-Safe Certified Firm is required for this project because:
❑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.
DATE:7/17/18 PERMIT/PLAN CHECK NUMBER 1
TYPE: Q COMMERCIAL *RESIDENTIAL !, MULTI-FAMILY C MOBILE HOME O POOL/SPA _SIGN
SUBTYPE: :D ADDITION ')ALTERATION C DEMOLITION S ELECTRICAL a MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
am panel upgrade to 125amps
DESCRIPTION OF WORK
29555 Avida Dr. 92584 ern e
PROJECTADDRESS 2Q �] ZIP Bufldin
ffASSESSOR'S PARCEL NUMBER ^ ..J I �CT(0j - LOT TRACT Jill
Tamra Irwin
OWNER NAME
29555 Avida Dr. Menifee, CA 92584
ADDRESS Received
PHONE EMAIL
APPLICANT NAME Ernesto Madrigal
ADDRESS 1850 Gateway Dr. Suite 450, San Mateo CA 94404
PHONE 951-575-7571 EMAIL _
CONTRACTOR'S NAME Complete Solar Inc. OWNER BUILDER? C•YES . O
BUSINESS NAME Complete Solar Inc.
ADDRESS 1850 Gateway Dr.Suite 450, San Mateo CA 94404 - -
8772994943
PHONE EMAIL
961988 C-10
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ 1`M — SQ FT FT L SQ FT],, I
APPLICANT'S SIGNATURE `— CY_!/ DATE
QATYST,AFF:USE'ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY:
PERMIT FEECap
SMIP GREEN
PLAN CHECK FEE INVOICETOTAL
OWNER BUILDER VERIFIED C YES C NO DRIVERS LICENSE# NOTARIZED LETTER ., YES 0 NO
City of W[enifee Building&Sgfery Department 29714 Houn Rd. Nlenifee, CA 92586 9=1-672-6777
WWw.cityDfinerifee.us
ADDRESS WEB PHONE
A'EfHgnl4Wzy. a85e Gat=via{•On,.,suu---5a, :a^mieteeelm.wm e77-5K,>502
_2f1 Mate ,CA Q�l W,
July2.6,2018
To Whom It May Concern:
I, Aaron Wise, licensed contractor, authorize, Ernesto Madrigal to act on my behalf and that of
Complete Solarforthe purpose of submitting, processing, or obtaining any and all documents
pertaining to building permits and business licenses forthe project located
29555 Avida Drive, Menifee, CA 92584.1 am named on the contractor's license listed below
and have the authority to authorize the people named above to act as agent.
Sincerely, City of Menifee
Building Dept.
JUL 17 2018
Received
Aaron Wise
Director of Operations, R.M.E.
Complete Solar
CSLB #961988