PMT16-02289 City of Menifee Permit No.: PMT16-02289
29714 HAUN RD. Type: Commercial Electrical
�CCEL/? MENIFEE, CA 92586
MENIFEE Date Issued: 0 7/2 212 01 6
PERMIT
Site Address: 29782 MCCALL BLVD, MENIFEE, CA Parcel Number:
92585 Construction Cost: $600.00
Existing Use: Proposed Use:
Description of INSTALL ONE 200AMP U/G TEMP POWER POLE TO POWER OFFSITE CONSTRUCTION TRAILER,
Work: TRAILER BEING RELOCATED
Owner Contractor
CAL ATLANTIC GROUP S R BRAY LLC
15360 BARRANCA PKWY 1210 N RED GUM STREET
IRVINE, CA 92618 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 01t Amount t$1
Services, Switchboards, Control Centers&Panels 1 183.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 148 148.37
GREEN FEE 1 1.00
General Plan Maintenance Fee-Electrical 1 9.15
$368.52
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_BIdg Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contractors State License taw).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class� CYo I a2. .License No. By my signature below l acknowledge that,except for my personal residence
Expires„1—1 11 Signature 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 I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
o 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 www.leeinfo.ca.eov/calaw.html.
this permit is issued.
Date
Policy#
PROPERTY OWNER OR AUTHORIZED AGENT
M have and will maintain workers compensation insurance,as required by
section 3700 of the tabor Code,for the performance of the work for which o By 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 orauthorized 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
XL 5� 1 r� r� with all applicable city and county ordinances and state laws relating to
�', 7 building construction.I authorize representatives of this city or county to
Policy#� W 6 '7zyb�'in7o 1 Expires� l _3 ? enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
01 certify that in the performance of the work for which this permit is issued,
I shall not employ 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 compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or
e7 ZL_(f mixture containing a hazardous material equal to or greater that the
Applicant / i Date l7 amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO� RE WORKER'S COMPENSATION COVERAGE IS o Yes ❑No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYERTO 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 forguldelines
CONSTRUCr10N LENDING AGENCY OYes 0No
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) ❑Yes 0 No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I understand my requirements under the State of
California Health&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 Items)(Section 7031.5 OYes D No
Business and Professions Code).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 700D)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 for 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.eoa.epv/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 o 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. o No EPA Lead-Safe Certified Firm is required for this project because:
01,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.
BUILDING ♦ SAFETY PERMIT/PLAN APPLICATION
.."Menifee
DATE PERMIT/PLAN CHECK NUMBER '
TYPE: O COMMERCIAL 0 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME POOL/SPA O SIGN
SUBTYPE: O ADDITION OALTERATION O DEMOLITION C; ELECTRICAL O MECHANICAL
O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 1m,5-rA C.. 6w- Zao^ q/G,
?O PL4" 1r56 79+46 , 61 GE1f t3EIN(,T [AWE1) T aN Afc�
PROJECTADDRESS Z G /s lzq
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME 64Z �zroj ,7C0 1-eazl
ADDRESS /S.316 //evm,6 G4
PHONE '71 / -gel "/j�00 EMAIL
APPLICANT NAME
ADDRESS
PHONE 133n3 EMAIL
CONTRACTOR'S NAME S je. 6194Y LC-G o&% o4J1�4 LGIS OWNER BUILDER? O YES -116
BUSINESS NAME
ADDRESS /Z/o N• �� �GCfi 6/tk4lf1 C-4 "SZ80(o
PHONE 21-7GS'? S EMAIL
CONTRACTOR'S STATE LIC NUMBER ���8"Q LICENSE CLASSIFICATION G/D
VALUATION$ 6;0. 00 S L SO FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE 121#V PAID AMOUNT
AMOUNT OCASH vCHECKN OCREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-5777
www.cityofinenifee.us Inspection Request Line 951-246-6213
i
,r
I
oil
' _ 11. �•
Vill
t � .
3 '.L111311
` f
ti Q , r7lZ
-Cl
'Ao►.�
� .. .f'�
■
1 , .
ENIFE
Y
Southern California Edison
Scott A. Mann
Mayor
RE: McCall Blvd—Dual Pedestals April 30, 2014
Wallace W. Edgerton City I.P. 09-012
Deputy Mayor
John V. Denver To Whom It May Concern:
Councilmember The assigned address for the dual meter pedestals on McCall Blvd./Heritage Lake Dr. are
as follows:
Thomas Fuhrman
Councilmember Stationing to be verified.
Greg August Station 53+54 29750 McCall Blvd.
Councilmember Station 53+55 29752 McCall Blvd.
The assigned address for the dual meter pedestals on McCall Blvd./Briggs Rd.are as
follows:
Stationing to be verified.
Station 65+45 29992 McCall Blvd.
Station 65+46 29994 McCall Blvd.
Craig Carlson
Senior Inspector
City of Menifee
951 -672-6777 ext. 1 1 9
29714 Haun Road
Menifee,CA 92586
Phone 951.672.6777
Fax 951.69.3843
nww.cityofm en ifee.us