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PMT16-03720 City of Menifee Permit No.: PMT16-03720 29714 HAUN RD. Type: Residential Electrical '17�CCEL^_' MENIFEE, CA 92586 MENIFEE Date Issued: 11122/2016 P E R M I T Site Address: 30339 BRISTOL GATE LN, MENIFEE, CA Parcel Number: 92584 Construction Cost: $2,000.00 Existing Use: Proposed Use: Description of INSTALL ONE 200A U/G TEMP POWER POLE AND 4 SUB-POLES TO POWER PRODUCTION Work: Owner Contractor LENNAR HOMES S R BRAY LLG 980 MONTECITO DRIVE,STE 300 1210 N RED GUM STREET MENIFEE, CA 92881 ANAHEIM,CA 92806 Applicant Phone:7145071881 MIKE MCGEE License Number: 980589 S R BRAY LLC DBA POWERPLUS 1210 N RED GUM STREET ANAHEIM, CA 92806 Fee Description DIV Amount Services,Switchboards, Control Centers&Panels 1 183.00 Receptacle, Switch. Outlet&Fixture 2 121.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 148 148-37 GREEN FEE 1 1.00 General Plan Maintenance Fee-Electrical 1 15.20 $495.57 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 B[dg_PerrntTemplate.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION 11 1 am exempt from ficensure under the Contractors'State License Law for the I hereby affirm under penalty or perjury that I am licensed under provisions of following reason: Chapter 9(commeneing 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 License Class tf I Z) —Uicense No. 47ro ST47 Improvements covered by this permit,I cannot legally sell a structure that I have Expires 13 1/17 Signs built as an owner-building if It has not been constructed in its entirety by licensed uTr !i contractors. I understand that a copy of the applicable law,Section 7044 of the WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is submilitted or at the following Web site: [I I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a cerlificate of consent of self-Insure for workers' httii:l/www.leginfo.m.ciov/calaw.htmi. compensation,Issued by the Director of Industrial 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 or Authorized Agent Poficy# El By my Signature below, I certify to each of the following: I am the property O� I 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 [he information I have provided is correcL I agree to comply permit is issued.My workers'compensation insurance carrier and policy number are: With all applicable city and county ordinances and state laws relating to building constmcrion.I authorize representatives of this cily or county to enter the above- Carrier&— identified property for the Inspection purposes. Policy#CLtn 7��,l Expires Property Owner or Authorized Agent Date (This section need DLD_t be completed If the permit is for City Business License# 03 5��z 5� one-hundred dollars($100)or less) HAZARDOUS MATERIAL DECLARATION 0 1 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 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'campensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide? Code.I shall forthwith comply with those provisions. DYES 151NO Applicam,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(SCAOMD)?See permitting checklist COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND OYES FINO 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 DYES 211NO 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 permitting 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. ,ETYES D!N�� OWNER BUILDER DECLARATIONS I hereby affirm under penalty of perjury that I am exempt from the Contractors Date 4-All(I 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 70311.5.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 file 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 childcare facility,to be RRP-certified finns 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 clivil penalty of not more than($500).) employees.For more information about EPA:s Renovation Program visit: www.epa.govfiead or contact the National Lead Information Center at 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 Cade; The Contractor's State License Law does not apply to an owner of a property 0 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, Certified Firm Name: the building or Improvement Is sold within one year of Completion,the Owner- Builder 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 foMls project because: contractors to construct the project(Section 7044, Business and Professions Code:The Contractors License Law does not apply to an.owner of a property who builds or imprOvPs'Kii�on, and whii�Zffntractsfiat t�J,pqjects with a BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ,Wenifee DATE PERMIT/PLAN CHECK NUMBER c)o TYPE: 0 COMMERCIAL 4:�ESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA 0 SIGN SUBTYPE: 0 ADDITION 0 ALTERATION 0 DEMOLITION -P-EfEECTRICAL 0 MECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES- DESCRIPTION OF WORK liurme,(_ olve- uAo-e 4elA -neve *�*eoa4iz 1w 1&r eg x "PA 7a W�W ( / A 7ME eAka PROJECTADDRESS ;�(T3.1 i*Sr3r-- 6;4� 14 ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME ADDRESS �Ifv hxt_Aj�,?v �)X. r-,,Z&1vA cA 3s&gl PHONI�5_1- 917-3J�10 EMAIL APPLICANTNAME _A,46 ADDRESS PHONE EMAIL /L1 IA�6 A g_A�A�J_Ur. 4oA-, CONTRACTOR'S NAME OWNER BUILDER? 0 YES CrI16` BUSINESS NAME (,&C- 111-,4404�e5_ ADDRESS Ifeb xAe� 5 Aflvthw�, (�.-f 2 r—ed& PHONE -2 S-S-/ EMAIL CONTRACTOFVS STATE LIC NUMBER LICENSE CLASSIFICATION L�/b VALUATION$ Z-1 Xt SQ FT L SQ FT APPLICANT'S SIGNATURE .01 FW ENIFEE BUSINESS LICENSE NUMBER DEPARTMENT DISTRIBUTION SMIP T� BUILDING PLANNING ENGINEERING FIRE GREEN INVOICE I PAIDAMOUNT AMOUNT I I I OCASH OCHECK# 0 CREDIT CARD VISA/Mc PLAN CHECK FEES I PAID AMOUNT I 1 0 CASH 0 CHECK# 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 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee.us Inspection Request Line 951-246-6213 m C-1 mr- NA z 10 14 z 20 ;PN tA ch -no m -74 CA Rr 2 C7 CD t( f! Ln oZ7zn