PMT17-03520 City of Menifee Permit No.: PMT17-03520
29714 HAUN RD.
<-�CCEL/� MENIFEE,CA 92586 Type: Commercial Electrical
"' 11S. .— MENIFEE Date Issued:
11/09/2017
PERMIT
Site Address: 29012 REDWOOD ST, MENIFEE, CA Parcel Number:
Construction Cost: $500.00
Existing Use: Proposed Use:
Description of INSTALL ONE 200A.UIG TEMP POWER POLE FOR PRODUCTION USE,TR 31582
Work: EP 17-344
Owner Contractor
LENNAR HOMES S R BRAY LLC
980 MONTECITO DRIVE,STE 300 1210 N RED GUM STREET
CORONA, CA 92879 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 QtV Amount ISl
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_Bidg_Permit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who antracts for the projects
I hereby affirm under penalty of perjury that 1 am under provisions of ' with a licensed contractor(s)pursuant to the Contracton5tate License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect 's the following reason:
License Class' — Ct� License No. �� By my signature below l acknowledge that except formy personal residence
Expires 71 /( � Signature in which l must have resided for at least one year priorto completion of
improvements covered by this permit.I cannot Iegallysell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
D 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 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
this permit is issued. www.leeinfo.a.eov/calaw.html.
Policy# Date
raTiaave and will maintain workers compensa Gon 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 workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
numberare: application and the information 1 have provided is wrred.I agree to comply
Carrierx�P�i/)fiia�l tNJl�EWGE- Gl��i 'T with all applicable city and county ordinances and statelaays relating to
building construction.I authorize representatives of this city or county to
Policy#CL�r'74'J7367DZ Expires 3//31he 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
o I certify that in the performance of the work for which this permit is issued, 7
ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if 1 should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply wit visions. Will the applicant or future building occupant handle hazardous material or
Applicant Date /�/�7 mixture containing a hazardous material equal to or greater thatthe
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes ailb
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant arfuture building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,OOD),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 DYes efNo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 10DO 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) DYes 01go
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements underthe State of
ContrayaffirmunseLaw for thalty ofe
peson(s)ry atlam exemptbelow from the California Health&Safety Code,Section 25505 and 25534 concerning
checkaRors License Law forthe reason(s)indicated below by the hazardous material reportir .
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 a4o; o No
Business and Professions Code).Any city or county that requires a permit to No Date
construct,alter,improve,demolish or repair anystructure,priorto its PROPERTY OWNER AUTHORIZEDAGENi
issuance,also requires the applicant forthe 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(RRPI
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 paintinapre-1978
and the basis for the alleged exemption.Any violation of Section 7031.S 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 arthrough their
o1,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 sole.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a oAn 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. o No EPA Lead-Safe Certified Firm is required for this project because:
D 1,as owner of the property am exclusively contracting with licensed
contactors to construct the project(Section-7044,Business and Professions
Code:The Contactors 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
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
a
Menifee
DATE: PERMIT/PLAN CHECK NUMBER - Q
TYPE: a;-COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION Q-tTECTRICAL O MECHANI�f H Menifee
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES Building&Safety Di pt.
DESCRIPTION OF WORK A),f U p/JE 2dQ,&nezAr " &-cZ bw- OCT 0 3 Al I!
PROJECTADDRESS -'qO &PAJQLSQ V: ZIP
ASSESSOR'S PARCEL NUMBER LOT TRACT ISO Z-
OWNER NAME (5av„/A AOC p
ADDRESS '30 /�t� d �/L. S7TO m CnawA c A a/F 977
PHONE `f j/- hop-IrOD EMAIL
APPLICANT NAME /-IG owe
ADDRESS
PHONE EMAIL 1/&E h J6.IG� f, Co
CONTRACTOR'S NAME OWNER BUILDER? O YES Q-
BUSINESS NAME 5.�, 34V UL 4x Aof��Z _r
ADDRESS ,Jr //-1 LA S
PHONE d�! EMAIL
q
CONTRACTOR'S STATE LIC NUMBER /o w� LICENSE CLASSIFICATION C u
VALUATION$ Yap — SQ FT L SQ FT
APPLICANT'SSIGNATURE ✓. DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY:
PERMIT FEE as 15 SMIP x GREEN
PLAN CHECK FEE INVOICE TOTAL Pao, vs
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE ti NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6 77 7
www.citVof,menifee.us
V)
°\ City of Menifee
ullding & Safety Dept.
4•
-I
8 _ L [i 7 9 OCT 0 Oil.
l
F--i _ -R _ 10 -
ui
LU
.+ ti U-
Z
W N LU
W
LL �1 V
Z 14 uj
� C
E �
0
� N
W a
w
Q �
Y i \" -�+ C Q
LU
LL.LL a o N N
a / W o .a
Lu
VI
\
O
OD
so LA.
y `o
0 a L V r = Q J 2
r o
CO d OC ¢ o
c �- MUS