PMT17-01466 City of Menifee Permit No.: PMT17-01466
29714 HAUN RD.
ZIl MENIFEE, CA 92586 Type: Commercial Alteration
MENIFEE MENIFEE Date Issued: 06/07/2018
PERMIT
Site Address: 28818 LINDENBERGER RD, MENIFEE, Parcel Number: 340-442-015
CA 92584 construction Cost: $24,999.81
Existing Use: Proposed Use:
Description of INSTALL STAND-BY DIESEL GENERATOR 15kW
Work:
Owner Contractor
SPECTRASITE COMMUNICATIONS VALLEY ELECTRIC T B INC
10 PRESIDENTIAL WAY 18487 GRAND AVENUE
WOBURN, MA 01801 LAKE ELSINORE, CA 92530
Applicant Phone:9516782195
, CA • License Number:516778
Phone: 9497169990
Fee Description gtv Amount(81
Power Apparatus 1 150.00
Administrative Fee 148 148.20
Building Permit Issuance 1 27.00
Additional Plan Review Building 165 165.00
Additional Plan Review Building 159 159.00
GREEN FEE 1 1.00
SMIP COMMERCIAL 1 7.00
New Construction Permit Fee 1 115.00
General Plan Maintenance Fee-New 1 5.75
Construction
$777.96
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_Pemnit_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 70D0)of Division 3 of the Business and ❑I am exempt from icensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the fallowing reason:
License Class -,;F> �U ensew No. S16 77 S By my signature below I acknowledge that,except for my personal residence
Expires (7 /fl 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
ereby 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 Cade,for the performance of work for which
this permit is issued. www.leginfo-ca.gov/calawhtml.
PolliisyJL�f77�/t� Date
�ave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act an 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 /'h Y
T7 �' 5 with all applicable city and county ordinances and state laws relating to
CV �•+� building construction.I authorize representatives of this city or county to
Policy 4 WiCN 1 3 9(� j -�J Expires 3,h /,1 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
❑I certify that in the performance of the work for which this permit is issued,
I shall not emolov any ns in any manner so as to become subject to the CITY BUSINESS LICENSE 4
workers campens on I ws9J��Califomia,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to thew >/rr �ensation provisions of Section 3700 of the Labor
Code,I shall fo hply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date is mixture containing a hazardous material equal to or greater that the
amounts sp ied on the Hazardous Materials Information Guide.
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes A No
UNLAWFUL,AND SHALLSUBIECT 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,DAMAGESAS PROVIDED FOR -Coast Air Quality Management District(SCAQMD)?See permitting checklist-
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelin
CONSTRUCTION LENDING AGENCY ❑Yes
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit Is issued outer boun of a school?
(Section 3097 Civil Code) a ENO
OWNER BUILDER DECLARATIONS I have read the Hazardous Material I armation Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist I e Stan y requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health& fety Od ection 25505 and 25534 concerning
hazardous ry�ter Irep i
checkmark(s)I have placed nett to the applicable item(s)(Section 7031.5 oyes n-No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,Improve,demolish or repair any structure,prior to its PROPERTY( OR AUTHORIZED AGENT
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 Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRPI
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 Iicensure 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 he 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($SOO). managers who do the paint-disturbing work themselves or through their
O 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.eoa.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 70",Business and Professions 1-BOG-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a o 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:
D 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors 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.
SAFETYBUILDING & PERMIT/PLAN CHECK APPLICATION
5
Meniiee
DATE PERMIT/PLAN CHECK NUMBER vMn. *(0
TYPE: COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME POOL/SPA []SIGN
SUBTYPE: ❑ADDITION ALTERATION ❑DEMOLITION [:]ELECTRICAL []MECHANICAL
❑P UMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 1 SQL, S'[YcNp (5 ' E l�vyz-
U PoN CNNC PcD
PROJECTADDRESS ZS8Ie� L/ND l3- ��GO'L- 2f�•
ASSESSOR'S PARCEL NUMBER 31H O— 4LI Z— 01-5 LOT TRACT
PROPERTY OWNER'S NAME SPFG'f�r� Sl"fL' •IUM�N\ -M1t:NS
ADDRESS 1C3) W oi3u1-_/\1 MA- G I CqOi ,
PHONE L-700 9 2 6 -- �-7 EMAIL
_ 010
APPLICANT NAME 1)Ek-t- ?�n-1 W I �E3.- S q
ADDRESS 1 5-5vS _ .AND ems, I u I_J fN�- /P v�I N �4 /26/S
PHONE (�'f R 7- 86-- -700U EMAIL AgaRIEfJ • e1lprNS
CONTRACTOR'S NAME \ OWNERBUILDERT DYES[]NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
Cj
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ ZSI 000 SO FT NA ,� L SO FT-
APPLICANT'S SIGNATURE N u C-NA-NE-E' DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION w CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE 1 �� PAIDAMOUNT
AMOUNT ` OCASH OCHECKN OCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES G NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213