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PMT15-03038 City of Menifee Permit No.: PMT15-03038 29714 HAUN RD. Type: Commercial Alteration -9 CCELA—. MENIFEE,CA 92586 MENIFEE Date Issued: 10/01/2015 PERMIT Site Address: 28125 BRADLEY RD, Suite#260, Parcel Number: 337-302-022 MENIFEE, CA 92586 Construction Cost $0.00 Existing Use: Proposed Use: Description of HOURLY INSPECTION FOR CERT OF OCC"MENIFEE VALLEY CARDIOLOGY, INC" Work: Owner Contractor BRADLEY MEDICAL ASSOCIATION 445 SOUTH D STREET PERRIS, CA 92570 Applicant License Number: MENIFEE,CA Fee Description (1.yl Amount ISI Building,Permit lssuance _ 1 27.00 Inspections not specified 129 129.07 $166.07 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA_Bldg_PermitTemplate.rpt Page 1 of 1 CERTIFICATE OF OCCUPANCY APPLICATION Menifee DATE PERMIT NUMBER BUSINESS NAME EtuIFECyA4.EyCA4ZDIoC-o '-_1Nc , TYPE OF BUSINESS a>6e--T0A5 OFF(cE ADDRESS oti$IoLS l7(LFDtGy �D Surfr �60 SuN C' «y CA 9a58ti NAME OF BUSINESS OWNER(S) 1-�uw Fty u N. • GHQ U 2G-S Ftl ADDRESS(IF DIFFERENT FROM ABOVE) �A ME LAs A GoJ PHONE r`151 666 - >c�C:3 EMAIL q/ � ( tlL� cil�AH4o. co>� OWNER OF BUILDINGn Building & Safety Dept. ept ADDRESS 4 ct ri- �56(U2t-H rD 5'rfzai-27-r A 9 a o OCT 0 1 2015 PHONE �9Sl�s�l-�(�93 �MaKAscR��'AR,aa� EMAIL ' _ d DESCRIBE EXACT USE OF BUILDING: MC--V(CAV ©'F'FIcc- U,3C- J+ H S � ss 't'rfir lREADMIL) �(RCN(MF_ Qo2'`P-6Lr-- r--CR0 - MP1 e(-tluaLy V&(Z�Tft 6 La IFK aI+(f4 '�-�Arn(ttcN� !� (3lGS j Gl-6�(2S LFt.I'� �x�rPu'TC2s 'E is PREVIOUS USE OF BUILDING/SUITE APPLICANT ACKNOWLEDGEMENT Applicant agrees that the Certificate of Occupancy shall be posted in a conspicuous location, and will operate subject to the City's issuance of the Certificate of Occupancy. I,k ttAMLt(llal , 1. LA(2C6H 1 M-n . hereby agree to comply with the above-described terms in this Application for Certificate of Occupancy. DATE <� APPLICANT CITY STAFF USE ONLY . DATE WAPPROVED) BUS LICENSE DATE ENGINEERING DATE BUS LIC.NUMBER FIRE DATE PLANNING DATE EMWD DATE HEALTH DEPT DATE BUILDING DATE REMARKS City of Menifee Building&Safety Department 29714 Naun Rd. Menifee, CA 92586 951-572-6777 www.cityofinenifee.us Inspection Request Line r � , p a• t�C]ERTIFICATE OF OCCUPANCY TENANT DISCLOSURE FORM a \�, �w"�_ Menifee DATE 30 o2a inn� PERMITNUMBER ADDRESS oI-D A-5— iJP-PoDCEy (Z1M 9LktTC a60 SLAN y 0A BUSINESS NAME M15N( - - vptt� �PtFZ��oto�y �� INTENDED BUSINESS USE M Gib i C A L ©j=V7i C G IS THIS A NEW BUSINESS IN THE CITY OF MENIFEE? YES NO (CIRCLE ONE) ARE YOU THE FIRST TENANT TO OCCUPY THIS SPACE? YES <P (CIRCLE ONE) IS THE BUILDING EQUIPPED WITH FIRE SPRINKLERS? kcrto(iYES NO (CIRCLE ONE) SQUARE FOOTAGE 1` 0 0 S P V#Z0 NUMBER OF EMPLOYEES N o o C NUMBER AND LOCATION OF RESTROOM FACILITIES N `hut fC LIST ANY TOXIC 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, PAPERING, FLOOR COVERING, MOVABLE CASES,SHELVING OR PARTITIONS NOT OVER 5' 9" HIGH? YES NO (CIRCLE ONE) • APPLICANT SHALL OBTAIN ALL REQUIRED CLEARANCES AND/OR APPROVALS FROM THE APPROPRIATE WATER DISTRICT AND FIRE DEPARTMENT PRIOR TO ISSUANCE OF ANY BUILDING PERMITS SIGNATURE DATE •�� �S PRINTNAME A-�UTnPt -?O ttA \ � u\`��N--V\ Mic) TENANT / OWNER / CONTRACTOR / ARCHITECT / ENGINEER (CIRCLE ONE) CITY STAFF USE ONLY OCCUPANCY GRP TYPE OF CONST STAFF INITIALS City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityoffi7enifee.us Inspection Request Line 951-246-62I3