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PMT16-03068 City of Menifee Permit No.: PMT16-03068 29714 HAUN RD. Type: Commercial Electrical 'CA—CCIELA> MENIFEE,CA 92586 MENIFEE Date Issued: 09/2312016 P E R M I T Site Address: 25777 ROUNDUP CIR, MENIFEE, CA Parcel Number: 358-511-018 92584 Construction Cost: $445.00 Existing Use: Proposed Use: Description of INSTALL 200A U/G METER TEMP POWER POLE Work: Owner Contractor RICHMOND AMERICAN TEMP POWER SYSTEMS 5171 CALIFORNIA AVE,#120 625 S FEE ANA STREET IRVINE,CA 92617 PLACENTIA, CA 92807 Applicant Phone:7142235607 WAYNE MCCOY License Number.,696713 TEMP POWER SYSTEMS 625 S FEE ANA STREET PLACENTIA, CA 92807 Fee Description QtV Amount 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 pennit 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.B1dg_Perrnft-Ternplate.rpt Page 1 of I 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 a I am exempt from licensure under the Contractor's State Ucense Law for Professions Code and my license is in full force and effect. the following reason: License Class /4y42r*Vfl> License No. I 0'3U'?I 2S By mysignature below I acknowledge that,except for my personal residence Expires )OV-11e Signature in which I must have resided for at least one year priorto completion of improvements covered by this permit.I cannot legallysell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder If It has not been constructed in Its entirety by a 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 workees 7W 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.Ieginfo.ca.gov/caIanv.html. this permit is Issued. Policy# Date '141 have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the La bor Code,for the performance of the work for which o By my signature below I certify to each of the following:I a m the property this permit is Issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's 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# 1�2)1:7%cl� �'—)'S' —Expires 0— —A 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 o I certify that in the performance of the work for which this permit is issued, I shall not employ any persons In any ma nner so as to become subject to the CITY BUSINESS LICENSE# 56Pft'tK__ workees compensation laws of Califomia,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's 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 a Applicant Date mixture containing a hazardous material equal to or greater that the amounts 7secified on the Hazardous Materials Information Guide? t WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS n Yes No UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the tended use of the building by the applicant or future building AN D CIVI L F1 N ES UP TO ONE H UNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO TH E COST OF COMPENSATION,DAMAGES AS PROVIDED FO Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guideR as CONSTRUCTION LENDING AGEN Dyes 7-N, 1 hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility he within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3CI97 Civil Code) ayes 0 OWNER BUILDER DECLARATIONS I have,�ad the Hazardous Material Information Guide and the SCAQUID permitting checklist.I understand my inequirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reasonis)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 0Yes 0 Business and Professions Code).Any city or county that requires a permit to Date 5-— to construct,alter,improve,demolish or repair any structure,priorto its PROPERTYVVVNE 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 Contraictoes State EPA RENOVATION,=RIR AN I1Z License Law(Chapter 9(commencing with Section 700D)of Division 3 of the The EPA Renovation,Re�air and&intirig(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs point in a pre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or cbildcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects th a applicant to a civil pena Ity 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 n 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 I I portion of the work,and the structure is www.epa.Rov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions I-BOD-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a ci 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 nut built or improved for the purpose of sale. cr No EPA Lead-Safe Certified Firm is required for this project because: a 1,as owner of the property a in exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractcies 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 RAP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE L PERMIT/PLAN CHECK NUMBER TYPE: VCOMMERCIAL 0 RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA OSIGN SUBTYPE: CADDITION 0ALTERATION ODEMOLMON IKELECTRICAL OMECHANICAL CNEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK MZ� Building & Safety Dept. PROJECTADDRESS ;�!7 z-;77-7 4ouAjouI� �Ep 15 20% ASSESSOR'S PARCEL NUMBER LOT _q9 TRACT OWNER NAME eicjkm, r) A",,V -5?L) ADDRESS ),)4-) PHONE 'IL19- Liu-1- ak2cro EMAIL APPLICANT NAME uv�r,67 "," ADDRESS U.1-n V�' A�A -c;T. _P�AcPmj-niQr c-14-. q;NF-7b PHONE EMAIL Av�go TIE:mf k�k-s-a_ CONTRACTOR'S NAME --rWMI? -96�,-v OWNERBUILDER? 0YESR'NO BUSINESS NAME ADDRESS U 14!s V%�w CA, SL&-] PHONE -114- a�a3 - Z56t>s. EMAIL WICiv eF "'L,04 CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION C-)0 VALUATION$ L-4LI7s;, SO,FT L SO FT APPLICANT'S SIGNATURE DATE Aiiiiiiiiiiiiiiiia DEPARTMENT D15TRIBUTION CITY OF MENIFEE BUSINESS LICENSE ER 0 __ BUILDING PLANNING ENGINEERING FIRE I GRE Iv— SMIP I X- g1B INVOICE 1(3g. PAIDAMOUNT AMOUNT 1 0 CASH 0 CHECK# —CREDITCARD VIS NIC PLAN CHECK FEES PAIDAMOUNT 1 7 0 CASH OCHECK# 0 CREDIT CARD VISAINIC :[ED 0 YES 0 No DLNUMBER NOTARIZED LETTER 0 YES C NO City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofnienifee,tts Inspection ReqUest Line 951-246-6213 MUNSON F4 nil in ,IA, nil WE&I 0 1\101 ,6- ��A-�V,—�,a w, L avill,