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PMT18-01381 City of Menifee Permit No.: PMT18-01381 29714 HAUN RD. MENIFEE, CA 92586 Type: Commercial Electrical MENIFEE MENIFEE Date Issued: 09/11/2018 PERMIT Site Address: 30232 CAREY RD, MENIFEE,CA Parcel Number: Construction Cost: $500.00 Existing Use: Proposed Use: Description of INSTALL(1)200AMP UNDERGROUND TEMPORARY POWER POLE FOR FUTURE CONSTRUCTION Work: TRAILER AND PRODUCTION AT RSI"CAMDEN PLACE"PROJECT. LOT 44 CAMDEN PLACE-TR37067 Owner Contractor RSI COMMUNITIES S R BRAY LLC 620 NEWPORT CENTER DRIVE 1210 N RED GUM STREET 12TH FLOOR ANAHEIM, CA 92806 Applicant Phone:7145071881 S R BRAY LLC License Number: 980589 1210 N RED GUM STREET ANAHEIM, CA 92806 Phone:7145071881 Fee Description Qtv Amount(EI Services,Switchboards, Control Centers&Panels 1 183.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 74 74.18 GREEN FEE 1 1.00 General Plan Maintenance Fee-Electrical 1 9.15 $294.33 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 contracts for the projects 1 hereby affirm under penalty of perjury that I am under provisions of ' with a licensed contractors)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and a I am exempt from Iicensure under the Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Class C10 License No. 9�'8 By my signature below l acknowledge that,except for nrypersonal residence Expires 31 inwhich lmusthave resided for at least one year priorto completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell 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:) 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 webske: by Section 3700 of the Labor Code,for the performance of work for which www.IeglnFc,.ca.f!av/caIaw.htmI.permit is issued. Policy If Date o'fhave and will maintain workers cgmpensaton 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 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 correct.I agree to comply yUQ�r � r/Uf �� G� with all applicable city and county ordinances and state laws relating to Carrier/` L building construction.I authorize representatives of this city or county to Polity BC�ir 7f"a3670Z Expires 31309 enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($10D)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑Icertify that in the performance of the work for which this permit is issued, �3 �YZ�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 I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply wit � wfA ions. Will the applicant or future building occupant handle hazardous material or 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 DYes c Wb 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($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY Dyes erNo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) o Yes ago OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I understand my requirements underthe State of Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item hazardous material reports g.$)(section 7031.5 � o No OO/ Business and Professions Code).Any city or county that requires a permit to s -No Date construct alter,improve,demolish or repair any structure,prior to its PROPERTY OWN—E—R Olt 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(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 Iicensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Seaton 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 properly owners and property than($SOOJ. managers who do the paint-disturbing work themselves or through their 01,as owner of the property,or my employee with wages as their sale 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.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of 0An 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-forthis pmjea because: 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. Ivilarli f6-' DATE: PERMIT/PLAN CHECK NUMBER I I� TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING 0 RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK Install one 200amp U/G temporary power pole for future construction trailer and productions at RSII''/s" "Camden Place" project, tract#37067. 1 Lvt- $' PROJECTADDRESS $b23 carw ea ZIP ASSESSOR'S PARCEL NUMBER V LOT TRACT#37067 OWNER NAME RSI COMMUNITIES ADDRESS 620 NEWPORT CENTER DR 12th FL, NEWPORT BEACH, CA 92660 PHONE 949-270-3628 EMAIL MIKEM@POWERPLUS.COM APPLICANT NAME Mike McGee ADDRESS PHONE 951-293-1333 EMAIL MIKEM@POWERPLUS.COM CONTRACTOR'S NAME OWNER BUILDER? O YES CNO BUSINESS NAME S.R. Bray LLC, dba PowerPlus ADDRESS 1210 N. Red Gum St,Anaheim, CA 92806 PHONE 714-765-7551 EMAIL CONTRACTOR'S STATE LIC NUMBER 980589 LICENSE CLASSIFICATION C10 VALUATION$ 500.00 SQ FT L SQ FT APPLICANT'S SIGNATURE DATE 3 '27-/J DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: PERMIT FEE 2ZO- �_ SMIP tt I GREEN 141 PLAN CHECK FEE INVOICETOTAL OWNER BUILDERVERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92589My-afAAEnlfee www.cityofinenifee.us Building Dept. MAR 2 7 2018 m -- --- - 00 f OD tA 3 rM tl b I{� H I of �6 v MIN � b f . , v orbowl � I !_ c, l.. t_ '.. ,] '��_-- '-- :�.; o IT I1 � Ll OFFICE COPY