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PMT14-02793 City of Menifee Permit No.: PMT14-02793 29714 HAUN RD. Type: Commercial Electrical C CEL MENIFEE, CA 92586 MENIFEE Date Issued: 1 012112 01 4 PERMIT Site Address: 25977 CARAVAN CT, MENIFEE, CA Parcel Number: 358-512-015 92584 Construction Cost: $445.00 Existing Use: Proposed Use: Description of INSTALL 200AMP UNDERGROUND TEMP POWER POLE Work: Owner Contractor RICHMOND AMERICAN TEMP POWER SYSTEMS 25977 CARAVAN CT 625 S FEE ANA STREET MENIFEE, CA 92617 PLACENTIA, CA 92807 Applicant Phone: 7142235600 WAYNE MC COY License Number: 696713 TEMP POWER SYSTEMS 625 S FEE ANA STREET PLACENTIA, CA 92807 Fee Description Oty Amount 1$1 o dry. we �P: e�,. FM EN., � ° Receptacle, Switch, Outlet&Fixture 1 116.00 GREEN FEE 1 1.00 $211.00 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_ri dg_Permit_Templatarpt 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 CtD License U 9 7 13 who builds or improves thereon, and who contracts for the projects with a Expires1*L5L1 I Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARA ❑ lam exempt from licensure under the Contractors'State License Law for the ❑ 1 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 Section 3700 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 permit is issued. built as an owner-building if it has not been constructed in its entirety by licensed Policy# 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 section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:hftp�//www.leciinfo.ce.ciov/calaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: Lam_ Property Owner or Authorized Agent Date Carrier�'tze„�z 62J PioP too� Expires ID ;,0Z policy# �NT,)-vG—bp57Sg4- g4kl ❑ By my Signature below, I certify to each of the following: I am the property Name of Agent Phone# 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 stale laws relating to building construction.I authorize representatives of this city or county to enter the above- 0 1 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 I workers'compensation laws of California, and agree that if I should become L subject to the workers'compensation provisions of Section 3700 of the Labor Property Owne on Agen Date 1 Code,I shall forthwith comply with those provisions. City Business License Date; I13/0,iot3 N Applicant;a.. WARNING: FAILURE TO SECU RK IHAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UNLAWFU , AN 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, DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES 9,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 ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION - ,,,---/// FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address y�NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR GUIDE LINES OWNER BUILDER DECLARATIONS 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 DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(Section 7031.5. Business and Professions Code: ,,,------///,,,��I BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter, improve, demolish, y�f•O SCHOOL7 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 I HAVE READ THE HAZARDOUS MATERIAL provisions of the Contractor's State License Law (Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or DYES 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 fh NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) T CODE, SECTION 25505 25533 AND 25534 CONCERNING ❑ 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL I EPOR�ING. compensation, will do( )all of or( ) porting of the work, and the structure is PR TY O ER OR AU ORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY OF MENIF E PLCKNo: P �r�I4- 13 29714 Haun Road Date: Dat Menifee, CA 92586 Phone: (951)672-6777 Dun mod a Fax:(951)679-3843 UK-#. k#: Building Combination Permit To Be Completed ByAppllcant Legal Description: Planning ase: t Property Address: Assessor's Pamel Number. c�Se97 C C' 334E-Tld -onS - O ProJec anent ame: Unit#: Floor Lo T S Name: Phone No. Fax N. Property — S Owner Address: Unk Number Zip Code '�I 1 CA �/ 1=oe. 14vt'. 2e N ore ram �3o2tol Email Address: Name: Phone No. Fax No. a 71 3'J(oQ B' 7/�-n3'J Applicant Address: Unit Number Zip Code U,>zS rc.� - l- C 9d&7 L) Email dense: J " Name: Phone No, Fax No. 't -ilti- 3-S / — — Contractor Address: City State Code H ST. P CA_ Contractors y us nest cones o. Cnntrectnr's City State or Califnmle License No. Classification: Number or Squares: Square Footage Description of Work: Cost of Work:$ _ NS pp cam's Signature 'a' 44J —Z- — Data: Competed y ty Stall Only I care As R-Received nr N/A Not Applicable 5 Cornplafeg gels of fully dimensioned,drown to sale pia wnio nclude: 1 set of documents which ineludo ❑ Title Shoot ❑ Elevations ❑ Electrical Plan ❑ Gee Tech/Bolls Report(on cd only) ❑ Plot/SAO Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8%x 11) ❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Structural Calculatlons ❑ Single Line diagram for also,services over 400 AMP ❑ Floor Plan ❑ Structural Framirtg Plan 6 Details ❑ Shoring Plan ❑ Sound Report-Residential Class Code: Work T New Construction Alteration' Addition` Meena/Methods Wei to Rif- RelrofiP Revidon to Wfing Permits Required? YES NO Proposed Building Weis): Existing Building Use(s): #Buildings; #Units: #Stories: Will the Building Have a Basement? Y of N Bldg,Code Occupancy Group Indicate Indicate x Indicate all Oeo-tech-Haz.Zone At Project Sprtnklared YES or NO Completion: Construction that apply: Coastal Zone TYpo(t C of<o YES or NO Noise Zone Required? Lisled on Historic Resources Inventory CITY PLANNING STAFF ONLY APPROVALS: Costal Commits lArch.Review Board Landmark Comm. I IPlanning Comm.Zoning Administrator Psis Exampf: City Project I JElec.Vehicle Charger Landmark Seismic Retrofit I pec"I see:Bldg. orsriala oval Expedite project(s): Child Care Cky Prdjed Green SuBdingI Landmark Affordable Housing For Staff Use Only Baildm /SaleT ermtt Specialist My PlanningCivil Engineering I E -Admin Transportation mgmi, 11Rent Conbal THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY 7 }aLE)----✓ II 21 lit pr Ila ir mil.'► 40 OK • _ III � �'/�� ��,�� F�3' \\ " I,�!�► I .