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PMT18-04550 City of Menifee Permit No.: PMT18-04550 j� 29714 HAUN RD.Alf MENIFEE, CA 92586 Type: Commercial Electrical MENIFEE MENIFEE Date Issued: 09/19/2018 PERMIT Site Address: 27851 SCOTT RD, MENIFEE, CA 92585 Parcel Number: 384-180-003 Construction Cost: $3,000.00 Existing Use: Proposed Use: Description of INSTALL ONE 100A O/H TEMP POWER POLE AND ONE 100A DISTRIBUTION PANEL TO PROVIDE Work: POWER TO A DOUBLE-WIDE CONSTRUCTION TRAILER "CIP PROJECT" Owner Contractor RIVERSIDE COUNTY TRANSPORTATION S R BRAY LLC DEPARTMENT 1210 N RED GUM STREET 3525 14TH STREET ANAHEIM, CA 92806 Applicant Phone:7145071881 MIKE MCGEE License Number:980589 S R BRAY LLC DBA POWERPLUS 1210 N RED GUM STREET ANAHEIM,CA 92806 Phone:7145071881 Fee Description My Amount ISI 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.rpl Page 1 of 1 CITY OF MENiFEE LICENSED DECLARATION property who builds or improves thereon,and who contacts for the projects hereby affirm under penalty of perjury that I am under provisions of ' with a licensed contrector(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 State License law for Professions Code and my license is in full force and effect. the following reason: License Class C/o License No. -7e6. j By my signature below l acknowledge that,except formypersonal residence Expires h/Aq Signature in which l must have resided for at least one year priorto 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 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 applimtion is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which wvnv.leeinfo.ca eav/calaw.html. this permit is issued. Policy it Date a'(have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work forwhich a 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 policy owner or authorized to act on the property owner's behalf.I have read this number are: application and the information 1 have provided is correct.I agree to comply Carrmr)_(= (ia� I'Vf &F— p/ *A1 with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy gGLY'7Ydi3a7oZ Expires 2/31 /11 enter the above identified property for Inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($300)or less PROPERTY OWNER OR AUTHORIZED AGENT to I certify that in the performance of the work for which this permit is issued, r Ishallnotemolov any persons in any mannerso as to become subject to the CITY BUSINESS LICENSE g �3 J y2r 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,l shall forthwith comply!w[ al visions. Will the applicant or future building occupant handle hazardous material or Applicant Date 9/1, //0p 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 COVERAGE IS to Yes E-mb UNLAWFUL,AND SHALLSUBIECTAN 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 requires permit for the construction or modification from South ADDITION TOTHE COST LABOR CODE,1INTERDAMA DATTOES AS ROVIDEDS Coast Air quality Management District(SCAQMD)7 See permitting checklist IN SECTION 37060FTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldeiines CONSTRUCTION LENDING AGENCY 0Yes 0140 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 a school? (Section 3097 Civil Code) 0 Yes 090 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that l am exempt from the permitting checklist.I understand my requirements under the State of Contractor's License Law for the mason(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 7032.5 hazardous material report' g. Business and Professions Code).Any city or county that requires a permit tos ❑No /)q/`� Date I issuance,construc also alter,Improve, applicansh t for hepermiany t to a signetsta 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING fRRPI 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 Cade)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.S 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 orthrough their or',as ownerof the property,or my employee with wages as theirsole 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 1-800424-LEAD(5323). ' Code;The Contractor's State License Law does not apply to an owner of a crAn 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. to No EPA Lead-Safe Certified Firm is required for this project because: 01,as owner of the property am ezclusfvely 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 A , ,I _ McSe-e' epp u er P II ,^ Acknowledgement.