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PMT17-03074 City of Menifee Permit No.: PMT17-03074 29714 HAUN RD. MENIFEE, CA 92586 Type: Commercial Electrical MENIFEE Date Issued: 0 910 812 01 7 PERMIT Site Address: 29570 LONGSHIP DR, MENIFEE, CA Parcel Number: 92585 Construction Cost: $500.00 Existing Use: Proposed Use: Description of INSTALL ONE 200AMP U/G TEMP POWER POLE TO PROVIDE POWER TO TRACT PRODUCTION Work: TR 34406-2 NEWPORT AT HERITAGE LAKES Owner Contractor CALATLANTIC GROUP S R BRAY LLC 15360 BARRANCE PKWY 1210 N RED GUM STREET IRVINE, CA 92618 ANAHEIM, CA 92806 Applicant Phone:7145071881 MIKE MCGEE License Number:980589 S R BRAY LLC 1210 N RED GUM STREET ANAHEIM, CA 92806 Fee Description ON Amount IEI 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 cared 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 perjurythat 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 a I am exempt from Ilcensure under the Contractor's State License Law for Professions Code and my license Is In full force and effect. a�srss the fallowing reason: License Class�C/o License No. 9Y" By my signature below l acknowledge that,except for my personal residence Expires 31/ e, Signature in which l must have resided for at least one year pdorto completion of improvements covered by this permit.I cannot legallysell 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 www.Ieginfo.ca.gov/calaw.htmI.permit is issued. Policy If Date e'fhave and will maintain worker's compensaton 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 worker's compensation insurance carrier and policy 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 Carrierx(-Jfteme—,�, 1N.1/1/Fla1GE. n,-rAml with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy#GL-6-741A3670Z Expires 3 h i M 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 persons in any manner so as to become subject to the CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if i should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply withAftoselocovislons. Will the applicant or future building occupant handle hazardous material or a �/y/!? mixture containing a hazardous material equal to or greater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes Q40b UNLAWFUL,AND SHALL SUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the Intended use of the building by the applicant orfuture building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant requires permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District hecons(SCtionor See permitting checklist IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airllnes Qua CONSTRUCTION LENDING AGENCY 0Yes efNo 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 boundary of a school? (Section 3097 Civil Code) 0 Yes a'No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements underthe State of Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 hazardous material report g. Business and Professions Code).Any city or county that requires a permit to ayes o No e�� Date 0 construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER 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(RRP) License Law(Chapter9(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-certlfied 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 perty than($500), q P p p hemsel owners orthroand ghth managers who do the paint-disturbing work themselves orthrough 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.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 Contractors State License Law does not apply to an owner of a D 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. D No EPA Lead-Safe Certified Firm is required for this project because: ❑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. SAFETYL= PERMIT/PLAN CHECK APPLICATION Menifee ldll�mkl_ DATE 8'I36h7 PERMIT/PLAN CHECK NUMBER TYPE: (�EOMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION C,<L-ECTRICAL O MECHANICAL O NEW O PLUMBING C RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK IWTAi L ONE ZOO AMP ul T , ?0 0 Ib= P W-Vicr &4kc-TioN. C 4hor O 3',Yam-Z. PROJECTADDRESS Z ,✓ 7O 1p G S/f7 4 j� ASSESSOR'S PARCEL NUMBER LOT Jpp TRACT L/dfd(o —Z OWNER NAME CAL A "Nwc dudtff ADDRESS 1.S3 b 114ffANo eklxl. RuINE `I ZG/d PHONE 9 - 7$1 - /�00 EMAIL APPLICANT NAME MIAE lic ADDRESS PHONE Nx/- 297 -1777 EMAIL MIAr: 14, Po4EICPG4rGSM CONTRACTOR'S NAME ,/ OWNER BUILDER? OYES c:<O BUSINESS NAME 5•je, drayc u O3, v,4!pGul ADDRESS JZ/0 N. RED RAAl ;T; N N£lh MO6 PHONE 7/y-76j-7SSI EMAIL CONTRACTOR'S STATE LIC NUMBER 9alos,e1) LICENSE CLASSIFICATION C/o VALUATION$ 5r60 SO FT L SO FT L APPLICANT'S SIGNATURE DATE -7 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CIN OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN ' SMIP INVOICE PAID AMOUNT AMOUNT 0CASH 0CHECK# 'OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES () NO DL NUMBER NOTARIZED LETTER O YES O NO City of A4eoifee Building&Sojety Department 29714 Noun Rd. Nlenir ee, _:A, 122525 55°-c7 0?, www.cityofinenifee.us inspection iFquest Line 951-245-6213 mo - a fn LLI n n\ �f am W R l W $ g I �t �� W LL otf n v ,y 1' H La H " V 2 �r r ui >; py C A T s CLOD W o gg z Z W d Q 3 tt LL LL JJ ~ W co a .24 a c m V // ti o WSJoC ¢ (C �� C Ol