PMT17-03972 City of Menifee Permit No.: PMT17-03972 29714 HAUN RD. Type: Commercial Electrical 'C�KCCELA? MENIFEE,CA 92586 MENIFEE Date Issued: 11/09/2017 PERMIT Site Address: 24327 PONDEROSA LN,MENIFEE, CA Parcel Number: 92584 Construction Cost: $500.00 Existing Use: Proposed Use: Description of INSTALL(1)200AMP U/G TEMP POWER POLE FOR CONSTRUCTION USE Work: TR31392 Owner Contractor BROOKFIELD HOMES S R BRAY LLC 3090 BRISTOL ST STE 200 1210 N RED GUM STREET MENIFEE, CA 92626 ANAHEIM,CA 92806 Applicant Phone:7145071881 MENIFEE, CA License Number.980589 Phone:9512931333 Fee Description QtV Amount(b) 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 building operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise slated,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 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 Contractor's State License Law for Professions Code and my license is in full force and effect. Gw the following reason: License Class C10 License No. 47q By my signature below l acknowledge that,except for my personal residence Expires �� inwhich l musthave resided for at least one year priorto 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 cz 1 hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.)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.eov/caIaw.htmI.permit is issued. Policy# Date g(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 ❑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 K�JP�Ci/}Gs-�% 1NJLl�h,1f�. Cr/�4Wf with all applicable city and county ordinances and state laws relating to Carrier_ building construction.I authorize representatives of this city or county to Policy#CL.Y'71273 67o 7— Expires 3/3 J//g 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 D 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# 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 witJLlhos visions. Will the applicant or future building occupant handle hazardous material or a Applicant Date /�/�7 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 0 Yes Q-Nb 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 OYES AO 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 2-90 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that l am exempt from the permitting checklist.I understand my requirements under the 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 reporti g. Business and Professions Code).Any city or county that requires a permit tos o N—o_ Date U 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 IRRP) License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires wntractors 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 fora 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 ❑1,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.zov/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. D No EPA Lead-Safe Certified Firm is required for this project because: 01,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. r_,✓ DATE: 1 1/3/17 PERMIT/PLAN CHECK NUMBER Twil Q TYPE: 8'COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA c SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION &ILECTRICAL O MECHANICAL O NEW O PLUMBING 0 RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK Install one 200amp U/G temporary power pole for construction use at Brookfiield's tract#31392. PROJECTADDRESS Z'Y-3Z 1 R6wr,`II5"54- L,c/• ZIP ASSESSOR'S PARCEL NUMBER LOT 87 TRACT#31392 OWNER NAME Brookfield Homes ADDRESS 3090 Bristol St Ste 200, Costa Mesa, CA 92626 PHONE (858) 481-8500 EMAIL mikem@powerplus.com APPLICANT NAME Mike McGee ADDRESS PHONE 951-293-1333 EMAIL mikem@powerplus.com CONTRACTOR'S NAME OWNER BUILDER? O YES �<O 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 SO FT L SQ FT APPLICANT'S SIGNATURE —✓ DATE 11/3/17 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE PERMIT FEE d"O`�• 1� SMIP GREEN PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED OYES 0 NO DRIVERS LICENSE iI NOTARIZED LETTER 0 YES 0 NO city of BtMilm Q60• City of Menifee City of Menifee Building& Safety Deg O�O#Houn Rd. Menifee, CA 92586 951-6" `-- wovw.ciiyo,m eni fee.us NOV 0 3 201:7 Received RPr:eived Vl —_ III 'II II II ITT— ix AtlMMI MONIM ti I III : III 7= � I I ii I 1 o I I clI 1!F o e _ --y. t•,4 ,N,.a 1_ `_ it 0 •M 3No=ns t` y f 2� 1i .t` ✓ r ` -17 M1 ' ' 2 Q I I• '�� Z I IILI a,_ L I.�ITN I -� �I .t 5d .. w , I L Ur i i ( FS W 1. r 'li) C171— In AVM OOOIJ 03tl y 3 I I W y� I I,ti �tJ t uj Y.1uj t4 lL to Z CM o I.III III Um