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PMT16-00153 City of Menifee Permit No.: PMT16-00153 29714 HAUN RD. Type: Commercial Addition <ACCEL/A� MENIFEE,CA 92586 MENIFEE Datelssued: 02/17/2016 PERMIT Site Address: 29150 HOLLAND RD, MENIFEE, CA Parcel Number: 364-200-016 92584 Construction Cost: $137,500.00 Existing Use: Proposed Use: Description of PARK PLAYGROUND EQUIPMENT Work: LOT 375 TR30422-2 Owner Contractor LENNAR HOMES OF CALIFORNIA LENNAR HOMES OF CALIFORNIA INC 980 MONTECITO DR 25 ENTERPRISE CORONA, CA 92879 ALISO VIEJO, CA 92656 Applicant Phone:9493498269 LENNAR HOMES OF CALIFORNIA INC License Number: 728102 25 ENTERPRISE ALISO VIEJO,CA 92656 Fee Description CQ,yt Amount(SI Building Permit Issuance 1 27.00 Inspections not specified 516 516.28 Additional Plan Review Building 148 148.37 GREEN FEE 1 6.00 SMIP COMMERCIAL 1 39.00 New Construction Permit Fee 1 632.50 General Plan Maintenance Fee-Building 1 25.81 General Plan Maintenance Fee-New 1 31.63 Construction $1,426.59 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_Perma 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 perjury that 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 ❑I am exempt from 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 License No. /x'J Z By my signature below I acknowledge that,except for my personal residence Expires �! / Signature / "� ✓//lam 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 1 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 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 Cade,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 for which w,ww.leeinfo.m.eov/calaw.html. this permit is issued. Policy# Date O I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT 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:1 am the property this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owners behalf.1 have read this number are: application and the information I have provided is correct.I agree to comply r with all applicable city and county ordinances and state laws relating to Carrier •, building construction.I authorize representatives of this city or county to Policy# /f�G, /y0 Expires / enter the above identified property for inspection purposes. (This section need not to be completed is the per 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, shall not employ any persons in any manner so as to became subject to the CITY BUSINESS LICENSE# 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 fo tv�ith comply wi hose provisions. Will the applicant or future building occupant handle hazardous material or a Applicant 1j( Date mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide. WARNING I URE S R AW KER'SCOMPENSATIO CO ERAGEIS OYes ❑No UNLAWFUL,ANDS U.SUB)ECTAN 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 forguidelines CONSTRUCTION LENDING AGENCY oyes ❑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) o Yes o No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the 5CAQMD I affirm under penalty of perjury that I am exempt from the permitting checklist I understand my requirements under the State of hereby California Health al 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 O No Business and Professions Cade).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,prior to 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(RRP) 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 far 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 01,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.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(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: D 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 70",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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Uf Menifee DATE PERMIT/PLAN CHECK NUMBER PMT16-00153 TYPE: X COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: X ADDITION O ALTERATION O DEMOLITION (" ELECTRICAL O MECHANICAL O NEW O PLUMBING ORE-ROOF APPLICATION NAME Menifee Lakes Community Park PA-18 PLAYGROUND DESCRIPTION OF WORK Construction of Playground at Holland Park PROJECTADDRESS 29150 Holland Rd, Menifee,CA 92584 ASSESSOR'S PARCEL NUMBER 364-200-016 LOT 375 TRACT 30422-2 OWNER NAME Lennar Homes of California, Inc. ADDRESS 980 Montecito Dr.,Suite 302,Corona,CA 92879 PHONE 951-817-3680 EMAIL Jeremiah.acayturri@lennar.com APPLICANT NAME Lennar Homes of California, Inc. ADDRESS 980 Montecito Dr.,Suite 302,Corona,CA 92879 PHONE 951-817-3680 EMAIL Jeremiah.acavturri@lennar.com CONTRACTOR'S NAME Lennar Homes of California, Inc. OWNER BUILDER? X YES ONO BUSINESS NAME Lennar Homes of California, Inc. ADDRESS 980 Montecito Dr.,Suite 302, Corona,CA 92879 PHONE (951)817-3680 EMAIL Jeremiah.acavturri0ennar.com CONTRACTOR'S STATE^LIIC NUMBER 728102 LICENSE CLASSIFICATION A&B VALUATION$ j 3 / SO SO FT L SQ FT APPLICANT'S SIGNATURE DATE ) �6 GITYSTAFFUSEONLY •: _ _ DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I SMIP GREEN INVOICE PAID AMOUNT AMOUNT Or-ASH OCHECK# OCREDrr CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKM OCREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES O NO LICENSE NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213