PMT14-01916 i
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City of Menifee Permit No.: PMT14-01916
29714 HAUN RD,
'WCCEI-1 MENIFEE, CA 92586 Type: Commercial Alteration
cmxnw Ult,.o MENIFEE Date Issued: 07/23/2014 I
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PERMIT
Site Address: 27134 SHADEL RD, MENIFEE, CA 92586 Parcel Number: 333-030-009
Construction Cost: $0.00
Existing Use: Proposed Use: Retail
Description of HOURLY INSPECTION FOR CERTIFICATE OF OCCUPANCY FOR"SPEEDY'S SMOKE SHOP'
Work:
Owner Contractor
THE FLEMING FAMILY LIMITED PARNTERSHIP
16255 VENTURA BLVD#420
ENCINO, CA 91436
Applicant License Number:
MENIFEE, CA
Fee Description Qtv Amount f$1
Inspections not specified 129 129.07
$156.07
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
j forfeited.
AA_Sldg_Permit_Template.rpt Page 1 of 1
4+� CITY OF MENIFEE PERMIT # PM71L�- (7I19I to
BUILDING AND SAFETY DEPARTMENT
NIF 29714 HAUN ROAD, MENIFEE, CA 92586
TELEPHONE: (951)672-6777 DATE: [3uilding & Safety City of Safety
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Dept.
APPLICATION FOR CERTIFICATE OF OCCUPANCY JUL 2 3 2014
PLEASE PRINTLEGIBLY OR TYPE Received
SECTION I—APPLICANT INFORMATION
ADDRESS WHERE BUSINESS WILL BE CONDUCTED:
a3N Sha e1 1M e4aee, a
NAME OF BUSINESS: ho TYPEOF USINESS:
,S 'OV oS el/ _ 2_ - i
k(, S&r-
NAM OF BUSINESS OWNER: BUSINESS PHONE:
n
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ADDRESS OF HOME OFFICE OF BUSINESS OWNER: PHONE: ? p
(IF DIFFERENT FROM ABOVE) S 3 Q y)T
OWN R OF BUILDING: ✓0 PHONE:
�l� 1 P?.O- �je✓e,/I WD l( {2 I M"I`J� Sl-6 9 Zo v
ADDRESS' CITY: J7 S ATE: ZIP:
>� SAC►' 9 FIFO/
DESCRIBE EXACT USE OF ALL P RTIONS OF EACH BUILDING AND LOT:
PREVIOUS USE OF BUILDING:
SECTION 2—APPLICANT DUTIES
1. Applicant agrees to ensure that the Certificate of Occupancy shall be posted in all businesses, which will
operate subject to the City's issuance of Certificate of Occupancy.
hereby agree to comply with the above-described terms in this Application for
(APPLICANT)
CerUficat f Occup ncy.
i�� 7�- Z 3
(APPLICANT) (DATE)
FOR DEPARTMENTAL USE ONLY
PLANNING FIRE
ZONE: e`P S
APPROVED BY: DATE: 7 2 3 / APPROVED BY: DATE:
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BUSINESS LICENSE PUBLIC WORKS/ENGINEERING
BUSINESS LICENS O 3-7"7 I-
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APPROVED BY: DATE: B'�'i' APPROVED BY: °J I DATE:
BUILDING DEPARTM NT EASTERN MUNICIPAL WATER DISTRICT
APPROVED BY: DATE:
APPROVED BY: j 'y� DATE:
HEALTH DEPARTMENT
APPROVED BY: DATE:
REMARKS
CITY OF MENIFEE
NI BUILDING AND SAFETY DEPARTMENT
y.
Tenant Disclosure Form
PERMIT No.
Property Address .9
Street Name/Number Area/Community zip code
Business name: 5hiot-
Suite name:
Occupancy group:
Square footage: /xm -ce
Type of construction: �A�F '
Is the building equipped with fire sprinklers
Number of Employees:
Number and location of restroom facilities: )
List any chemicals used or stored and quantities:
Are you making any improvements to the suite or building other than
painting, papering, floor covering, movable cases, counters or
partitions not over 5 feet 9 inches high? /JO
Are you a new tenant? 5
Are you the first tenant? n� U
Plans Required:
•If you are not doing any work that requires a permit, please provide four copies of a
plot plan and a floor plan.
♦If you are making other improvements, please see the Tenant Improvement Plan
Requirements handout.
Signature Print Name Date
Circle OneoTenant Owner / Contractor / Architect / Engineer
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