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PMT17-03970 City of Menifee Permit No.: PMT17-03970 29714 HAUN RD. Type: Commercial Electrical <-�CCEL/> MENIFEE, CA 92586 MENIFEE I Date Issued: 1 110 912 01 7 PERMIT Site Address: 29676 CANYONLANDS DR, MENIFEE, Parcel Number: CA 92585 Construction Cost: $500.00 Existing Use: Proposed Use: Description of INSTALL(1)200AMP U/G TEMP POWER POLE FOR CONSTRUCTION USE Work: TR 34406 Owner Contractor CAL ATLANTIC GROUP S R BRAY LLC 15360 BARRANCE PARKWAY 1210 N RED GUM STREET IRVINE,CA 92618 ANAHEIM, CA 92806 Applicant Phone:7145071881 MENIFEE, CA License Number:980589 Phone:9512931333 Fee Description Ohl Amount IS) 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 thereunderwhen 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_Pennit Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects 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 o I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect Cw the following reason: License Class C/o License Na. By my signature below l acknowledge that,except for my personal residence Expires 7f/ Q Signature in which l must have resided for at least one year prlorto 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 o 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 www.IeRinfo.ca.goy/caIaw.htmI.permit is Issued. Policy q Date ¢'fhave 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 ❑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 number are: application and the information I have provided is correct.I agree to comply Carrier)( tis /jriii� rNOVAige G/rzyf with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city Or county to Policy#CL_ z77ld7$6707— Expires 3hfhie 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, 7 Ishallnotemolov any persons in any manner soasto become subject tothe CITY BUSINESS LICENSER 035-W workers 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 wit isions. � Will the applicant or future building occupant handle hazardous material or a Applicant Date /�I/j7 mixture containing a hazardous material equal to or greater that the amounts specified an the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes a Wb 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 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(SCtionor See permitting from checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines Qua CONSTRUCTION LENDING AGENCY o Yes orNo 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 e'IGo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements underthe State of I hereby affirm under penalty perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractors license Law far thee reason(s)indicated below by the hazardous material report( g. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 D,� O No Business and Professions Code).Any city or county that requires a permit to Date 8�/y�7 construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER AUTHORIZEDAGENT 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(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 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-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 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 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. o No EPA Lead-Safe Certified Firm Is required for this project bemuse: o I,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. J DATE: 11/3/17 PERMIT/PLAN CHECK NUMBER — V O TYPE: KCOMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION 4-1rLECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK Install one 200amp U/G temporary power pole for construction use at Cal Atlantic's "Parkview" project, tract#34406. PROJECTADDRESS Z��o7Co &,jy .1G,i o S ZIP y S ASSESSOR'S PARCEL NUMBER bb LOT 57 TRAcr#34406 OWNER NAME CAL ATLANTIC GROUP ADDRESS 15360 BARRANCE PKWY, IRVINE, CA 92618 PHONE (949) 789-1600 EMAIL APPLICANT NAME Mike McGee ADDRESS PHONE 951-293-1333 EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES GI16 BUSINESS NAME S.R. Bray LLC, dba PowerPlus ADDRESS 1210 N. Red Gum St,Anaheim, CA 92806 PHONE 714-765-7551 EMAIL CONTRACTOR'S STATE LIC NUMBER 980589 LICENSE CLASSIFICATION C10 VALUATION$ 500.00 SQ FT L SQ FT APPLICANT'S SIGNATURE DATE 1113/17 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSIN ESSkICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: PERMIT FEE „ LE SMIP GREEN PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE ti NOTARIZED LETTER O YES O NO City of Menifee city 0 City of Menifee Building& Safety DepartmelB -30d. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us NOV 0 3 2017 Received Received loymegoo O Q o -1i'xz'1 xI' � LI (� s m m. M"o 7 OT D ^ 8J PNAWNmfL � � y W N H s f+ n S 0 O v Z Y + Q` 0 Zi C u i e P / m � !♦! N b v + a A a m m _ ^ V W ♦ e m � V a i W N V m y H V a ^ m r c Cl n �T1 Z r W , n S2 0 m a m 99 N O O Z 7 �\ zo Wn my -a M 9 /� CL d O V { , a p n m 0 pm s - D v m 0 CDr D m T M ^CL v OD a o• n N _ C 3 O o mccm w m m o