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PMT18-01274 City of Menifee Permit No.: PMT18-01274 29714 HAUN RD. Type: Residential Electrical �!-�CCFI-i? MENIFEE,CA92586 MENIFEE Date Issued: 03/20/2018 PERMIT Site Address: 25530 ROLLING HILLS DR, MENIFEE, CA Parcel Number: 358-240-001 92584 Construction Cost: $2.500.00 Existing Use: Proposed Use: Description of INSTALL 280LF U/G ELECTRICAL LINE WITH NEW 120V/20A CIRCUIT X 2 AND 1 GFCI OUTLET Work: FOR GATE OPENER. Owner Contractor BRIAN&KATE FOXWORTH SERAT ENTERPRISES INC 25530 ROLLING HILLS DRIVE 32212 CORTE GABAIVA MENIFEE, CA 92584 TEMECULA, CA 92592 Applicant Phone:9513650587 BEAU SERAT License Number..967745 SERAT ENTERPRISES INC 32212 CORTE GABAIVA TEMECULA, CA 92592 Fee Description g,yt Amount f51 Services, Switchboards,Control Centers&Panels 1 116.00 Building Permit Issuance 1 27.00 Administrative Fee 10 10.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Electrical 1 5.80 $159.80 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 staled,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_Peonit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION propertywho 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 ❑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 Cla#`_(a In License No. 76 L�� 2 �` By my signature below I acknowledge that,except for my personal residence Expires ' SignaturegZ— =� in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I 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 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 ,,.�,ww.leeinfo.ca.eov/calaw.html. this permit Is issued. Policy# Date XI have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Cade,for the performance of the work for which ❑By my signature below I certify to each of the fallowing: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: r application and the information I have provided is correct.1 agree to comply Carrier . �P✓�J/lt? Al C�: !`�/ ��/y with all applicable city and county ordinances and state laws relating to o b building construction.I authorize representatives of this city or county to Policy# 041ZF��C�� Expires��—Z/'/n 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, 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 become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Z-'Applicant Date „�`J 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 o Yes o No 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($300,000),IN occupant require a permit for the construction or modification from South IN SECTIONON 3 THE COST LABOR CODE,INTEREST, DAMAGES ATTORNEYS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY O Yes ❑No I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) o Yes ❑No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guideand the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item hazardous material reporting.$)(Section 7031.5 oyes ❑No 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 Date 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 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 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.epa.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 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. ❑No EPA Lead-Safe Certified Firm is required for this project because: o I,as owner of the property am exclusively contracting with licensed contactors 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. City of Menifee Building Dept. )Uj c MAR 2 0 2018 WZ Received \1J w N .s` o Y s p E I H 4 LJJ LU LL A 1 rUJ L ® L _ Z Oca J /y W iY ® O a � Z a c y �:1� v LLJ an a 0: laoCn � City of Menifee Building Dept. , ' l �— MAR 2 2 2018 CITY OF MENIFEE Received BUILDING AND SAFETY DEPART . !� PLAN APPROVAL aon07 2JAV! y 40wdJ +**m� V f:m i REVIEWED B Q� �,Qr ^Qrl 'Approval of these plans shall notbe conswed to be a erl.'lor,ar an {.. U moo/ p approval of,any vicla4on of any provisions of the feller I,s' e of regulations and ordinances. This set of approved plans u:' ;e'0r on the �y Q7n" jobsite until wmpletion• -,? ? City of Menifee Permit No.: PMT18-01274 29714 HAUN RD. lACCF-u? MENIFEE, CA 92586 Type: Residential Electrical MENIFEE Date Issued: 03/20/2018 PERMIT Site Address: 25530 ROLLING HILLS DR, MENIFEE, CA Parcel Number: 358-240-001 92584 Construction Cost: $2,500.00 Existing Use: Proposed Use: Description of INSTALL 28OLF U/G ELECTRICAL LINE WITH NEW 120V/20A CIRCUIT FOR GATE OPENER Work: Owner Contractor BRIAN &KATE FOXWORTH SERAT ENTERPRISES INC 25530 ROLLING HILLS DRIVE 32212 CORTE GABAIVA MENIFEE,CA 92584 TEMECULA, CA 92592 Applicant Phone: 9513650587 BEAU SERAT License Number: 967745 SERAT ENTERPRISES INC 32212 CORTE GABAIVA TEMECULA, CA 92592 Fee Description Oft Amount($) Services, Switchboards, Control Centers&Panels 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Electrical 1 5.80 $149.80 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 ❑I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. �7 the following reason: License Class C/0 License No. /fv / yS By my signature below I acknowledge that,except for my personal residence f7 Expires //3o-. . 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 ❑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 this permit is issued. www.leainfo.ca.gov/calaw.htm 1. Polity N Date Ahave 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 an the property owners behalf.I have read this number are:: { /�' application and the information I have provided is correct.I agree to comply Carrier �ri><,ke ILKIGc/Tis2Ct o/y/�ff2� with all applicable city and county ordinances and state laws relating to 7� y building construction.I authorize representatives of this city or county to Policyri —Expires 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, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE p worker's 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 Cade,I shall for with c p Ith those provisions. 7 /p Will the applicant or future building occupant handle hazardous material or a Applicant Date J CU 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 ❑No 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 ❑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 ❑No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am ezemptfrom the California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ciYes ❑No 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 PROPERTY OWNER OR AUTHORIZED AGENT 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 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 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 or through 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.epa.¢ov/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 forthis 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: ❑1,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. MENIFEE DATE: 3 ,ZO`A0 PERMIT/PLAN CHECK NUMBER PLANNING CASE NUMBER TYPE: O COMMERCIAL RESIDENTIAL C MULTI-FAMILY O MOBILE HOME O POOL/SPA C SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION ELECTRICAL O MECHANICAL C NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES f DESCRIPTION OF WORK W( e w `-OV aW A µ!T j PROJECTADDRESS �'S3o l�nv .([f f r. ZIP - ASSESSOR'S PARCEL NUMBER ,M— p' MO-Qoj LOT TRACT Building Dept. OWNER NAME 23t-Io-A b cavr4h MAR 'J ADDRESS (D t) I II[ c 6�-e PHONE �si'Ay0- K3 EMAIL eceive APPLICANT NAME ADDRESS la per PHONE EMAIL CONTRACTOR'S NAME // e4K // OWNERBUILDER? OYES NO BUSINESS NAME /�S4J "/e.GTIrT G I ADDRESS C, ,' t C�y[CG I ;S�h PHONE _�S/-27�-/%Ca EMAIL .. d ,�. LO. t CONTRACTOR'S STATE LIC NUMBER Q� `7y,� LICENSE CLASSIFICATION VALUATION$ �� SQ FT L SQ FT l p APPLICANT'S SIGNATURE ' - DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICETOTAL • $ GREEN ,— SMIP X OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER D YES O NO City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofmenifee.us NI City of Menifee /� Building Dept. Ouj c MAR 2 0 2018 Received im � o l i 1 100 II n CITY OF MENIFEE BUILDING AND SAFETY DEPA TMENT PLAN APPROVAL J REVIEWED BY N3011 DATE 'Approval of these plans shall not be construed to be pormit for ores d of approval of,any violation of any provisions of the fede I,state orcdy p regulations and ordinances. This set of approved plena ust be kept on the Q7� jobsite until completion. �b