PMT15-01791 i
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City of Menifee Permit No.: PMTIS-01791
29714 HAUN RD.
CC'EL.. MENIFEE, CA 92586 Type: Commercial Alteration
MENIFEE Date Issued: 09/01/2015 i
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PERMIT
Site Address: 29966 HAUN RD, Suite#B&C, MENIFEE, Parcel Number: 336-380-003
CA 92586 Construction Cost: $10Q016,20
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Existing Use: Proposed Use:
Description of TENANT IMPROVEMENT FOR NAIL BAR 2203 SO FT
Work:
Owner Contractor
HAN PHAN KING DAVID AND JONATHAN
10511 SCHOONER AVE 5415 NEWCASTLE AVENUE#40
GARDEN GROVE, CA 92843 ENCINO, CA 91316
Applicant Phone: 8184702749
HAN PHAN License Number: 985906
HAN PHAN
10511 SCHOONER AVE
GARDEN GROVE, CA 92843
Phone:4344665732
Fee Description Qtv Amount I$1
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Services, Switchboards, Control Centers&Panels 1 183.00
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Plumbing Fixtures and Vents, fixtures 12 161.00
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Sewer 1 150.00
Reinspections 129 129.07
GREEN FEE 1 4.00
New Construction Permit Fee 1 460.07
$2,556.14
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.
CONDITIONS
Condition Comment
1 FIRE APPROVAL REQUIRED
2 CF1R WATRE HTR REQ'D
AA_aldg_Permit Template.rpt Page 1 of 1
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City Of Menifee
LICENSED DECLARATIO„iV. ❑ I am exempt from licensors underthe Contractors'State License Law fertile I'
I hereby affirm under penalty or perjury that I am licensed under provisions of following reason;
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Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that,except for my personal residence In
Professions Code an. my license is in full force and efts ,�� which I must have molded far at least one year prior to completion of
Ucense Glass Llrstisa V t J _.. Improvements covered by this permit,I cannot legally sell a structure that I have
Expires,_ -_ Signature <7y^„✓" built as an owner-buildfng if It has not been constructed In HE entirety by licensed
contractors. I understand that a copy of the npplicable law,Section 7044 of the
WOR„EERS�jTIC7N DECLARA-PION Business and Professions Code,is available upon request when this application is
submitted or at the following Web ails:
III hereby affirm under penalty of to of c one of the following our workers; �I
I have and will maintain a certificate of oonssnt of sn • our fur wori<o�rs' hl}:lwwwi=l Into,,-ca yevlcalaw ht0l). 1
compensation,Issued by the Director of Industrial Relations as provided for by Data i
Section 3700 of the Labor Code, for the performance of work for Which this -- - -----
permit Is issued. Property Owner or Authorized Agent
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__. . _Policy#�-_____ -...r ❑ By my Signature below, I gadfly to each of the fallowing;I am the property
d I have and will maintain workers'compensation Insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
section 3700 of the Labor Code, for the performance of the work for which this application and tine Information I have pravided Is corract. I again to comply
pormltle issued,Mywodmrs''c7a�mnPaninfle insurance caroler and policy number are, with all applicable city and county ordinances and state law%rotating to building
T � .! 001saulcllon.I authorize rapresantativss of this city or cpunly,to enter the above j
Canter T 000 Identified property for the Inspection purposes. !
Policy# —ElOres 1.
Property Owner or Authorized Agent
(This section need ElW be completed If the permit Is for I
one-hundred dollars($100)or less) City Business LicenseLAZ
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0I certify that In the performance of the work for which this permit Is Issued, h ,J\RDOUB MA'TERiAL.DHCLA4xATiON
shall flohr:7n.Lr2Y any persons In any manner so as to become subject to the WIII the appilcant or future building occupant handle hazardous material or a
workers'compensation laws of California,and agree that If I should beacons mixture containing a hazardous material equal to or greaterthat the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide?
Code,I shall forthwith comply with those provisions. ❑YES D NO
Applicant; VYr->'t "f"'& ('Date;- ...1..�e WIII the Intended use of the building by the applicant oriuhne building
occupant require a peril for the construction or modification from South
1N. RN17,{}i.Q; FAILURE TO SECURE WORKERS' Coast Air Quality Managament District(SCAQM D)?Sae permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES ❑NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000DAMAGES IAS PROVOIDRD FOR IN TOTHE
SEC 370E OF OTION HE boundary school?l the nrof Icy or modified facility be within 1000 fast of the outer
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES ❑NO
COMSTRTION LENDING AGE�1 ,Cy, I have read the Hazardous Materlal Information Guide and the SCAQMD
I hereby offlrt that under the penally of perjury there Is a construction lending permitting checklist,I understand my requirements under file State of
agency for the performance of file work which this permit Is Issued (Section Califarnla Health&Safety Code,Section 25605 and 25534 concerning
3007.Civil Cade) hazardous material reporting.
C3WNL-""RBUI6P_F_RD ,ARATIONS. DYES ONO
I hereby affirm under penalty of perjury that I am exempt from the Comracfor'e
License Law for the rencon(s)Indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable Item(s)(Sectlon 7031.5.Business and Professions Code;
Any city or county that requires a permit to construct,alter,Improve,demolish, EPA RENOVQ7'IDN,REPAf,R ANtI PAIN -C''_(fift
or repair any sffuctul%prior id its issuance,also Mucking tha applionm for the,
permit to no a u'ignell statement that he or she Is husband pursuant to Ins The EPA Renovation,Repair and Paining(RRP)Rule routines contractors
provisions of the Contractor's State Licorice Law(Chapter 0 (commouchig with receiving compensation for must work(hail disturbspaintin a pro-I978
Section 7000)of Divlsion 3 of the Business and Professions Cads)or that Inc or realden'cs or chfkteare facility to he RRP-cerllged firms and comply with
she is oaempt from Iluehopra and too basic for the ullogod oxamplfan. (arty niquivd pratkices,This htoludas rdntat property owners and property
violation of Socten 7031,0 by soy Applicant for a permit smnjeets the applicant to manager who do the palmroffsnrbing work themselves or through their
a civil penalty of not more than'($500).) amproYtios,For ounce burnmoborr about EPRs Renovator Program visit;Ll -
www.epa.govllead or contact Ilia National Land Infortuatlon Center at
I, n owner of the property, or )p sting of h with wands as their sale 1-600-424•LEAD(6323),
compensation,will do( )all of or( )porting of the work,and the structure is
not alanded or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law dogs not apply to art aglow of a proparty D An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through empknyeee or parsnnei effort, builds or Improvos the properly,
provided that dnc 5nprevalnants are not Mtended or oteroil for refs.If,bowevu, Certified Firm Name:
11'I0,building Or hnmpliiysrnnn(IS sold within ripe year of wripiofiom (lie:Owner- - --
Urdl(ar wilt have the burden or pawing Bitat It was not hulk urImproved for Ilia Firm Certification No.;
purposel of sago). F
0 1, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Cartlfed Firm is required for this project because: I
contractors to construct the project(Section 7044,Business and Professions
Coda;Tha Contractor's License Lew does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a --- -- �"-�_—
licensed conu action(s)pursuant to the Contractors State License Law)- If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.