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PMT16-04264 City of Menifee Permit No,! PMT16-04264 29714 HAUN RD. Type: Commercial Electrical <A—CCELA—> MENIFEE, CA 92586 MENIFEE Date Issued: 12/29/2016 P E R M I T Site Address: 26394 DESERT ROSE LN,MENIFEE, CA Parcel Number: 92586 Construction Cost: $500.00 Existing Use: Proposed Use: Description of INSTALL ONE 200A U/G TEMP POWER POLE FOR PRODUCTION Work: Owner Contractor DR HORTON S R BRAY U-C 2280 WARDLOW CIRCLE,#100 1210 N RED GUM STREET CORONA, CA 92879 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 ON 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 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 otherMse 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_Permft—Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION 0 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 mason: 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 License Class License No. '70 improvements covered by this permit.I cannot legally sell a structure that I have Expires 113711--? Signa built as an owner-building if it has not been constructed in its entirety 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 requestwhen this application is submitted or at the following Web site: 0 1 hereby affirm under penalty of perjury one of the following declarations: hftP*/Awww.Ieqmf6. qcv/caIaw.html. I have and will maintain a certificate of consent of self-insure for workers. Ca compensation,issued by the Director of Industrial Relations as provided for by Date Section 370D of the Labor Code, for the performance of work for which this permit is issued. Property Owner orAuthodzed Agent Policy# 0 By my Signature below, I cerilly to each of the following: I am the property 121� 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 the Information I have provided is correct. I agree to comply permit is issued.My workers'compensafion 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- Carrier)(/— identified property for the inspection purposes. Policy#C ? If_Expires Property Owner orAuthorized Agent Date (This section need not be completed if the permit is for City Business License# 03 S4,2 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,1 shall not eMPIDy 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 mbdume containing a hazardous material equal to or greater that the subject to the workers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide? Code,I shall forthwith comply with those provisions. D YES 11-NO Appfican,t,_�Data; Will the intended use of the building by the applicant or future building :t_ 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 DYES PRO 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 ErNO CONSTRUCTION LENDING AGENC 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. OWNER BUILDER DECLARATIONS �I!TYES D I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date- Ulcense Law for the mason(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 IRRP) 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.E.PA 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 reeldence or childcare facility to be RRP-certffied fins 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-disturbinil work themselves or through their a civil penalty of not more than($500).) employees.For more information about EPA's Renovation Program visit: www.epa.govAead 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 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 Firim 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 Cerfirication 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 an.owner of a property who builds or improves lKiikiri, and whd6lintractsfict qJ,pr1jects with a Q#4.ej—,kM—A If M�Iwurfh]PPA PPP d. fil—1,th.PPP DATE PERMIT/PLAN CHECK NUMBEROMS oq2A TYPE: O'COMMERCIAL ORESIDENTIAL CMULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION C)ALTERATION C)DEMOLITION 0-'ELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK IN 5-r.4t-L ONC ZODA" (4 le, -r&*wr ssai,� Ag— ira &wc-mu PROJECTADDRESS ASSESSOFVS PARCEL NUMBER LOT 7'f' TRACT40 3 o 50-? OWNER NAME 'M APPIN, 0ity of anifee, ADDRESS Z?,i?b I-AKbLAj cf-.1 s7jr-W100 1; CV-NA , CA I Z9 13uilding Dept PHONE 15-1 - Z2 2-9,0� EMAIL DEC 2 0 APPLICANT NAME A? ADDRESS ived PHONE IV- Z13 -133 3 EMAIL CONTRACTOR'S NAME OWNERBUILDER? CYES &<O BUSINESS NAME ADDRESS &b rr4&A% -s7-- , Ae�A&6115, a4 '1?0& PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ 3700 SOFT LSQFF APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF M ENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP � INVOICE PAIDAMOLINT OCASH OCHEC AMOUN I I K# OCREDITCARD VISAIMC PLAN CHECK FEES PAIDAMOUNT I I OCASH OCHECK# OCREDITCARD �ISA/MC OWNER BUILDER VERIFIED OYES 0 NO CILNUMBER NOTARIZED LE17ER 0 YES 0 NO City of Meaifee Buhld,-"�7g 8Z Sofety Deper Mient-29714Hc--nRd. itl/eru,�ee�. CA92586551-�72-6777 insliection Request L&,,e 951-246-52-13 -3 C-4 0 cr -A C7 w'- r1j w 0 0 0% 0 Um tw4 7 20 5. F—n H = rn giioz 0 ZAG t 0 Idaa BUMP 9L 904!ualm 10 A110 rri q Z7, — 7-7, g 5r CO) rn CD z rn ws *A<