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PMT18-01612 City of Menifee Permit No.: PMT18-01612 29714 HAUN RD. 'ACCEUh MENIFEE, CA 92586 Date Issued: 06/07/2018 Type: Commercial Addition MENIFEE PERMIT Site Address: 29035 DEL MONTE DR, MENIFEE, CA Parcel Number: 338-024-031 92586 Construction Cost: $6,500.00 Existing Use: Proposed Use: Description of ADD NEW PARKING LOT LIGHT ON POLE AT VALLEY CHURCH OF CHRIST Work: Owner Contractor VALLEY CHURCH OF CHRIST RHODES ELECTRIC INC 29035 DEL MONTE DR 29668 AVENIDA DE SERENO MENIFEE, CA 92586 MENIFEE, CA 92586 Applicant Phone:9517752132 DILLON RHODES License Number. 1020135 RHODES ELECTRIC INC 29668 AVENIDA DE SERENO MENIFEE, CA 92586 Fee Description city Amount r$1 Pole or Platform Mounted Fixtures 1 183.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 65 64.55 GREEN FEE 1 1.00 SMIP COMMERCIAL 1 2.00 General Plan Maintenance Fee-Electrical 1 9.15 $286.70 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 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_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. the following reason: License Class c^ 0 U/cen�e.No. O O 13 By my signature below I acknowledge that,except for my personal residence Expires 212 Signature/ 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 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 worker's 70"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 N,w„N,le iaf this permit is issued. ovc w.html. �1 CC PPo'licy# Date 1 - 1- have and will maintain worker's compensation insurance,as required by ROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work far which a 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 Carrier = UN l with all applicable city and county ordinances and state laws relating to br building construction.I authorize representatives of this city or county to Pali # Z Z 7 S Z cV c7 � Expires ` enter the ah identified property for inspection purposes. (This section need not to be completed Is the permit is dollars($100)or less for one-hundred - DateT�/ P PERTY OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of the work forwhich this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwitthhy�mply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant , Date / 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 C VERA E IS ayes js 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($100,0001,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 o Yes "o I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1DD0 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) D Yes VNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and 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 Contractor's 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 �haazardous material reporting. Business and Professions Code).Any city or county that requires a permit to _,T N Date 7 construct,alter,improve,demolish or repair any structure,prior to its pjy 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 Contractor's 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( I 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-SDD-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a a 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: a 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's 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 MENIFEE A' A.- DATE: 5 PERMIT/PLAN CHECK NUMBER PLANNING CASE NUMBER TYPE: Q COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION ELECTRICAL O MECHANICAL O NEW O PLUMBING J RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK j�l C iJ Iv ! 0'— ( A (a PROJECTADDRESS zCl �2�2�1Dr l /176,u-t- r D2 t _ ZIP ASSESSOR'S PARCEL NUMBER ✓JD O HOJ� LOT (00 TRACT p �� OWNER NAME VA if E- C Ue, I-A n 1= C' P 4f I S� ADDRESS Z cl Q`3 S V A- O •T- z PHONE ��p��/•, �7 EMAIL APPLICANT NAME �I��Uy.. /G up �� ADDRESS Z So c'C7 N+4n/ E IC STE 3 3 64 'F PHONE `3S' f-77� - ? I EMAIL l 1(f O� (��-IOl7i=. (tA- I • CONTRACTOR'S NAME O _ _ _ C AI �' , OWNER BUILDER? O YES �,INO BUSINESS NAME l C (.V ADDRESS Z 60 - w v ic- 3� vlu2 -T� 9ZSCnL PHONE �-/5 / - 7�S - 2/3 2 EMAIL CONTRACTOR'S STATE LIC NUMBER /O Z b /'7 LICENSE CLASSIFICATION VALUATION$ L SQ FT APPLICANT'S SIGNATURE -CJ - DATE L/ / CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICE TOTAL I GREEN SMIP OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofmenifee.us NIF �I a3 PERMIT NO. SITE PLAN NAME Valley Church Of Christ PHONE ((951) 679-1010 SITE ADDRESS 29035 Del Monte Dr of MpnifE-- ASSESSORS PARCEL NUMBER Building Dept. Provide North Arrow REAR PROPERTY LINE APR 0 9 2018 We T Received S , S I I D D E r+,�K � „ Hand Hole P " New Pole P E T Y LIM L CITY OF.MENIF 57 i BUILDINt AND SA DEPARTMENT I N PLAN APPUV ' f N E f E(It P 10 203 REVIEWED B O"� rPA, Cali I I eti= =1 IWATE 9 'Approval of these plans all not be con"s;nled to be a permd tor,or an ampoo e approvai of,any violation oflOy�rovisions of the federal,state or city regulations and ordinances. set of approved plans must be kept on the ` jc n;doempletian. ba e�I 000 d_•I pR ndlnd Pn 1 of 9