Loading...
PMT16-00953 City of Menifee Permit No.: PMT16-00953 29714 HAUN RD. Type: Commercial Electrical �f-�CCEL/? MENIFEE,CA 92586 MENIFEE Date Issued: 10/27/2016 PERMIT Site Address: 27925 MENIFEE RD, MENIFEE, CA 92585 Parcel Number: 333-162-014 Construction Cost: $35,000.00 Existing Use: Proposed Use: Description of REPLACE DEFECTIVE PARKING LOT LIGHTS,ADD NEW PARKING LOT LIGHTS Work: REVISION 6/16/16 APPROVED Owner Contractor MENIFEE LAKES CONGREGATION OF JEHOVAH'S RIVERSIDE ELECTRICAL SERVICE& WITNESSES CONSTRUCTION 26050 ALLENTOWN DRIVE PO BOX 7848 Applicant Phone:9517859531 DANIEL STRINGER License Number:583377 RIVERSIDE ELECTRICAL SERVICE&CONSTRUCTION PO BOX 7848 RIVERSIDE,CA 92513 Fee Description 0tv Amount ISI Pole or Platform Mounted Fixtures 11 233.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 148 148.37 Additional Plan Review Electrical 180 180.00 GREEN FEE 1 2.00 SMIP COMMERCIAL 1 10.00 New Construction Permit Fee 1 161.00 General Plan Maintenance Fee-Electrical 1 11.65 General Plan Maintenance Fee-New 1 8.05 Construction $781.07 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_Pemnit_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 o I am exempt from licensure underthe Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Class if 'Q Ifc se Flo. By my signature below 1 acknowledge that,except for my personal residence Expires 17. Signature -GL.s in which I must have resided for at least one year priorto completion of improvements covered by this permit.I cannot legally sell a structure that I 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 a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,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 this permit Is issued. www.Ieginfo.ca.eov/calaw.html. Policy# Date .ei have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which jp dy my signature below I certify to each of the following:I am the property this permit Is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: .�� application and the information I have provided Is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy#5 st, 10CM69c} Expires 7—1 R en the above entified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date Z. dollars($100)or less PROPERTY OW EROR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, I shall not emolov any persons in any manner so as to become 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 compe sation provisions of Section 3700 of the Labor Cade,I shall hwith comply lvith those provisions. WIII the applicant or future building occupant handle hazardous material or Applicant Date Z 4 mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SEC41M WORKER'S COMPENSATION COVERAGE IS a Yes wNo UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES WIII 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 SECf10N 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY a Yes PAO 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) D Yes pr(o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning hazardous ma tertgl reporting. chsiness and I have placed next to the applicable item(s)(Section 7e31.5 NNo Date Business and Professions Code).Any city or county that requires a permit to 1154 construct,alter,improve,demolish or repair any structure,prior to its pROPERTY O JER 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 IRRPI Ucense Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRPJ Rule requires contractors Business and Professions Code)or that he or she is exempt from licensure t disturbs paint in apre-1978 receiving compensation for most worktho and the basis for the alleged exemption.Any violation of Section 7031.5 by residence orchildcarefacilitytobeork that dfirms and comply with than Applicant fora permit subjects the applicant toacivil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their a 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code,The Contractors State License Law does not apply to an owner of a D An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. in No EPA Lead-Safe Certified Firm is required for this project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. }$ N�jj$ yx ,' r��+4F " F f DATE 0 3128/2 01 6 PERMIT/PLAN CHECK NUMBER Ida TYPE: ✓❑COMMERCIAL ❑RESIDENTIAL []MULTI-FAMILY ❑MOBILEHOME POOL/SPA []SIGN SUBTYPE: []ADDITION []ALTERATION []DEMOLITION [-]ELECTRICAL []MECHANICAL []NEW []PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Replace defective parking lot lights,add new parking lot lights City of Menifee Building & Safety D pt. PROJECTADDRESS 27925 Menifee road, Memifee Calif 92585 ASSESSOR'S PARCEL NUMBER 333-162-01it{ LOT 8 TRACT He PROPERTY OWNER'S NAME Menifee Lakes congregation of Jehovah's Witnesses ce i Ve aLLOW itentdM^ W ADDRESS cfo Robert Stivers 26+++-�Sun City Calif 92586 PHONE (951)897-5506 EMAIL APPLICANT NAME Robert Stivers ADDRESS 26111 KRtAnseft,Sun City,Calif 92586 PHONE (951)897-5506 EMAIL CONTRACTOR'S NAME Daniel G.Stringer OWNER BUILDER? ❑YES©NO BUSINESS NAME Riverside Electrical Service and Construction ADDRESS PO Box 7848 Riverside,Ca.92513 PHONE (951)785-9531 EMAIL riversideelectricel@msn.com CONTRACTOR'S STATE LIC NUMBER 583377 LICENSE CLASSIFICATION C-10 VALUATION$ $35,000.00 SQ LSQFT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT AMOUNT I I OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDERVERIFIED OYES O NO DLNUMBER NOTARIZEDLETTER 6 YES O NO City of idenifee Building&Safety Department 29714 Haun Rd. Menifee, C4 92586 951-672-6777 v',vvv.cityofinenifee.us Inspection Request line 951-246-6213