PMT15-03750 City of Menifee Permit No.: PMT15-03750
29714 HAUN RD.
�ACCEL/-> MENIFEE, CA 92586 Type: Commercial Alteration
MENIFEE Date Issued:
03/03/2016
PERMIT
Site Address: 30080 HAUN RD, Suite#P2, MENIFEE, Parcel Number: 360-690-007
CA 92586 Construction Cost: $324,974.00
Existing Use: Restaurant Proposed Use: Retail
Description of TENANT IMROVEMENT FOR"LENS CRAFTERS"3016 SO FT
Work:
Owner Contractor
DONAHUE SCHRIBER CEDARS ENTERPRISES TOO INC
5694 MISSION CENTER RD 18757 TURFWAY PARK
SAN DIEGO, CA 92108 YORBA LINDA,CA 92886
Applicant Phone:7146850775
PERMIT ADVISORS License Number.650785
CA
Fee Description city Amount 1El
Services, Switchboards,Control Centers&Panels 2 366.00
Receptacle, Switch,Outlet&Fixture 144 831.00
Plumbing Fixtures and Vents,fixtures 9 146.00
Water Heater 1 83.00
Sewer 1 150.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 1,286 1,285.78
GREEN FEE 1 13.00
SMIP COMMERCIAL 1 91.00
New Construction Permit Fee 1 1,494.88
General Plan Maintenance Fee-Plumbing 1 18.95
General Plan Maintenance Fee-Electrical 1 59.85
General Plan Maintenance Fee-New 1 74.74
Construction
$4,641.20
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise staled,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_Bldg Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and 2 my license is in full force and effect. the following reason:
License Class J Liccee95a No. (u5 C)`l$ By my signature below I acknowledge that,except for my personal residence
Expires V-V-tb Signature / L-%k in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECIA TION have built as an owner-builder if it has not been constructed in its entirety by
P I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which wwwleR1nfo.ca.Rov/ca1aw.htm1.
this permit is issued.
Policy# 1 6C)OO15501151 Date
yfl have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this.
number are: application and the information I have provided is correct.I agree to comply
Carrier EyQCU� W:a,rw„1 -ys5 . c/o {{rrou] with all applicable city and county ordinances and state laws relating to
building construction.[authorize representatives of this city or county to
Policy# '1Io obls3011gs1 Expires $ - I -I enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
zrI certify that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant "�t-b Date 3-$'Ilp mixture containing a hazardous material equal to or greater that the
amounts spe 'Red on the Hazardous Materials Information Guide?
WARNIN :FAILURETO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes x1
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldefines
CONSTRUCTION LENDING AGENCY ❑Yes Zoo
I hereby affirm that under the penalty of perjury there Is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yes 9<o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements underthe State of
California Health al Safety Code;Section 25$05 and 25534 concerning
Contractor's License Law for the reasons)indicated below by the
hazardous material reporting.
checkmark(s)I have placed next to the applicable Items)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to No 49
Date
construct,alter,improve,demolish or for the
permit
structure,signets its PERTY OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant forthe pernitto file a signed statement
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Cade)or that he or she is exempt from[!censure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation;will do( )all of or( )portion of the work,and the structure is www.epa.gov/tead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractors state License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name.
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
❑I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.