PMT15-03323 City of Menifee Permit No.: PMT15-03323
29714 HAUN RD.
�ACCELA..' MENIFEE, CA 92586 Type: Commercial Alteration
MENIFEE Date Issued: 10/27/2015
PERMIT
Site Address: 28125 BRADLEY RD, Suite#180, Parcel Number: 337-302-022
MENIFEE, CA 92586 Construction Cost: $0.00
Existing Use: Proposed Use:
Description of HOURLY INSPECTION FOR C OF O"GHH MINISTRIES"
Work:
Owner Contractor
BRADLEY MEDICAL ASSOCIATES
445 SOUTH D STREET
PERRIS, CA 92570
Applicant License Number:
MENIFEE, CA
Fee Description ON Amount($)
Building Permit Issuance 1 27.00
Inspections not specified 129 129.07
$156.07
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_Bldg_Pennit_Template.rpt Page 1 of 1
CERTIFICAT OF OCCUPANCY APPLICATION
Building & Safety Dept.
l I1_
_ �11 {tom
,, ,R." OCT 2 7 2015
S 3�
m - p_ "Menifee OCT 2015
/ Received p
DATE 101(0 ��1 PERMIT NUMBER Paf,#
BUSINESS NAMES IfI,,.,".f1T\1� TYPE OF BUSINESS
ADDRESS AeIa5 &tCtJ! • , �14• S-If, mo Nk{nl e , CA g2.s$�p
NAME OF BUSINESS OWNER(S) 46ciriand g • E-Agt t7 htet�,Jr. cceD /Pba a Tizm C5cc-.)
ADDRESS(IF DIFFERENT FROM ABOVE) -<Vh
PHONE a5I) (0'ICI-L[6(o I-y EMAIL v1 "��,�IhhMiri�s`l Yi�i .C�vt
OWNER OF BUILDING LJOI'1Y1 MOtt-V / RACY Medical A-CC06gicC
ADDRESS L- 4S Sn4+Vi D 9+. PCwi S r CA- gas-'0
PHONE °ISi) (097^gSq`f EMAIL
DESCRIBE EXACT USE OF BUILDING: Oho W1ce Cw(ir a 10IVty Y-syskm of Of HCCL
�.tx►�n•IIy o tucleY' ar, e�ciS-I-i b. I�ce�s+e'iJ fvr'the soles
�hos?i crE da 8lrrty� book�kje'rf°�p�r�
PREVIOUS USE OF BUILDING/SUITE ��1Cq� V►►
APPLICANT ACKNOWLEDGEMENT
Applicant agrees that the Certificate of Occupancy shall be posted in a conspicuous location, and will operate subject
to the , is
Cittyy'ss issuance of the Certificate of Occupancy.
th
I, al Troy il . hereby agree to comply with the above-described terms in this
Application ertif a of Occupancy.
7 DATE )0I(oIts"
uCANT
CITYSTAFFUSEGINLY (PLEASE SIGN AND DATE
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 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line
OCCUPANCYCERTIFICATE OF O•
'Menifee
DATE DATE lo�bf�s PERMIT NUMBERPef 'As- 15-09-03
ADDRESS a($laS GVd . i• MPhi�ecf Ga%fo
BUSINESS NAME Mbr%!!;:y, CS
INTENDED BUSINESS USE Wh—Pl�-1 MUt�
IS THIS A NEW BUSINESS IN THE CITY OF MENIFEE? YES NO ? (CIRCLE ONE)
ARE YOU THE FIRST TENANTTO OCCUPYTHIS SPACE? YES (CIRCLE ONE)
IS THE BUILDING EQUIPPED WITH FIRE SSPRNKLERS? YES N® (CIRCLE ONE)
SQUARE FOOTAGE �� •T"f
NUMBER OF EMPLOYEES
NUMBER AND LOCATION OF RESTROOM FACILITIES
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 OV 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 PER ITS
SIGNAT E DATE �oI eI tS
PRINT NAME
TENANT OWNER / CONTRACTOR / ARCHITECT / ENGINEER (CIRCLE ONE)
CITY STAFF USE ONLY
OCCUPANCY GRP TYPE OF CONSf STAFF INITIALS
City of Menifee Building& Safety Deportment 29714 Houn Rd. Menifee, CA 925B6 951-672-6777
www.citycfinenifee.us Inspection Request Line 951-246-6213