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PMT18-04172 City of Menifee Permit No.: PMT18-04172 29714 HAUN RD. 'r MENIFEE, CA 92586 Type: Commercial Electrical MENIFEE MENIFEE Date Issued: 09/06/2018 PERMIT Site Address: 30098 ANDALUCIA WAY, MENIFEE, CA Parcel Number: 92584 Construction Cost: $2.500.00 Existing Use: Proposed Use: Description of INSTALL 200A TEMP U/G METER FOR PRODUCTION Work: Owner Contractor BROOKFIELD HOMES S R BRAY LLC 3200 PARK CENTER DRIVE#100 1210 N RED GUM STREET COSTA MESA, CA 92626 ANAHEIM, CA 92806 Applicant Phone:7145071881 VIC LUNA License Number: 980589 S R BRAY LLC DBA POWERPLUS 1210 N RED GUM STREET ANAHEIM, CA 92806 Fee Description OQt Amount($I 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_Pemmit_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 o I am exempt from licensure under the Contractor's Stale License Law for Professions Code and my license is in full force and effect. the fallowing reason: License Class 'A G/o JP 31 Ul;. a Na. q 0"S Fj By my signature below l acknowledge that,except for my personal residence Expires 2 Z/ I Signatur€/ in which l 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 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 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 website: by Section 3700 of the Labor Code,for the performance of work for which ,H,�,ty.leeinfo.ca.eov/calaw.html. this permit is issued. Policy# Date o I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 370D of the Labor Code,for the performance of the work for which o By my signature below l certify to each of the following:I am the property this permit is Issued.My worker's compensation insurance carrier and polity owner or authorized to act on the property owner's behalf.I have read this number are: n application and the information I have provided is correct I agree to comply Carrier �G f2[�-Pd6Li L with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# /GcV3�i/�/expires 3 enter the above identified property for inspection purposes. (This section need not to be completed is the permit is fop ne-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, �GI_"4U�5G. I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# D .J worker's compensatio ws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the wor is ampensation provisions of Section 3700 of the Lab r Code,I shall fa wit comply wit those provisions. C, Will the applicant or future building occupant handle hazardous material or Applicant Date if /S mixture containing a hazardous material equal to or greater that the amounts sp��"fied on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVE GEIS oYes X. 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 IN SECTIODITION N 3 THE COST OF COMPENSATION,CODE,INTEREST, DAMADATTOGES AS ROVIOED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 37060�THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forgufdel" CONSTRUCTION LENDING AGENCY ❑Yes czNo 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�y of a school? (Section 3097 Civil Code) o Yes oNo 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 Heal! Safety Cade,Section 25505 and 25534 concerning has ous n) eY I reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es o Business and Professions Code).Any city or county that requires a permit to idlDate construct,alter,Improve,demolish or repair any structure,prior to its p PERTY NER OR THORIZED AGENTIssuance,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 g 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( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-80"24-LEAD(5323). Code;The Contmctofs State License Law does not apply to an owner of ❑pn 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 for this project 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 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 .I• p u,� p rA p`r. /\ Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: zj �� PERMIT/PLAN CHECK NUMBER - Q GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: O COMMERCIAL O RESIDENTIAL (E)MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: (E)ADDITION O ALTERATION O DEMOLITION O ELECTRICAL () MECHANICAL ()NEW,.�-,()PLUMBING ORE-ROOF NUMBER OF SQUARES / DESCRIPTION OF WORK `%�/�I//d'� Pi/Y�i� -Zvo �d U OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS®4SSlfy f�enifee up . PROJECTADDRESS ZIP ��pp ASSESSOR'S PARCEL NUMBER / LOT TRACT U'l OWNER NAME /�Cf ,ryee ADDRESS Z O C U X / OC7 PHONE EMAIL J APPLICANT NAME /Y� N l G ADDRESS PHONE //'' po6�S� EMAIL CONTRACTOR'S NAME s�7/r�` G�/S OWNER BUILDER? OYESONO BUSINESS NAME�7 ADDRESS G 7� PHONE t,/,g7 EMAIL CONTRACTOR'S STATE LIC NUMBER jgy( L6!7 LICENSE CLASSIFICATION VALUATIONS . D O sQ FT L SO FT V '- APPLICANT DATE d 2� CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE LA-M INVOICETOTAL d, GREEN SMIP �^ V OWNER BUILDER VERIFIED OYES 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.cityofm en i fee.us NI I . o _ pp ee \1 © m it m �� 1I low m o v c .. S m' - m5 � m o• m ull� �n • a �i�11�1111■1■1■111 111111111111I■1■11�1 . 9111Y� I I� I ��II .. �� ■1■IIII