PMT17-03194 City of Menifee Permit No.: PMT17-03194
29714 HAUN RD.
4�A—> MENIFEE,CA 92586 Type: Commercial Electrical
MENIFEE Date Issued: 09/28/2017
PERMIT
Site Address: 26761 NEWPORT RD, MENIFEE, CA Parcel Number: 360-020-029
92584 Construction Cost: $1,617.00
Existing Use: Proposed Use:
Description of INSTALL(1) 100 A OVERHEAD TEMP POWER POLE
Work:
Owner Contractor
STRONG INC ANDY GUMP INC
10373 LOS ALAMITOS BLVD 26954 RUETHER AVENUE
LOS ALAMITOS, CA 90720 SANTA CLARITA, CA 91351
Applicant Phone:6619773851
ANDY GUMP INC License Number:357789
26954 RUETHER AVENUE
SANTA CLARITA, CA 91351
Phone: 9492890149
Fee Description QQt Amount ISI
Services, Switchboards,Control Centers&Panels 1 116.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 148 148.37
GREEN FEE 1 1.00
General Plan Maintenance Fee-Electrical 1 5.80
$298.17
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_Pennit_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 contractors)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from Iicensure under the Contmctofs State License taw for
Professions Code and my license Is In full force and effect. the fallowing reason:
License Class L I o License No. 9G-175 01 By my signature below I acknowledge that,except for my personal residence
Expires 7i 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
0I 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 workers 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/caIaw.htm1.permit Is Issued.
Policy# Date
❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which o 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: jr7 ,/ application and the Information I have provided Is correct.I agree to comply
Carrier�r`—1`2 F— with all applicable city and county ordinances and state laws relating to
44('
cY building construction.I authorize representatives of this city or county to
Policy# I7-7Y UJ12 lD�y� Expires - r V enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
01 certify that in the performance of the work for which this permit is Issued,
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
worker's compensation laws of California,and agree that if I should became HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I s 1 fo, hhwwf`t`h`� mply with those provisions. WIII the applicant or future building occupant handle hazardous material or a
Applicant N.ILw * Date Z$ , mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SEC WORKER'S COMPENSATION OVE GE IS ❑Yes ❑No
UNLAWFUL,AND SHALL SUBI 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 Aft Quality Management District(SCtionor odi permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Airlines
Qua
CONSTRUCTION LENDING AGENCY 0 Yes ❑No
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) ❑Yes 0 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 under the State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Cade,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to OYes ❑No
construct,alter,improve,demolish or repair any structure,prior to its Date
issuance,also requires the applicant for the permit to file a signed statement
PROPERTY OWNER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's 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
than
Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($50D). 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.eoa.gov/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 0 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
Code: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.
ss
rt�1r.v L�1�� tp1�7p .: ....
. CITY OF MY.+1\I�Y'1t B PLO(No. PCIirtlft:
29714 Haun Road oaca - - - oam: -
Menifee, CA 92586
Phone:(951)67M777 Atownt
Fax:(951)679-3843 Ck ,
Building Combination Permit
To Be Core leted ElyApplIcant
UOIDescv— :enn Cece: F:
PropedyAddrese: .<...,:: :.._._._.
Pend Nlanber.'
Piojo..:: erred we: CAL-CRUZ PROJECT Unit#: Floor tk`
Nome: STRONG INC Phone,Na, Fax No.:
P owne°rw �d BS9' 10373 LOS ALAMITOS BLVD LIDS ALAMITOS,CA 9016t Number ZJpCode'
Ernall f88B' Ibodte@strong-ino.net
Name:: .. .... . .. ... . Phw,A o. 9-2 .Fax No
6aiLA �489-0149 No.
Applicant .."Ad reds: .. unit Number Zq CPde .. . . . '`
re TPADMIN NDYGUMP.COM
,at ::..
ANDY GUMP INC. . .. .. . _. ... Phoneft1-310-2145 Fek 61- -0052
oanheear AddMS%' . ... ._ Sate 'Zip Gotle .
26954 RUETHER AVE SA A CLARITA CA 91351
Contractor r d ue neee contra o. Conlratlor Osllkmla Cleanse No.: Clesslocaile�:
0
6queroFodtege -
nesetoaanafwads INSTALL TEMP POWER POLE Costarwork.$
I,ndleete As R•RewWad w WA=No1 Apptkable
kamp dleaseta of Nliy dmmnslaned,dmvm to Said p18ns whkh include: .. .. .. l mtCf doCWnents:Wtdch.inctede
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo.Tech/Salle,Report(oh ad only)
❑ Plot I Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24:Energy(an a%x 11)
❑ foundation Plan ❑" Cress Section ❑ Plumbing Plan -❑ SWCWraI:Celada6ons
❑ Single:Una Nagmmforelec.samloesover,100AMP -
❑ .Moor Plan..... ❑ Shuatumi tmBngPlm160e1M ❑ Sharing Plan ITI Sound ftwirt-Resldeh9al
Gass'.Code: Indicate Nevi-Giristiicdlar Alteration' Addition• Means"th la
Wohk7ypa. ReW Rebofit• RW&n to Ellisthlg Pamti'Requireff YES NO
Proposed Building Use(s)o Existing Building Use(s):
:p eulldrigs: :. .NUnits; #.Stories: WAN the Buildmg Have.aSasemenl? V of
eft.Code Occupancy Group : ,Indicate IndW.ate.Ir YES orNO Indicateall- Geo-taSaKHak.Zone
At.Project Spdhklemd
:Completion: Cor=ctlon that apply CoaSlatZone-
Type(s): Coro YES or NO N0130Zone
Required? I . Usled:on:Hlstodc Resources-Inventory
CITY.PLANNING STAFF ONLY
APPRO.VAW^: .. Cos1al;ComrrusS ... ArcltrReW.ew BoelU L.andmark.Comm. PtatntrtgCamm ZaaingAtlMnlstrgtor
Fee swnipt" City Project EleerVWcId.Q srget - Landmark ISeLwnia(tebafll a
.... Oa1tln1A rent
Expedite:Pro eq s: Child Care CI .Building. _ Landrn Alfoalablelloustog
1 . O ty Project' Groan
For Stair Use Only
Iarm 1 - al 1 ly an n ,ra n Inaenrlg n I 1MnSP0MMftM9MLIenl(kn8ol'.
City of Menifee
�# p �`' THANK YOU FOR HELPING USCREATEA BETTER COMMUNITY Building & Safety Dept.,.
Oft,
V QPV � 1461 ,5� SEP 11 201 '
Received
3
SITE PLAN
SITE ADDRESS 26575 NEWPORT RD, MENIFEE, CA 92584
ASSESSORS PARCEL NUMBER_ 3C
Provide North Arrow REAR PROPERTY LINE
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I I I V
D � I✓1ir'CE� D
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P CITY OF MENIFEE
R BUILDING AND SAFETY DEPARTMENT = R
P PLAN A04ROVAL I r O
E E ....�
T REVIEWED BY • Z 10 � AlT
Y DATE Y
N
L Approval of these plans shall not be construed n be a perr, t`or,or an + L
I approval of,an violation of any provisions of thp federal,state or city
I
INrgula ' n ek�This set of approved plans must be kept on the I IN
E jobsite until co pletion. E 1
FRONT PROPERTY LINE
City of Menifee
28+199 (Rev.06/2009) Building & Safety Dept.
UTT C Opy SEP 11 201?
Received