PMT15-00876 I
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City of Menifee Permit No.: PMTIS-00876
29714 HAUN RD.
' - -A> MENIFEE, CA 92586 Type: Commercial Alteration
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MENIFEE Date Issued: 04/15/2016
I
PERMIT
Site Address: 27159 NEWPORT RD, MENIFEE, CA Parcel Number: 360-050-005
92584 Construction Cost: $500.00
Existing Use: Proposed Use:
Description of 8'x 14'TRAILER W/GENERATOR,W/11 PARKING STALLS, ONE ADA
Work: 1 HOURLY INSPECTION FOR SITE VERIFICATION
Owner Contractor
MICHAEL CLEARY
30746 EARLY ROUND DR
CANYON LAKE, CA 92587
Applicant License Number:
JULIA DONE
MENIFEE, CA
Fee Description QQrt Amount($1
�Bulldlna P�rmlf IssuanEe� 't;�� '.4'�`c`�;� �`�`� "`•"' � F � 1:�''`'^ '� � ��" `'^2i'd4'
Inspections not specified 129 129.07
$166.07
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
forfeited.
AA_Bldg_Permit_Template.rpt Page 1 of 1
1 City Of Menifee
LICENSED DECLARATION
N I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions Code and my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class License No. who builds or improves thereon, and who contracts for the projects with a
Expires Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors'Stale License Law for the
❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that, except for my personal residence in
compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. improvements covered by this permit, I cannot legally sell a structure that I have
Policy# built as an owner-building if it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
❑ 1 have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htto/Iwww.leoinfo.ca.gov/calaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier Property Owner or Authorized Agent Date
Expires Policy#
❑ By my Signature below, I certify to each of the following: I am the property
Name of Agent Phone# owner or authorized to act on the property owner's behalf. I have read this
(This section need not be completed if the permit is for application and the information I have provided is correct. I agree to comply
one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
El I certify that in the performance of the work for which this permit Is issued,I identified property for the inspection purposes.
shall not employ any persons in any manner so as to become subject to the //
workers' compensation laws of California, and agree that if I should become . `�1 '� H -I, l5
subject to the workers'compensation provisions of Section 3700 of the Labor Property Owner or Authorized Agent Date
;I Code,I shall forthwith comply with those provisions.
City Business License#
Date; Applicant;
WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
L COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION, OYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑NO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE?
agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address ❑NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reason(s)indicated below by the checkmark(s)I have placed DYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, ❑NO SCHOOL?
or repair any structure, prior to its 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 License Law(Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or OYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL 1)EPORtING.
compensation,will do( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
BUILDING & SAFETY PERMIT/.PERMIT/PLAN CHECK APPLICATION
4J4
�•fMenifee
DATE ,�7 �?j 5 PERMIT/PLAN CHECK NUMBER rkk-T
TYPE: ` COMMERCIAL []RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA []SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION []DEMOLITION []ELECTRICAL ❑MECHANICAL
N []NEW []PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 1/ 12, Sktal
Q.V 8 Glc7Yt YWA
,au\ iN 0
PROJECTADDRESS N L - I I Un CfZ
ASSESSOR'S PARCEL NUMBER }��1r7 �S� - 5 LOT TRACT 060
OWNER NAME I
ADDRESS 011,58
PHONE L(-1 , 2JItA - 111(o EMAIL
APPLICANT NAME ja ,wy'j
ADDRESS /j t3 C Gt
PHONEj'7. '72A (Q EMAIL
CONTRACTOR'S NAME G OWNERBUILDER? ❑YES❑NO
BUSINESS NAME City of Menifee
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUf•QBER LICENSE CLASSIFI
VALUATION$ b•4s SO FT L SO FT
APPLICANT'S SIGNATURE h DATE I"11
S
DEPARTMENT DISTRIBUTION CITYOF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT ;>CASH CHECK H .)CREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT CICASH OCHECKN OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES ') NO
City cf Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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For Official Use Onl
Project Number
Gl7Y Oti.
Date Received:
T1, C
Received By:
�rw1ENIFE�'
Case Planner:
V,
CITY OF MENIFEE
Community Development Department
TEMPORARY OUTDOOR EVENT SYNOPSIS
APPLICATION FOR A TEMPORARY OUTDOOR EVENT MUST BE MADE TO THE PLANNING
DEPARTMENT AT LEAST 60 DAYS PRIOR TO THE EVENT.
INCOMPLO-EAPPLIC477ONS WILL NOT BEACCEPTEO.
CASE NUMBER: " 1 �, DATE SUBMITTED:
$A
Type of Event: lY. 0 Sl �w I(0 ti m I (bi qs� i 1 Lw�"Iw ie4 11(X
Il,Pitr Ill u
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Applicant: < �I1/,f. 1
Event Location: \A 35eSsc�1 M_a 1 .0 iJ f/m t r
Assessor's Parcel Number: �21 pb I)F)p ' uo`j L1
Thomas Brothers map, edition year, page number, and coordinates: �/Z(�p L l Z
Date(s) of Proposed Event: 7� $� �, Uj 1221 15
Estimated Daily Attendance:
Hours of Operation: 1 D Do /1 1 Y) - In bt) am - �'Y>CSYI V(�
Number of On-Site Parking:
Please be advised to call ahead to the agencies listed. Depending on the address of the subject
property, you will be directed to the appropriate office of the Department in question for sign-off.
Sheriff's Department (951) 776-109995 Engineering Department (951) 672-6777
Health Department (951) 955-8980 Fire Department (951) 955-4777
29714 Haun Road
Menifee, California 92586
,_4J0 7( ) 672-6777 Fax (951)679-3843
of Menifee
APR I G 2014
Receiv- •
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CITY pF
MENIFEE
CITY OF MENIFEE
Community Development
Department
DATE: March 25, 2015
RE: Planning Application 2015-065 — Shaved Ice Stand on Newport Road- 360-
050-005
TO: Craig Carlson
Building and Safety
FROM: Tamara Harrison, Assistant Planner
Attached please find TOE 2015-065 for Building and Safety review and approval. Please note
that this is the same event as last year.
Project Description:
Temporary Outdoor Event No. 2015-065 proposes a temporary shaved ice stand to be located
on Newport Road, south of Newport Road, north of Swift Street, east of Bradley Road and west
of Haun Road. Road (APN: 360-050-005). The proposed hours of operation are from 10:00 a.m.
to 10:00 p.m. for a six month period.
The sale will consist of an 8' x 14' trailer to be located 21 feet from the front property line towards
the eastern side of the property, along with an ice merchandiser machine, 11 parking stalls (10
standard parking stalls and 1 ADA accessible parking stall) and one-8' x 4' sign with an overall
height of 8'.
Please provide me with your determination of completeness (review/comments and/or
conditions) by April 9, 2015.
Thanks
Tamara Harrison
1040�-, 6z