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PMT17-03215 City of Menifee Permit No.. PMT17-03215 29714 HAUN RD. �� MENIFEE,CA 92586 Type: Commercial Electrical MENIFEE MENIFEE Date Issued: 0712312018 PERMIT Site Address: ANTELOPE RD, MENIFEE, CA 92584 Parcel Number: Construction Cost: $88,000.00 Existing Use: Proposed Use: Description of SITE LIGHTING CONVERSION FROM LPS TO LED. 110 FIXTURES TO BE REPLACED AND INSTALL Work: NETLINK CONTROLS LED DIMMING. Owner Contractor WEINGARTEN REALTY INVESTORS V S S ELECTRIC INC 2600 CITADEL PLAZA DR 469 E HARRISON ST#E HOUSTON,TX 77008 CORONA,CA 92879 Applicant Phone: 9512799048 MENIFEE, CA License Number:858464 Phone:9512048143 Fee Description G1yt Amount Is) Pole or Platform Mounted Fixtures 103 693.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 77 77.46 GREEN FEE 1 4.00 General Plan Maintenance Fee-Electrical 1 34.65 $836.11 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 D I am exempt from licensure under the Contractor's State License law for Professions Code and my license is in full force and effect. the following reason: License Class (L7^/0 L ense�No�.. G 6 By my signature below l acknowledge that,except for my personal residence Expires l-'V—/ Signature in which 1 must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that 1 WORKER'S COMPENSATION DECLARAION 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.leeinfo.ca.eov/calaw.h[ml. this permit is issued. Policy# Date I I have 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 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 correcL I agree to comply Carrier (�/J (,,></'17r/%?�'/ with all applicable city and county ordinances and state laws relating to (-� Q building construction.I authorize representatives of this city or county to Policy# d IV V56J2 13 Expires J 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, 1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the ter's compensation provisions of Section 3700 of the Labor Code,I shall f wi c ply with those provisions. Will the applicant or future building occupant handle hazardous material or Applicant Date 7 O 3�/ d mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS OYes JNo 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 forguidelines CONSTRUCTION LENDING AGENCY D 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) O Yes mtNo 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 Califor 'a Health&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicated below by the hazar us m ter I reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 6IYe O N 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 PR PERTY 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 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.Anyviolation 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 D 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.aov/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 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. ❑No EPA Lead-Safe Certified Firm is required for this project because: D 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. i c: r, WAPPLICATION ,� Menifee DATE PERMIT/PLAN CHECK NUMBERf�-M-1'Q l/ TYPE: COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATION []DEMOLITION OELECTRICAL []MECHANICAL ❑NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK S/ / 1� i%2e777 1!� O ,C� lit) PROJECT ADDRESS 3 0/0 7- 0/$7 H17l�Go SI Po . /Zl>5n1f6-b G/! q Z.Ky ASSESSOR'S PARCEL NUMBER LOT TRACT PROPERTY OWNER'S NAME /.VFj 17, -2 /ZS26LLr T b 110 ADDRESS pp""Z 6 L, Z� USjvh J7Ov^� PHONE y� - (��'� -D�� EMAIL Gbh @ tu6n6A7z?>�i�•�/YJ APPLICANT NAME I-qPZ4-a 5WIZEFoc ADDRESS 110 r,11WXA15M '�T- lE 9Zk7 PHONE 951, may- 91V3 'cif EMAIL �/Lf�� l/S 6"L6C JZ/(��Cp'y✓I CONTRACTOR'S NAME OWNERBUILDER? [IYES5#NO BUSINESS NAME / ADDRESS n G$ E �rtJ%j/LJ59-Y1 ,j. E t�l"n4 `A jZjv PHONE EMAIL 151&q0 0 11,C:S Z G. CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION G'�O VALUATION$ $$/tj Q FT L SQ FT / APPLICANT'S SIGNATURE DATE CITYSTAFF USE ONLY . DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER DI NNI ENGINEERING FIRE GREEN SMIP Ol INVOICE /j�� PAIDAMOUNT AMOUNT ��// 6 ! O CASH O CHECK# O CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 0CREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building&Safety Depc tment29714 Haun Rd. Menifee, CA 92586&IIaY-pbenifee www.cityofinenifee.I s Inspection Request Line 951-246-6213 I ng afety Dept. SEP 12 20V Rer-Pivrzti :heck ALicense -License Detail Page 1 of Contractor's License Detail for License # 858464 DISCLAIMER:A license status check provides information taken from the CSLB license database. Before relying on this information,you should be aware of the following limitations. CSLB complaint disclosure is restricted by law(B&P 7124.6)If this entity is subject to public complaint disclosure,a link for complaint disclosure will appear below.Click on the link or button to obtain complaint and/or legal action information. Per B&P 7071.17,only construction related civil judgments reported to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload,there may be relevant information that has not yet been entered onto the Board's license database. Business Information V S S ELECTRIC INC 469 E HARRISON ST#E CORONA, CA 92879 Business Phone Number:(951)279-9048 Entity Corporation Issue Date 05/05/2005 Expire Date 05/31/2019 License Status his license is current and active. II information below should be reviewed. Classifications 10-ELECTRICAL Bonding Information Contractor's Bond his license filed a Contractor's Bond with AMERICAN CONTRACTORS INDEMNITY COMPANY. and Number: 10142198 and Amount: $15,000 ffective Date:01/01/2016 ontractor's Bond History Bond of Qualifying Individual e qualifying individual BRADLEY PAUL SCHRETER certified that he/she owns 10 percent or more of the voting tock/membership interest of this company;therefore,the Bond of Qualifying Individual is not required. ffective Date:05/05/2005 Workers' Compensation his license has workers compensation insurance with the MID-CENTURY INSURANCE COMPANY olicy Number:A09456093 ffective Date: 05/01/2012 xpire Date: 05/01/2019 orkers'Compensation History Other Personnel listed on this license(current or disassociated)are listed on other licenses. ttps://www2.cslb.ca.gov/OnlineServices/CheekLicenseII/LicenseDetail.aspx?LicNum=858464 //23/201