PMT14-02219 City of Menifee Permit No.: PMT14-02219
_ 29714 HAUN RD,
4:i R MENIFEE, CA 92586 Type: Commercial Alteration
s� smm�P MENIFEE Date Issued: 0 812 012 01 4
PERMIT
Site Address: 28069 BRADLEY RD, MENIFEE, CA Parcel Number: 337-302-009
92586 Construction Cost: $0.00
Existing Use: Proposed Use:
Description of HOURLY INSPECTION FOR CERTIFICATE OF OCCUPANCY FOR"IN A RUSH TAX SERVICES,
Work:
Owner Contractor
PRIME PARTNERS
29826 HAUN RD
MENIFEE, CA 92586
Applicant - -- - - - - - - -- - License Number: -
CA
Fee Description Otyt Amountiial f$1
Pe Issiaa- a 700
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 building operations being carried on thereunderwhen 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
Building & Safety Dept.
CITY OFMENIFEE PERMIT # AUG 2 Q 2M
BUILDING AND SAFETY DEPARTMENT �m11� (�`.�,�
M 29714 HAUN ROAD, MENIFEE, CA 92586 �
TELEPHONE:(951)672-6777 DATE: Received
APPLICATION FOR CERTIFICATE OF OCCUPANCY
PLEASE PRINT LEGIBLY OR TYPE
SECTION I-APPLICANT INFORMATION
ADDRESS WHERE BUSINESS WILL BE CONDUCTED:
moc,,q
NAME OF BUSINESS: TYPE OF BUSINESS:
Rush.iax ctevl Ti�>L P
NAME OF BUSINESS OWNER: BUSINESS PHONE:
1R71+A Q us °I S I- i 7,"N Z32
ADDRESS OF HOME OFFICE OF BUSINESS OWNER: PHONE:
(IF DIFFERENT FROM ABOVE)
330Mt N �.� d AIa x-_ 6swo(rc, CA o �I�l
OWNER OF BUILDING: PHONE:
� A)
ADDRESS: — es
9 Cl CV)If- C" STATE_: Z"I:
1 �S•o L2
DESCRIBE EXACT USE OF ALL PORTIONS OF EACH BUILDING AND LOT: C/J1
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 theCity's issuance of Certificate of Occupancy.
I, AA4_; "A- QvC VI,hereby agree to comply with the above-described terms in this Application for
(APPLICANT)
Certificate of
Occupar cy.
J vLI Zc)
(APPLICANT) (DAT )
FOR DEPARTMENTAL USE ONLY
PLANNING FIRE
ZONE:
APPROVED BY: DATE: APPROVED BY: DATE:
BUSINESS LICENSE PUBLIC WORKS/ENGINEERING
BUSINESS LICENSE#
APPROVED BY: DATE: APPROVED BY: DATE:
BUILDING DEPARTMENT �} EASTERN MUNICIPAL WATER DISTRICT
APPROVED BY: DATE: 047 APPROVED BY: DATE:
HEALTH DEPARTMENT
APPROVED BY: DATE:
REMARKS
CITY OF MENIFEE
NrF BUILDING AND SAFETY DEPARTMENT
Tenant Disclosure Form
PERMIT No. _��
Property Address SkI4� j e u
Street Name/Number Area/Co m nity _ zip code
BUSIneSS name: rJ (� �U(C
Suite name:
Occupancy group: 13
Square footage: 11Do S-;
Type of construction:
Is the building equipped with fire sprinklers mo
Number of Employees: I
Number and location of restroom facilities: a
List any chemicals used or stored and quantities: 'S2(
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? 1,40
Are you a new tenant? Ye-S
Are you the first tenant?
Plans Required:
e If you are not doing any work that requires a permit, please provide four copies of a
plot plan and a floor plan.
o If you are making other improvements, please see the Tenant Improvement Plan
Requirements handout.
�� Nt.p2il+rl �uSL� `5/2D It+
Signature Print Name Date
Circle On Ten>�/ Owner / Contractor / Architect / Engineer
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