PMT15-02845 City of Menifee Permit No.: PMT15-02845
29714 HAUN RD. Type: Commercial Alteration
�CCF—OmZ MENIFEE, CA 92586
MENIFEE Date Issued: 10/13/2015
PERMIT
Site Address: 28115 BRADLEY RD, Suite#2, MENIFEE, Parcel Number: 337-302-015
CA 92586 Construction Cost: $0.00
Existing Use: Proposed Use:
Description of HOURLY INSPECTION FOR C OF O"H&R BLOCK'
Work:
Owner Contractor
DONALD HOBBS
2324 WALMAR LANE
SAN DIEGO, CA 92109
Applicant License Number.
MENIFEE,CA
Fee Description City Amount($1
Building Permit Issuance 1 27.00
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
forfeited.
AA_Bldg_Permit_Template.rpt Page 1 of 1
DATE I15��5 PERMIT NUMBER
BUSINESS NAME H&R Block( cTYPE OF BUSINESS Tax Prep Svcs
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ADDRESS ,T�\�S 1C0. �\� K C I �1C—mot �(� �C��� 4 o
NAME OF BUSINESSOWNER(S)_ HRB Tax Group Inc.
ADDRESS(IF DIFFERENT FROM ABOVE) AM Business License (6(_ One H & R Block Way
PHONE (816)759-0000-2 `Kansas City,
MOEM05 OCOEBuslinessLicen_cA_(Dhrhlnck com
-
OWNER OF BUILDING 7�'nCL,
ADDRESS c,/o ,k�c Q ' ),Q C,�z C
A
G a l09
PHONE EMAIL
DESCRIBE EXACT USE OF BUILDING: Tax Prep Svcs
PREVIOUS USE OF BUILDING/SUITE H&R Block Tax Prep Svcs
(� APPLICANT ACKNOWLEDGEMENT
Q Applicant agrees that the Certificate of Occupancy shall be posted in a conspicuous location,and will operate subject
t e City's' :an�0 , Certificate of Occupancy.
l l���� hereby agree to comply with the above-described terms in this
Application for Certificate of Occupancy.
Licensing & Tax Specialist DATE
nr{ APPLICANT
BUS LICENSE DATE ENGINEERING DATE
'6 BUS LIC.NUMBER FIRE DATE
PLANNING DATE EMWD DATE
HEALTH DEPT DATE BUILDING DATE
REMARKS
V
't- 3oa• s
ADDRESS \-\ `
BUSINESS NAME
INTENDED BUSINESS USE Tax Pmp-Svcs
IS THIS A NEW BUSINESS IN THE CITY OF MENIFEE? YES NO (CIRCLE ONE)
ARE YOU THE FIRST TENANT TO OCCUPY THIS SPACE? YES NO (CIRCLE ONE)
IS THE BUILDING EQUIPPED WITH FIRE SPRN KLERS? YES NO (CIRCLE ONE)
SQUARE FOOTAGE
NUMBER OF EMPLOYEES
NUMBER AND LOCATION OF RESTROOM FACILITIES
LISTANYTOXIC CHEMICALS, FLAMMABLE/COMBUSTIBLE LIQUIDS OR GASES USED OR STORED WITH
MSDS SHEETS AND QUANTITIES OF EACH BELOW OR ON A SEPARATE ATTACHED SHEET(S):
• ARE YOU MAKING ANY IMPROVEMENT TO THE SUITE OR BUILDING OTHER THAN PAINTING,
CCCJJJ PAPERING, FLOOR COVERING, MOVABLE CASES,SHELVING OR PARTITIONS NOT 05'9" HIGH?
YES NO (CIRCLE ONE)
S • APPLICANT SHALL OBTAIN ALL REQUIRED CLEARANCES AND/OR APPROVALS FROM THE
C APPROPRIATE WATER DISTRICT AND FIRE DEPARTMENT PRIOR TO ISSUANCE OF ANY
BUILDING PER ITS
�� SIGNATURE DATE
PRINT NAME tom,, � C,C_ Licensing & Tax Specialist
ct TENANT / OWNER / CONTRACTOR / ARCHITECT / ENGINEER (CIRCLE ONE)
FOR CITY STAFF PERMIT NUMBER
OCCUPANCY GRP TYPE OF CON ST STAFF INITIALS
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