PMT18-02102 City of Menefee Permit No.: PMT18-02102
29714 HAUN RD.
MENIFEE,CA 92586 Type: Commercial Electrical
MENIFEE MENIFEE Date Issued: 0 611 512 01 8
PERMIT
Site Address: 27772 ZEIDERS RD, MENIFEE, CA 92584 Parcel Number: 384-180-044
Construction Cost: $1,000.00
Existing Use: Proposed Use:
Description of TEMP POWER POLE 200A
Work:
Owner contractor
OLTMANS CONSTRUCTION UNITED SITE SERVICES OF CALIFORNIA INC
10005 MISSION MILLS ROAD 118 FLANDERS ROAD SUITE 1000
WHITTIER, CA 90601 WESTBOROUGH, MA 01581
Applicant Phone: 5085942634
STEVEN SCHNIERER License Number:873553
UNITED SITE SERVICES OF CALIFORNIA INC
118 FLANDERS ROAD SUITE 1000
WESTBOROUGH, CA
Phone:8187357876
Fee Description Qy Amount ISI
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 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_Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
• LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that 1 am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Cl ss G)O License No. �� 3 By my signature below I acknowledge that,except for my personal residence
Expires Z" Zc� 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 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 wwwleginfo.ca.gov/calaw.htmi.
this permit is issued.
Policy 8 Date
I have and will maintain workers compensation insurance,as required by APP'ERTYOWNER OR AUTHORIZED AGENTAon 3700 of the Labor Code,for the performance of the work for whichy signaturebelow 1 certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and polity or authorized to act on the property owners behalf.I have read this
number arse:^ n ` f'� application and the information I have provided is correct.I agree to comply
Carrier 4:-Fe`�- N0.T101'�0.I l_u:S�,a��-u with all applicable city and county ordinances and state laws relating to
`{ building construction.I authorize representatives of this city or county to
Policy R LD s 4 tY1l3-)O Expires -11I 3'I S' enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred ^_te 4
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
n 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 8
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 f�hw=th comply with those provisions. Will the applicant or future building occupant handle hazardous material or
Applicant CJv'✓- --Bate- 151118 mixture containing a hazardous material equal to or greater that the
amounts ss cified on the Hazardous Materials Information Guide?
WARNING!FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yev�s N,
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($500,000),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(SCAQMDI?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidleliges
CONSTRUCTION LENDING AGENCY D Yes/gyp 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 boun ary of a school?
(Section 3097 Civil Cade) o Yes o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
1 hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I understand my requirements under the State of
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
Business and Professions Code).Any city or county that requires a permit to 60 _�� meaty
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 MRP)
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 7032.5 by residence or childcare facility to be RRP-certifted 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
D 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.aov/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 Ucense Law does not apply to an owner of 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. D No EPA Lead-Safe Certified Firm is required for this project because:
D 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 05/02/2018 PERMIT/PLAN CHECK NUMBER m'"N '
TYPE: ❑COMMERCIAL []RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA []SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION [Z]ELECTRICAL [-]MECHANICAL
❑NEW ❑PLUMBING FIRE-ROOF-NUMBEROFSQUARES
_ 6ity of Menifee
DESCRIPTION OF WORK 200 AMP temporary power pole Building Dept.
PROJECTADDRESS 27750 Zeiders Road
ASSESSOR'S PARCEL NUMBER LOT TRACT Receive
OWNER NAME Oltmans Construction
ADDRESS 10005 Mission Mills Road,Whittier,CA 90601
PHONE (562)948-4242 EMAIL
APPLICANT NAME Steven Schnierer
ADDRESS 31225 La Baya Drive Suite 213 Westlake Village, CA 91362
PHONE (818)735-7876 EMAIL swschnierer@roadrunner.com
CONTRACTOR'S NAME United Site Services of California Inc. OWNER BUILDER? ❑YESQNO
BUSINESS NAME United Site Services of California
ADDRESS 118 Flanders Road Suite 1000,Westborough,MA 01581
PHONE (508)594-2634 EMAIL
CONTRACTOR'S STATE LIC NUMBER 873553 LICENSE CLASSIFICATION C10
VALUATION$ $1,000.00 SO.FT L SQ FT
APPLICANT'S SIGNATURE DATE 05/02/2018
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN F SMIP
INVOICE PAID AMOUNT AMOUNT I I OCASH `CHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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PLAN APPROVAL
REVIEtil1!ED R Y 112018
DATE
*Approval of these plans shall not be construed to he a perrna tor,or an
n approval of,any violation of any provisions of the federal,state or city
I ' l ✓✓�� I i!41ations and ordinances. This set of approved plans must be kept on the
jolbsite until completion.
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