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PMT17-01093 City of Menifee Permit No.: PMT17-01093 29714 HAUN RD. Type: Commercial Electrical <CCEL/ MENIFEE, CA 92586 MENIFEE Date Issued: 0 412 412 01 7 PERMIT Site Address: 31489 EVANS RD, MENIFEE, CA 92585 Parcel Number: Construction Cost: $2,000.00 Existing Use: Proposed Use: Description of INSTALL ONE 200A U/G TEMP POWER POLE WITH 8 SPAN POLES Work: FOR FUTURE ONSITE CONSTRUCTION FOR CYPRESS TR 30142 Owner Contractor KB HOMES S R BRAY LLC 36310 INLAND VALLEY DRIVE 1210 N RED GUM STREET WILDOMAR,CA 92595 ANAHEIM,CA 92806 Applicant Phone:7145071881 JANE RECKTENWALD License Number:980589 S R BRAY LLC DBA POWERPLUS 1210 N RED GUM STREET ANAHEIM, CA 92806 Fee Description Qtv Amount f$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_Bldg_Permit_Template.rpt Page 1 of 1 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 ❑I am exempt from licensure under the Contractor's State License Law for Professions Cade and my license is in full force and effect. the following reason: License Class 00 CG License Nol rko,5 1 � By my signature below I acknowledge that,except for my personal residence Expires 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 ❑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 worker's 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 yyww leeinfo.ca.eov/calaw.html. this permit is issued. Policy# Date PROPERTY OWNER OR AUTHORIZED AGENT ❑I have and will maintain worker's compensation insurance,as required by section 3700 of the Labor Code,forthe performance of the work for which. ❑By my signature below I certify to each of the fallowing:I am the property this permit is issued.My worker's compensation insurance carrier and polity 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 X J— SY7..Q.LtG..\ with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# CV3�'�1 Lklf'1 7-l61 Expires 7�,-7J\-66, enter the above identifie perty for inspection purposes. (This section need notto be completed is the permit is for one-hundred Date ' n _ dollars($100)or less PROPERTY OWNER O ORIZED AGENT ❑I certify that in the performance of the workfor which this permit is issued, .�'S�� I shall not employ any persons in any manner so as to become subjectto the CITY BUSINESS LICENSE# worker's compensation laws of California,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 comp ith those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant mixture containing a hazardous material equal to or greater thatthe amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO RE WORKER'S COMPENSATION COVERAGE IS ❑Yes 44� UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO 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 for guidelines CONSTRUCTION LENDING AGENCY ❑Yes— 0 1 hereby affirm that under the penalty of perjury there is a construction Will the 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 Cade) ❑Yes ' No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements underthe State of I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the reason(s)indicated below by the hazaCalifornia Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable items)(Section 7031.5 Dyes eu�s.,material repo Business and Professions Code).Any city or county that requires a permit to oyes 'b-fdo Date I construct,issuance, alsoalter,improve, applicantsh for pair any mistructure,a prior signed to PROPERTY OWNER O A THORIZED AGENT ts issuance,also requires the applicant far the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRP) License Law(Chapter 9(commencing with Section 7000)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 ❑I,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.epa.eov/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 Contractor's State License Law does not apply to an owner of a ❑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. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Cade:The Contractor's 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. 1' ..L:�. � . aT &'-t +Ety�11CRa � ; 'i'}>rr may zn >_ . _, •� DATE 4_13_17_-__ PERMIT/PLAN CHECK NUMBER TYPE: CO(v1MERCIAI . RESIDENTIAL MULTI-FAMILY MOBILE HOME ?OO.jS?a SIGN SUBTYPE: ADDITION ALTERATION DEMOLITION ELECTRICAL MECHANICAL ' NEW PLUMBING _RE-ROOF-NUIMBER OF SQUARES I DESCRIPTION OF WORK _Install one (1_)_200 amp U/G temp ower pole to power _____.future onsite construction for tract # 30142 1 PROJECT ADDRESS 0 _--�3 fW -f I i 1'�� I _-City_nf.Menifee_ 1 ASSESSOR'S PARCEL NUMBER LOT B7APR ng& Safety Dept. TRACT OWNER NAME �J-•IQr11eS __ 3 Z�� I ADDRESS 36310 Inland Valley Dr Wildomar CA 92595 — ' — ---� PHONE .�5,-69,-5182 EMAIL _ II APPLICANTNAME —JAme Recktenwald _. 1 ADDRESS — PHONE 714-336-6159 EN.,,L j CONTRACTOR'S NAME _Rawer Plus OWNER BUILDER? YES N0� BUSINESS NAME ADDRESS ._27,9QN_P_erris Blvd Perris. CA 92571 _ PHONE 951-293-1333 EMAIL CONTRACTOR'S STATE U/�C NUMBER 980589_-.. LICENSEE CLASSIFICATION g % & D 3 1 VALUATIONS `Z QOv.00 --- $� FT ---._ !SOFT APPLICANT'S SIGNATUREDATE 4-13-17 C + JF`.1E'�1 a 3U5'NES5 L CENSE NUNIS-R 4Ul.pIPiG � 1 =_ ='-= Gc - SM IP i INVO.CE --- - --- _j ANi0UN7 ,I iPAIDAMOU�; _ —. cREDITCARD v!sAlmC PLAN CHECK FEES DA:D AMOUNT - 1 CREDITCFRD VISAImC j DINNER BUILDER VERINED EVES NO DL NUIb1BER FIOTAR!ZED LEiiER YES NO Mice Copy City of Menifee Building & Safety Dept. APR 13 2017 RkiaivGi o z 2 I ® rLI , w N N m r1y m x x E N y- 1 •� � y TT' //1 ✓ d'r b R / l A