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PMT18-04958 City of Menifee Permit No.: PMT18-04958 29714 HAUN RD. Type: Commercial Electrical j F MENIFEE, CA 92586 MENIFEE MENIFEE Date Issued: 10/31/2018 PERMIT Site Address: 29012 NEWPORT RD, MENIFEE, CA Parcel Number: 340-040-029 92584 Construction Cost: $5,000.00 Existing Use: Proposed Use: Description of INSTALL 1/2"CONDUIT FOR POWER TO NEW REACH IN COOLER AT AM/PM; NEW 30AMP Work: BREAKER IN PANEL Owner Contractor ANDREA SHREMELIS BRIGHT BULBS ELECTRIC CO INC 29012 NEWPORT RD 17915 RAMONA AVENUE MENIFEE, CA 92584 FONTANA, CA 92336 Applicant Phone: 9092323354 MELVIN CABALLERO License Number: 1004286 BRIGHT BULBS ELECTRIC CO INC 17915 RAMONA AVENUE FONTANA, CA 92336 Fee Description QQt rr Amount($j Receptacle, Switch, Outlet&Fixture 2 121.00 Building Permit Issuance 1 27.00 Inspections not specified 153 152.60 Additional Plan Review Building 153 152.60 GREEN FEE 1 1.00 General Plan Maintenance Fee-Electrical 1 6.05 $460.25 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 Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑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 Class License No. By my signature below I acknowledge that,except for my personal residence Expires 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 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 www.leginfo.ca.gov/calaw.html. this permit is issued. �7f� Polity# ( 3 T v� 1­6 l Date ❑I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT 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 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 I have provided is correct.I agree to comply �r C Carrier p�s� �`\ with all applicable city and county ordinances and state laws relating to —7.- building construction.I authorize representatives of this city or county to Policy# (3 i2 S_trb'70 7- Expires [ 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 employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's c py�rsati V provisions of Section 3700 of the Labor Code,I shall f2aWK4t with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant l Date / mixture containing a hazardous material equal to or greater that the amounts spp .cified on the Hazardous Materials Information Guide? WARNING:FAILURE TO 5 RE WORKER'S COMPENSATION COVERAGE IS ❑Yes efNo 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 for guidelines CONSTRUCTION LENDING AGENCY ❑Yes 77 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 a school? (Section 3097 Civil Code) ❑Yes &No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California He Ith&Safety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicated below by the hazardou ateria o g�� checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes Business and Professions Code).Any city or county that requires a permit to Date G / construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWMER OR UT IZED 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(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 o 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.epa.gov/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 Contractor's 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.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑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 Acknowledgement. f BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: 10/10 PERMIT/PLAN CHECK NUMBER f7NCt p " GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: ''' COMMERCIAL RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME ®POOL/SPA 0 SIGN SUBTYPE: (}ADDITION ;___'ALTERATION DEMOLITION E)ELECTRICAL ®MECHANICAL NEW DPLUMBING C'RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK Install 1/2" conduit for power to new reach in cooler at AM/PM; New breaker in panel. OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS r'YES C.NO PROJECT ADDRESS 29012 Newport Rd. ZIP92584 ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME Andrea Shremelis ADDRESS 29012 Newport Rd. PHONE 562-881-6185 EMAIL mrobinson@permitplace.com APPLICANT NAME Mike Robinson ADDRESS 13400 Riverside Dr. Suite 202, Sherman Oaks, CA 91423 PHONE 213-308-0674 EMAILmrobinson@permitplace.com CONTRACTOR'S NAME Melvin Caballero OWNER BUILDER? OYES(:-)NO BUSINESS NAME Bright Bulb Electric ADDRESS 29012 Newport Rd. PHONE 909-232-3354 EMAILJkassity@apeximagingservices.com CONTRACTOR'S STATE LIC NUMBER 1004286 LICENSE CLASSIFICATION C10 VALUATION$ 59000 SQ FT na L SQ FT APPLICANT'S SIGNATURE DATE 10/1 0 • DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS UCENNSE NUMBER BUILDING PLANNING ENGINEERING FIRE 1// INVOICE TOTAL 1 GREEN O� SMIP OWNER BUILDER VERIFIED =%YES NO DRIVERS LICENSE# , NOTARIZED LETTER YES NO City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-677 GSv o� city of Menifee wwwbtyofinenifee.us - Building Dept MENIFEE OCT 11 ��1� :