PMT14-03068 City of Menifee Permit No.: PMT14-03068
MENI EE, C 92 Type: Commercial Electrical
MENIFEE, CA92586
MENIFEE Date Issued: 1 112112 01 4
PERMIT
Site Address: 29578 CHELTON WAY, MENIFEE, CA Parcel Number: 364-190-010
92584 Construction Cost: $500.00
Existing Use: Proposed Use:
Description of INSTALL ONE 200 AMP U/G 120/240V TEMP POWER POLE FOR TRACT PRODUCTION
Work:
Owner Contractor
LENNAR HOMES S R BRAY LLC
380 MONTECITO DR#300 1210 N RED GUM STREET
CORONA, CA 92879 ANAHEIM, CA 92806
Applicant Phone: 7145071881
MIKE MCGEE License Number: 980589
S R BRAY LLC
1210 N RED GUM STREET
ANAHEIM, CA 92806
Fee Description Oft r Amount($)
T a1, a 8 0:
Services, Switchboards, Control Centers&Panels 1 183.00
IN
Additional Plan Review Building 148 148.37
Q+
$426.37
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_Permit_Templaterpl 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 IQ0 License No.No. CF805;?9 who builds or improves thereon, and who contracts for the projects with a
Expires I 1 JS SignatA�'"'"—' 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
❑ 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
-N" 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.leainfo.ca.ciQvlcalaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier XL ac-lY /v"Jli rF �• Property Owner or uthodze gent Date
f�fC!Expires 3/I I y/� Policy# U.�r-7�'0
&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 state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
El 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
workers' compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor Property Owner or Authorized Agent Date
Code,I shall forthwith comply with those provisions.
// ��.��' City Business License#
Date; //'2-��7 Applic
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, 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 ONO 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
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: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, Improve, demolish, D 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 (Chapter9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
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 ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE SECTION
E 3 ION 25505RIALff 5533 AND 25534 CONCERNING
HAZAKDO❑ I, as owner of the property, or my employees with wages as their sole
compensation,will do( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
-ra.?
Y r'% Building & Safety Dept.
Menifee
MR I
DATE �� I�7 —/�/ PERMIT/PLAN CHECK NUMBER
TYPE: COMMERCIAL -eRESIDENTIAL O MULTI-FAMILY :> MOBILE HcWr ` : 'POOL/Sq C>SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION 4-1ELECTRICAL MECHANICAL
O NEW O PLUMBING ORE-ROOF
APPLICATION NAME
DESCRIPTION OF WORK /NSTALL 6Nf twja /20Z ',Fv , LJt,�c f6e
D4 6 - or/ON DP I/4,�-T/6/I/Y
PROJECT ADDRESS
ASSESSOR'S PARCEL NUMBER 3� L�./g 6 • O/ (.) LOT 3 -7 TRACT -// 30/ZZ -
OWNER NAME L%+uNAK /,/11-0—S
ADDRESS 396 /f"A17-4e /TD 62. S'�,qE$DD Cy2o/U//- c4 YZe77
PHONE q-5-1- P7--3Sb0 EMAIL
APPLICANT NAME /tr/A!� 1*46i115`E
ADDRESS
PHONE '?51- Z5.3—/373 EMAIL
CONTRACTOR'S NAME 59 6M LLG DaA OWNER BUILDER? 0 YES <t-NO
BUSINESS NAME
ADDRESS Z/D ,fib 6;OA 141U,41161A c4 'i28J(�
PHONE 7/d/- 76S- 1 EMAIL
CONTRACTOR'S STATE LLIIC NUMBER �Cp osfl LICENSE CLASSIFICATION C/Q
VALUATION $ .ADO- Qb SO FT L SO FT 4
APPLICANT'S SIGNATURE DATE
jjffLF
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE SMIP GREEN
INVOICE PAID AMOUNT
AMOUNT *%CASH 0CHECK# !.%CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH •DCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES C% NO LICENSE NUMBER g T IZE <<: NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-677-077
www.cityofinenifee.us Inspection Request Line 951-246-6213
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2 REVIEWED
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DATE
'Approval of these plans shall not be construed to be a permit for,0r aq
approval of,any violation of any provisions of the federal,state or "'
regulations and ordinances. This set of approved plans must be kept o
jobsite until completion.