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PMT16-00134 City of Menifee Permit No.: PMT16-00134 29714 HAUN RD. <ACCELA7 MENIFEE, CA 92586 Type: Commercial Alteration MENIFEE Date Issued: 0412 0/2 01 6 PERMIT Site Address: 30083 HAUN RD, MENIFEE, CA 92584 Parcel Number: 360-080-053 Construction Cost: $144,574.24 Existing Use: Proposed Use: Description of TENANT IMPROVEMENT EUROPEAN WAX CENTER 1,402 SQ FT Work: Owner Contractor RICH DEVELOPMENT ENTERPRISES, LLC C C&M INCORPORATED 600 N TUSTIN AVE, STE 150 23905 CLINTON KEITH RD 114-200 SANTA ANA, CA 92705 WILDOMAR,CA92595 Applicant Phone:9516000783 MENIFEE, CA License Number:723432 Fee Description Ply Amount ISI Receptacle, Switch, Outlet&Fixture 84 531.00 Plumbing Fixtures and Vents, fixtures 2 116.00 Water Heater 1 83.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 982 982.18 GREEN FEE 1 6.00 SMIP COMMERCIAL 1 41.00 New Construction Permit Fee 1 665.04 General Plan Maintenance Fee-Plumbing 1 9,95 General Plan Maintenance Fee-Electrical 1 26.55 General Plan Maintenance Fee-New 1 33.25 Construction $2,520.97 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_Blog_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 my license is in full force and effect. the following reason: License Gass Y..1 License No. 3 Lt z. By my signature below I acknowledge that,except for my personal residence Expires /2'3T' /G Signature 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 DE TION have built as an owner-builder if it has not been constructed in its entirety by ❑I hereby affirm under penalty of perjury one of thefollowing 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 ww.feainfo.ca.eov/calaw.html. this permit is issued. w Policy# Date PROPERTY OWNER OR AUTHORIZED AGENT ❑I have and will maintain worker's compensation insurance,as required by 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 owners behalf.I have read this number are: application and the information I have provided is correct.I agree to comply Cartier c J 7`i9 TY lrlia�lJ with all applicable city and county ordinances and state laws relating to GG building construction.I authorize representatives of this city or munty to :�Policy#�a7 ? l2-eel S Expires z7' 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 ❑I 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# workers compensation laws of California,and agree that if I should become 14AZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor code,1 shall forthwith omply with those provisions. Will the applicant or future building occupant handle hazardous material or a App' nt Date Zfl`� mixture containing a hazardous material equal to or greater that the / R SE WO amounts specified on the Hazardous Materials Information Guide? WARNNS :FAILU ERKER'S COMPENSATION COVERAGE I5 ❑Yes )ii(No UNLAWFUL,AND SHALL SUBIECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FINES UPTO 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 for guideh es CONSTRUCTION LENDING AGENCY ❑Yes 7No 1 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 D(No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of CaliforniaContractors License law for the reasons)indicated below by the Califo Health&Safety Cade,Section 25505 and 25534 concerning h ardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 (gs No //�� /' Business and Professions Code).Any city or county that requires a permit to Date % �Z� "�G construct,alter,improve,demolish or repair any structure,prior to its p OR AUTHORIZED AGENT issuance,also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors State ARENOVATION.REPAIR AND PAINTING(FIRM 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 Code)or that he or she is exempt from licensure 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 orthrough 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.eoa.eov/lead 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: ❑1,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. ala DATE 01/18/2016 PERMIT/PLAN CHECK NUMBER —� TYPE: ❑✓ COMMERCIAL [—]RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION [2]ELECTRICAL ❑✓ MECHANICAL ❑NEW ✓❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Tenant Improvement for European Wax Center,interior work only.New non-loading bearing walls,new ceilings,doors,light fixtures, plumbing fixtures, HVAC ducts and registers,Tie-into(E)elec.panel and HVAC unit PROJECTADDRESS 30083 Haun Road C� ASSESSOR'S PARCEL NUMBER 3LOO —rl?j0- O" LOT TRACT PROPERTY OWNER'S NAME Rich Development Company ADDRESS 600 N Tustin Ave,Suite 150, Santa Ana,CA 92705 City Dt Menifee wi mg & tiamly PHONE (714)835-3311 EMAIL APPLICANT NAME Mike Gioseffi J ADDRESS 12263 Highland Ave,Suite 110, Rancho Cucumonga, CA 91739 �♦ PHONE (626)253-4799 EMAIL mgioseffi@mg2company.com CONTRACTOR'S NAME OWNERBUILDER? ❑YESONO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER F4,402 LICENSE CLASSIFICATION ILA VALUATION$ 7'OJ;DOD.O0 S� I LSQFT APPLICANT'S SIGNATURE DATE O DEPARTMENT DISTRIBUTION _ ' CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN LQ SMIP INVOICE [u� PAIDAMOUNT AMOUNT O-I O CASH O CHECK# O CREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKN OCREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213