PMT15-00261 i
City of Menifee Permit No.: PMTIS-00261
29714 HAUN RD.
4q C-E A—> MENIFEE, CA 92586 Type: Commercial Electrical
MENIFEE Date Issued: 0 2/2 612 01 6
i
PERMIT
Site Address: 25125 DERBY HILL DR, MENIFEE, CA Parcel Number:
92584 Construction Cost: $0.00
Existing Use: Proposed Use:
Description of IRRIGATION METER PEDESTAL
Work:
Owner Contractor
SUTTER MITLAND 01 LLC BROOKFIELD LOS ANGELES BUILDERS INC
3090 BRISTOL ST 12265 EL CAMINO REAL STE 180
COSTA MESA, CA 92626 SAN DIEGO, CA 92130
Applicant Phone: 7144276868
ANN HO License Number: 960237
BROOKFIELD LOS ANGELES BUILDERS INC
12265 EL CAMINO REAL STE 180
SAN DIEGO, CA 92130
Fee Description O_yt Amount lSl
kSe wces Switchboards'vControl Centers&Panelsr y 1 " - 1830_0
Pole or Platform Mounted Fixtures rw.. 1 183.00
IU lding Permit iSSUahCBi_ zyF ,. ..3 x,,y .,��. y i3i ,l 27_00�_
Additional Plan Review Building 148 148.37
•�GREEN FEEw mod.,_�...�:�.�....v..,t.�_.- ..f._.,e..r_..... .... ..... .. � ,__� ;'�..,�....�.�;.s 0 OOn
$541.37
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_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 License No. who builds or improves thereon, and who contracts for the projects with a
Expires 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
❑ 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
❑ 1 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:http'//www.IeoInfo.ca.gov/caIaw.htmI.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier Property Owner or Authorized Agent Date
Expires Policy#
❑ 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-
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 employ 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; Applicant;
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 HANDLEA HAZARDOUS MATERIAL ORA
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 forthe 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 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($500).) CODE, SECTION 25505 25533,AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL DEPORTING.
compensation, will do ( ) all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENdFFF,
of Menifee PLCK No: ol
P 't
29714 Haun Road din & Safety Dept. ��
Building Y Date: Date:
Menifee, CA 92586
Phone: (951)672-6777 FEB 0 9 2015 Amount: Amount.
Fax:(951)679-3843 Ck#: Ck#:
�CCeIVed
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R
Property Address: Assessor's e: Parcel Number.
Drive., Menifee CA 92584
Project/Tenant Nam Unit#: Floor#:
Name: Sutter Mitland 01 LLC Phone No. 714-200-1608 Fax No.
Property Address: Unit Number Zip Code
Owner 3090 Bristol Street, Costa Mesa Suite 200 p 92626
Email Address:
Name: Phone No. Fax-No.
Ann Ho 949-422-4812 949-565-1239
Address:
Applicant Unit Number Zip Code
3 Hughes, Irvine 92618
Email Address aho@hunsaker.com
Name: l,�
Brookfield Los Angeles Builders, Inc. P 0200-1608 Fax No.
Contractor Address: City octa State Zip Code
3090 Bristol Street Suite 200 CA
Contractor's City Business tense o. Contractor's City State of California License No Classification:
Number of Squares:
Square Footage
Description of Work: Irrigation Meter Pedestal Cost of Work:$
Applicant's Signature Date:
To Be Completed By City Staff Only
Indicate As R-Received or N/A-Not Applicable
5 Completes sets of fully dimensioned,drawn to sale plans which include: 1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on ed only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 Y:x 11)
❑ Structural Calculations
Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑
❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan 1 ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' Means/Methods
Work Type: Repair' Retrofit` Revision to Fucisbng Permit' Required? YES NO
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units: #Stories: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate Indicate if YES or NO Indicate all Geo-tech.Haz.Zone
At Project Construction Sprinklered that apply: Coastal Zone
Completion: Type(s): C of o Noise Zone
Required? YES or NO
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 Retrofit sPacial case:Bldg
OfficialAppma
Expedite Project(s): Child Care City Project Green Building I Landmark Affordable Housing
For Staff Use Only
BuildinglSalety I Permit Specialist I Uly planning I Civil Engineering LPWM-Admin ITranspodation Mgmt. Rent Control
(f\C\wo\1873\126 D17-ah.pdf) THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
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Scott A. Mann
Mayor
Wallace W. Edgerton Re: TR31393 IRRIGATION PEDESTAL Date: November 20, 2014
Deputy Mayor
John V. Denver
Councilmember
Thomas Fuhrman
Councilmember To Whom It May Concern,
The following addresses have been assigned:
Greg August
Councilmember
Landscape Meter (50 +96): 25152 Derby Hill Dr
Craig Carlson
Senior Inspector
City of Menifee
951 -672-6777 ext. 119
29714 Haun Road
Menifee,CA 92586
Phone 951.672.6777 PAYMENT REQUIRED PRIOR TO PERMIT ISSUANCE
Fax 951.69.3843
vww.cityofinenifee.us