PMT16-03719 City of Menifee Permit No.: PMT16-03719
29714 HAUN RD. Type: Commercial Electrical
'5A—CCIEU� MENIFEE,CA 92586
MENIFEE Date Issued: 1112212016,
P E R M I T
SiteAddress: 26024 BOW CT, MENIFEE,CA 92584 Parcel Number:
Construction Cost: $2,000.00
Existing Use: Proposed Use:
Description of INSTALL ONE 200A U/G TEMP POWER POLE AND 100A SUBPANEL WITH 8 SPAN POLES FOR
Work: CONSTRUCTION TRAILER
Owner Contractor
KBHOME S R BRAY LLC
36310 INLAND VALLEY DRIVE 1210 N RED GUM STREET
MENIFEE, CA 92595 ANAHEIM, CA 92806
Applicant Phone:7145071881
MIKE MCGEE License Number: 980589
S R BRAY LLC POWERPLUS
1210 N RED GUM STREET
ANAHEIM. CA 92806
Fee Description Qtv Amount($)
Services,Switchboards, Control Centers&Panels 1 183.00
Receptacle, Switch, Outlet&Fixture 1 116.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 148 148.37
GREEN FEE 1 1.00
General Plan Maintenance Fee-Electrical 1 14.95
$490.32
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.
AkUdg_Permit—Ternplaterpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION 0 lam exempt from ficensure under the Contractors'State License Law for the
I hereby affirm under penalty or pedury that I am licensed under provisions of following reason:
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that,except for my personal residence in
Professions Code and my license is in full force and effect. which I must have resided for at least one year prior to completion of
C,
License Class License No. IWO 5T IT improvements covered by this permit. I cannot legally sell a structure that I have
Expire, 113111-7 Sign built as an owner-building If it has not been constructed in its entirely by licensed
contractors. I understand that a copy of the applicable law,Section 7044 of the
WORKER&COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is
0 1 hereby affirm under penalty of perjury one of the following declarations* submitted or at the following Web site:
I have and will maintain a certificate of consent of self-insum for workers; http,/Avww.leginfo.m.Qovlmlaw.htmI
compensation,issued by the Director of Indushial Relations as provided for by Date
Section 3700 of the Labor Code, for the performance of work for which this
permit is Issued. Property Owner crAuthodzed Agent
Policy# 0 By my Signature below, I certify to each of the 101113warig: I am the property
13� 1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comply
permit is issued.My workers'compensation insurance carder and policy number are: 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-
Carded(/— identified property for the inspection purposes.
Policy#CL167M.1 Expires 3/3 1 Property Owner orAuthorized Agent Date
(This section need not be completed If the permit Is for City Business License# 03 5��z
one-hundred doflari�_($l 00)or less)
HAZARDOUS MATERIAL DECLARATION
0 1 certify that in the performance of the work for which this permit is issuea.1
shall not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers'compensation laws of California,and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensatiDn provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide?
Code,I shall forthwith comply with those provisions. E]YES 151NO
Appfican,t,,�Date; Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS* Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND OYES 12'NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES E]YES ErNO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there Is a construction lending pennitting checklist.I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous material reporting.
OWNER BUILDER DECLARATIONS ETYES D
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date 11_IL�116
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable item(s)(Section 7031.5. Business and Professions Code:
Any city or county that requires a permit to construct, alter,improve,demolish, EPA RENOVATION,REPAIR AND PAINTING(RRP)
or repair any structure, prior to Its Issuance, also requires the applicant for the
permit to rile a signed statement that he or she is licensed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint in a pre-1 978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childmre facility to be RRP-certffied firms and comply with
she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees.For more information about EPAs Renovation Program visit:
www.epa.govilead or contact the National Lead Information Center at
0 1, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the work,and the structure is
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Low does not apply to an owner of a property D An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees'or personal effort, builds or Improves the property,
provided that the Improvements are not intended or offered for sale,If,however. CerUfled Firm Name:
the building or improvement is sold within one year of completion,the Owner-
Bullider will have the burden of proving that it was not built or improved for the Firm Certification No.:
purpose of sale).
0 1, as owner of the property an exclusively contracting with licensed 0 No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's License Law does not apply to anjowner of a property
who builds or improves ltiiiidon, and wh6:*cqrntrac%,fiot t0a prVects with a
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
., 1
""Men'fee
DATE //-It PERM IT/PLAN CHECK NUMBER a
C
TYPE: 0 COMMERCIAL (7-R'ESIDENTIAL 0 MULTI-FAMILY 0 MOBILE H OME 0 POOL/SPA 0 SIGN
SUBTYPE: OADDITION OALTERATION ODEMOLITION eti-EcTRICAL. OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK _ /A;�-,�L ApJE 44
/00,*'vo �'4(,Lf-/,Y e 10"e �Ofv rA��- 41Nf2Rw PD\<fj�
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER LOT TRACT 701-4/1—
OWNERNAME A6�5 1-1-1-C
ADDRESS 36JIL) IMIt/0,
PHONE 23-1 EMAIL
APPLICANT NAME
ADDRESS
PHONE �;F-/-Vi 3- 1.7 3 3 EMAIL /L
CONTRACTOR'S NAME OWNERBUILDER? OYESOWO
BUSINESSNAME .5,,e. aA�p
ADDRESS &6� F7-. .F Arj~lao C,� -�Z_fvf�
PHONE Zirl EMAIL
CONTRACTOR'S STATE LIC NUMBER le%r(N.7 LICENSE CLASSIFICATION C/o
VALUATION$ Z it 00 SO FT L SO FT
APPLICANT'S SIGNATURE DATE
......... .....
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN S
INVOICE I PAIDAMOUNT
AMOUNT I I OCASH 0CHECK# 0 CREDIT CARD VISIVMC
PLAN CHECK FEES I PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES () No DILNUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.citycfmenifee.us inspection Request Line 951-246-6213
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