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PMT18-02716 City of Menifee Permit No.: PMT18-02716 AV A 29714 HAUN RD. MENIFEE, CA 92586 Type: Commercial Electrical LEE MENIFEE Date Issued: 0 611 3/2 01 8 PERMIT Site Address: 29743 NEW HUB DR, MENIFEE,CA Parcel Number: 336-380-014 92586 Construction Cost $2,500.00 Existing Use: Proposed Use: Description of INSTALL 200A TEMP POWER POLE WITH 1 SERVICE POLE AND 6 SPAN POLES TO PROVIDE Work: POWER TO SMART&FINAL CONSTRUCTION Owner Contractor REGUS MCCOY S R BRAY LLC 31620 RAILROAD CANYON ROAD 1210 N RED GUM STREET CANYON LAKE,CA 92587 ANAHEIM, CA 92806 Applicant Phone:7145071881 VIC LUNA License Number: 980589 S R BRAY LLC DBA POWER PLUS 1210 N RED GUM STREET ANAHEIM,CA 92806 Fee Description Qtv Amount($1 Services, Switchboards, Control Centers&Panels 1 183.00 Building Permit Issuance 1 27.00 Administrative Fee 74 74.18 GREEN FEE 1 1.00 General Plan Maintenance Fee-Electrical 1 9A 5 $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 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 late). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect. 9 aJ��'�'/ _ the following reason: License Class/.d C r u /Jy// License No. - By my signature below I acknowledge that,except for my personal residence Expires Signature in which l must have resided for at least one year prior to 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: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 370D of the Labor Code,for the performance of work for which wtvW.leelnfo.ca.eov/calaw.html. this permit is iss Policy gr� Date , Fl ave and will maintain workers compensation Insurance,as required by PROPERTY OWNER OR AUTHORIZEDAGENT section 3700 of the Labor Code,for the performance of the work forwhich ❑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 numberare: application and the Informatlan I have provided is correct.I agree to comply Ly�y� pu�(r`L with all applicable city and county ordinances and state laws relating to Carrier At 3 , building construction.l authorize representatives of this city or county to A Policy tC a n)_17p Expires `.3/3 f//a 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 o I certify that in the performance of the work for which this permit is issued, I shall not emolov any persons in any mannerso as to become subject to the CITY BUSINESS LICENSE 9 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 tv ossee provisions. Will the applicant or future building occupant handle haEardous material or a Applicant Date mixture containing a hazardous material equal to orgreater that the amounts specified an the Hazardous Materials Information Guide? WARNING:FAILURE TO iC E WORKER'S COMPENSATION COVERAGE IS o Yes EN0 UNLAWFUL,ANDSHA BJECF 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 madiriation 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 �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 school? (Section 3097 Civil Code) Dyes .No 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 California Health&Safety Cade,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 oyes IGNo Business and Professions Code).Any city or county that requires a permit to Date/B-(6 .f � construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWN THORIZEDAGENT 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 RENOVAT ON.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 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 ❑1,as owner of the property,or my employee With wages as their sole employees.For mare information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is W WW.eoa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-8D0-424-LEAD(S323). 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.: i completion,the Owner-Builderwill 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 project because: o I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Caere: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 - AZAA Si DATE: 43 PERMIT/PLAN CHECK NUMBER City of Men' ee PLANNING CASE NUMBER Building Dejxt. TYPE: O COMMERCIAL O RESIDENTIAL 4 MULTI-FAMILY 0 MOBILE HOME O POOL/SPA SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK `Z� A / PROJECTADDRESS �a � ��a�1'1�r'('�� {2 ZIP ASSESSOR'S PARCEL NUMBER J ?2W 'O LOT TRACT OWNER NAME SUU4 /L ADDRESS L117 `z 'Tg ST �P_ C 264-3 PHONE EMAIL APPLICANT NAME C ADDRESS 8gD c/IJOG// PHONE Q ft `� 9Sl �S/ '' SbEMAIL CONTRACTOR'S NAME G�/L G.v OWNER BUILDER? O YES O NO BUSINESS NAME ADDRESS Z / /S� s -4 PHONE EMAIL CONTRACTOR'SSTATELICNUMBER 980SS / LICENSE CLASSIFICATION 15 VALUATION$ Z S0 G SQ FT L SO FT APPLICANT'S SIGNATUR /�� DATE r CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITYOF1YylENIFEE$U51�ICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE J�/`55 LL'IJJ1/o2 INVOICE TOTAL b,1C5 GREEN 1� SMIP x OWNER BUILDER VERIFIED OYES 0 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.cityofinenifee.us elf,I*�_ANI M� • � tj, r! I • I < I " ! Z-;1'-`-. III U 4:r M I A•. I � I I`-T I � 91 w IT s r ( � Vr r .. , Z 1;. CAI �. ylA-y F ''�' •.1 _ ,l. r