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PMT18-03538 City of Menifee Permit No.: PMT18-03538 29714 HAUN RD. j MENIFEE,CA 92586 Type: Commercial Electrical MENIFEE MENIFEE Date Issued: 08/0112018 PERMIT Site Address: 25920 LA PIEDRA RD, MENIFEE,CA Parcel Number: 92584 Construction Cost: $2,500.00 Existing Use: Proposed Use: Description of U/G TEMP POWER METER 200A Work: Owner Contractor MENIFEE-LA PIEDRA ROAD 29-L S R BRAY LLC 110 N LINCOLN AVE,#100 1210 N RED GUM STREET CORONA, CA 92882 ANAHEIM, CA 92806 Applicant Phone:7145071881 VIC LUNA License Number:980589 1210 N RED GUM STREET ANAHEIM, CA 92806 Phone:9512595656 Fee Description Oft Amount 1$) 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 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/O 031 Lic a 10. t o S g xj ��— By my signature below I acknowledge that,except for my personal residence Expires Z `L/ 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 www.leginfo.ra.gov/calaw.html. this permit is issued. Polity# Date PROPERTY OWNER OR AUTHORIZED AGENT ❑I have and will maintain workers compensation insurance,as required by 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 on the property owners behalf.I have read this number are: application and the information 1 have provided is correct.I agree to comply Carrier QG,O V/�U e with all applicable city and county ordinances and state laws relating to AA building construction.I authorize representatives of this city or county to Policy#7fJICW?i7ySI700 Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit i 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 If worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the wor r'compensation provisions of Section 3700 of the Labor Code,I shall fo 'fi com ly with those provisions. / ' Will the applicant or future building occupant handle hazardous material or a Applicant Date 7 Z a../ mixture containing a hazardous material equal to or greater that the amounts specs ed on the Hazardous Materials Information Guide? WARNING: AIL TO SECURE WORKER'S COMPENSATION COVERAGE IS O Yes o 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($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelin$s' CONSTRUCTION LENDING AGENCY ❑Yes oA6o I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 5000 feet of the lending agency for the performance of the work which this permit is issued outer bound of a school? (Section 3097 Civil Code) ❑Yes ❑ o 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 Contractors License Law for the reason(s)indicated below by the California Health&S fe4JCode,Section 25505 and 25534 concerning haz,;lydous materi 6rting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ❑ es ❑No ----77�� Business and Professions Cade).Any city or county that requires permitto Date Tv;; construct,alter,improve,demolish or repair any structure,prior to its PROPER O ER 0 THORIZED 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 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 mare 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( I 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-BOD-424-LEAD(5323). Code;The Contractors State License 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 RAP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: I� PERMIT/PLAN CHECK NUMBER �T GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: O COMMERCIAL O-RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN SUBTYPE: QADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL ONEWq� OPLUMBING ORE-ROOF NUMBER OFSQUARES /! DESCRIPTION OF WORK N s`Tf/}(iL 2`p(7 (/ Building Dept. OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERSOYEAUI©Nb 20�� PROJECTADDRESS La Y\PdY2Q ZIP ASSESSOR'S PARCEL NUMBER / LOT nn TRACT OWNER NAME (� — !�(� /� (Zt�A� 2 "- ADDRESS �j L �/ /U ©O 65Imo)/)-- Z TS PHONE �cJ / 5477 �� /� EMAIL APPLICANTNAME (T �l�-- ADDRESS 1%?c) S PHONE qS j -Zo 5 9 EMAIL CONTRACTOR'S NAME ,Cj OWNERBUILDER? OYESONO BUSINESS NAME ADDRESS a SO IS G C)YJ 2-577 PHONE qS1 6 57 0Cf 31 EMAIL CONTRACTOR'S STATE LIC NUMBER C/ Sg� LICENSE CLASSIFICATION Q VALUATION$ GS OO SQ FT L SO FT ^7 APPLICANT'S SIGNATURE DATE ��/ CITYSTAFFUSE ONLY MOM DEPARiMENTDISTRIBUTION ACCEPTED BY: CITYOF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICETOTAL GREEN 1� SMIP OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES 0 NO City of Menifee Building &Safety Department 129714 Haun Rd., Menifee,CA 92586 (951)672-6777 www.cityofmenifee.us IENIFE 7 � A N Oq + -0 'D 'U 'O 'O -O 'a V 'O p Fi N N m N N m N . LA m 0 T In to W In A N A A Z or N W N � 9 CG � � •ra I �j' �y- � N 3 O` Z y y fo ' L o 04 00 tj v 014 Z m n DUI m wt ° �o � co D I N C CA v GtnLp tvaa v CD W c? D >� _ CD A < 0 CL cn OFFICF MPV