PMT14-01972 City of Menifee Permit No.: PMT14-01972
29714 HAUN RD. Type: Commercial Electrical
�CF.A,#�. MENIFEE, CA 92586 i
MENIFEE Date Issued: 0 8/0 812 01 4
PERMIT
Site Address: 29750 MC CALL BLVD, MENIFEE, CA Parcel Number:
92585 Construction Cost: $3,250.00 �?
Existing Use: Proposed Use:
Description of INSTALL 100 AMP ELECTRICAL METER PEDESTAL
Work:
Owner Contractor
S R BRAY LLC
1210 N RED GUM STREET
ANAHEIM, CA 92806
Applicant Phone: 7145071881
SHAWN LARSEN License Number: 980589
S R BRAY LLC
1210 N RED GUM STREET
ANAHEIM, CA 92806
Fee Description Oft Amount
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
$369.37
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_Permil_Template,rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION
I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions Code and my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class Ct License No. ct 8b b fr r who builds or improves thereon, and who contracts for the projects with a
Expires t 31 I Signature �`�`� licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors'State License Law for the
❑ I hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that, except for my personal residence in
compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of
permit is issued.Section 3 of the Labor Code, for the performance of work for which this improvements covered by this permit, I cannot legally sell a structure that I have
Policy# built as an owner-building If it has not been constructed in its entirety by licensed '.
contractors. I understand that a copy of the applicable law, Section 7044 of the
I have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
sedtion 3700 of the Labor Code, for the performance of the wort( for which this submitted or at the following Web site:http://www,leginfo,ca.gov/calaw,html.
permit Is issued.My workers'compensation insurance carrier and policy number are:
Carrier XL SPOCt NL T`, Property Owner orAuthorized Agent Date
Expires �31� Policy# e—w6 —790 9307
Name of Agent Phone# El By my Signature below, I certify to each of the following: I am the property
owner or authorized to act on the property owner's behalf. I have read this
(This section need not be completed if the permit is for application and the information I have provided is correct. I agree to comply
one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
I certify that in the performance of the work for which this permit is issued, I identified property for the inspection purposes, .
shall not emolov any persons in any manner so as to become subject to the ,r
workers' compensation laws of California, and agree that if I should becomeW�' 0subject to the workers'compensation provisions.of Section 3700 of the Labor
Sit Code, I shall forthwith comply with those provisions. Property Owner or Authorized Agent Date
Date; IS Applicant; City Business License# U 7} y 2
WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION, AYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A -
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑NO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE?
agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address ❑NO DISTRICT (SCAQMD) SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reason(s)indicated below by the checkmark(s)I have placed []YES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s) (Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, ❑NO SCHOOL?
or repair any structure, prior to its 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 License Law (Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or AYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
El1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do ( ) all of or ( ) porting of the work, and the structure Is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's Slate License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFIEE PLCKNo: -TVMm,
29714 Haun Road Date (� Date:: �
Menifee, CA 92586
Phone: (951)672-6777 Amount' Amount:
Fax:(951)679-3843 Ck#: Ck#:
Building Combination Permit
To Be Completed By Applicant
Legal Description: FLEGTRIC_ �OESTAL Plannin Case: F;METQR 9 L: Rl: R:
Property Address: Assessor's Parcel Number.
!° -7J® Mg.( 11 Iv4.
ProjecUTenant Name: Unit#: Floor#:
STALMAeb Qp(,I FI C - h{ER 1 T^GE 1.61<e
Name: S.PN 0M.0 PACIFIC roj!q Phone No. Fax No.
Property Address:
Owner Ls$' Q, Rim �- # �O CCWQ / Unit Number Zip Code
Email Address: CF1 q2g 7
Name:
OWE2 PLUS Phone No. Fax No.
Applicant Address: laEh 61 114^2�1-$OOq
vrb Ji• Pe RQIS BLVSI, r r;,/} Uni[Number Zip Code
Email Address:
SL-"SGA 0 POVAse PLUS . Cc PA
Name:
Pd 1,vQ12.. PLUS Phone No,
Fax No.
71 41-'23k-§°°9
Contractor Address: C city ORRIS Stal`e� Zip Code
27S-o N. ?eee1S gLvo, nV%S A " p g2s7(
ontractor s Uty Business License No. Contractor's City State of California License No.
q Classification: CIO
Number of Squares:
Square Footage
Description of Work: T-MS`VArL L. `I®tl A^P 1
.�fL
EL�C-1� CAL M6 PAS fAr Cost of Work:$ B
Applicants ign Sature ® � 7
F� Date: -7 2rJ /y
To,Be Completed By,.71 iStaff only
Indicate As R-Received or N/A-Not Applicable
5 Completes sets of fully dimensioned.drawn to sale plans which include: t set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan
❑ Goo Tech/Soils Report(on cd only)
❑ Plot/Site Pan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 Y,x 1f)
❑ Foundation Plan ❑ Structural Calculations
❑ Cross Section ❑ Plumbing Plan
❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan ❑ Sound Report-Residentiatial
Class Code: Indicate New Construction Alteration` Addition` MeanslMethods
Work Type: Repair" Retroft` Revision l06cisfing Permit' Required? YES NO
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units: 0 Stories: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate if Geo-tech.Haz.Zone
At Project Indicate YES or NO Indicate all
t Construction Sprinklered thata 1 Coastal Zone
Completion: apply.
Type(s): C Of O YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retroft yeaal Case:Bldg.
Ot(cialA royal
Expedite Project(s): Child Care City Project Green Building Landmark I Affordable Housing
For Staff Use Only
Building/Salery Permit Specialist City Planning Civil Engineering EPWM-Admin Trans onation M mt.P 9 Renl Control
THANK YOU FOR HELPING US CREATE BETTER COMMUNITY
6ATe— CO/40 v1" T3 �-Z
Standard Pacific Homes
Cops' TRACT 34406
Ofte
so
Heritage Lake Backbone Ph IV"
`
]] ]I, ,g11 Menifee, California
<'13 "�, w WORK ORDER PHASING
H]1, 69IIF
5136a B] 90a1/81�� ��. \\'
��
SA�rTy1EPARTMENT
/ 3B 6I 196 5 LJ ) 49
59 69 1Q3 � O
60 6i fo �II u
53 5) Q! 1 a I8J db \ \ M
]> ]g80 d9 48 Y.. 106 181 ] 8 18
10 db OS foB 179 � '{�i6i\
]6 4I IS n f lyy l09 180 59 3 56] e 10 y/Lg \
,1 !4 F 10 119 1f0 f' /]b \ BO 69 II 19 \ .��
� v4 f eb Ia9 rn „flilBz to 19un9 u' z n 11 z]
J 9} 8] es B1 9H f]] 115 d1
8a 8l 98 fi 15 \ 6] i fI ]0 P] 1
PO Jf 96 iP8 �• I 15 1l Ive T:. �10 bd g 6) » � IB I.� ��
Id PS y P 'u f1f19 'd15015 169 0�• l51 db a]/� � (O � W Y114 18 ) / 1 "
f9 1B � g 31Jf f0)Q1 SQ6 �r /``gg • �Jry] 6 6P 8 ,Of Pl
14 B]
idi 19 J S
11 _ 15/{/ �- ff� Sadly O�OM ` 1Qr VB1W RIMQ ��] I—SL f a {_
110 ]�l1]/
I9 51969
gP a)f z 56 9 � S B,
BS M
6 61 ! � 6 g 8
\61/b bQ L1�1 l i�Ue_90 E9 III. :
fib l _ sb 51 5 9 !B d 6 As d. I9 IP, 10�99,
17 1y,
1711E I I
r2, �a✓J✓ � I�,
II�
wTW 34406-1 ,
\ v ea e] 9B Hµ lmry 16. n w l
SB a6 85 y]91\'P]\ f01 I e \ _ ® •1 L 1
1 \\ a B9 HO B1 0Z f04 1P5 f18 oui
5�A f06\f0)f06� K
9 ,deli)9 sod B1F3
109 p112
dcd] z6 v fi zs z4
I � zPm
0 ]\1f 7r Y .16 gH 16i 36 % I PP
w \ �) is i J ✓ .$r a ° als t1109B�a9 72jwr
n
I6 J21211 ) 6 11 88
4' 4.
Ill�Y ✓91 J e � � 3,d ll ) hJ
5 !i 1B7-" ]a - 151 P9 1
\\ t I)9 BB 91 85 71
y 9 91 106 0 5 `P• ,y .
/ 181'.fa 1901i 19/ Po) 09 1 41/ 16
27
/1
7 11 ��1 1 ,18 f00 I 97 a4
A} C �I
33'zd l21 19116E 16I,SllI12
,3 III I,I'l 9 B�Q d] )I6 99 BQ 81 J 1]
5,]8 0I61
I� // II4s s]sB SsB1 m' �ol
1
-emu
LEGEND
,) 1 "'i, 9� 4 5 'w
Backbone W01
cxnxo vsxue
I
Backbone WO2 yP,C? �
Backbone WO3
r� 6Rq o
M.E.Nollkamper, Inc. 94 Manor Way Corona,CA 92882 951.808.4645,Fax 951.737.9343.