PMT16-00309 City of Menifee Permit No.: PMT16-00309
29714 HAUN RD.
�AACCELA� MENIFEE,CA 92586 Type: Sign-Permanent
MENIFEE Date Issued: 0 210512 01 6
PERMIT
Site Address: 27856 HWY 74, MENIFEE, CA 92585 Parcel Number: 329-172-033
Construction Cost: $4,200.00
Existing Use: Proposed Use:
Description of INSTALL 1 SET OF LED ILLUMINATED CHANNEL LETTERS"ROMOLAND LIQUOR AND MARKET'
Work:
Owner Contractor
YONG SOO KIM DENNIS SEVER SIGNS
1918 ST SIMONS PLACE 523 EL REY CIRCLE
FULLERTON, CA 92831 PERRIS,CA 92571
Applicant Phone:9513338987
DENNIS SEVER License Number.830443
DENNIS SEVER SIGNS
523 EL REY CIRCLE
PERRIS,CA 92571
Fee Description Qtv Amount I$l
Sign Permit 1 190.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 9.50
$227.50
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_Pernit_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ 1 am exempt from licensure under the Contractors'State License Law for tht
1 hereby affirm under penalty or perjury that I am licensed under provisions of fallowing reason:
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence it
Professions Code and my license is in full force and effect. which I must have resided for at least one year prior to completion o
License Class 5— License improvements covered by this permit I cannot legally sell a structure that I have
Expires 1 b-3 1— 16' Signature built as an owner-building If it has not been constructed in its entirety by license(
contractors. I understand that a copy of the applicable law, Section 7044 of tht
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is
submitted or at the following Web site:
❑ 1 hereby affirm under penalty of perjury one of the fallowing declarations: httol/www.leainfo.ca.aov/calaw.html.
I have and will maintain a certificate of consent of self-insure for workers'
compensation,issued by the Director of Industrial Relations as provided for by Date
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. Property Owner or Authorized Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the properb
❑ I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read thit
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comph
permit is issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to buildup
construction.I authorize representatives of this city or county to enter the above
Cartier identified property for the inspection purposes.
Policy# Expires Date
Property Owner or Authorized Agent
(This section need not be completed If the permit is for City Business License#
one-hundred dollars($100)or less)
XI certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
shall not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers' compensation laws of California,and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts s ecified on the Hazardous Materials Information Guide?
Code,I shall forthwith co y with those provisions. / DYES ;NO
Applicant;/ Date; ^s t!� Will the Intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES NO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous material repo g.
OWNER BUILDER DECLARATIONS 19YESS NO
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
� — �' DateZ-S'^/
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZEDAGENT
next to the applicable Item(s)(Section 7031 A Business and Professions Code:
Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION,REPAIR AND PAINTING(RRP)
or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's Stale License Law(Chapter 9 (commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firths and comply with
she is exempt from licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees.For more information about EPA's Renovation Program visit:
❑ I, as owner of theproperty, or m em to employees with wages as their sole www.epa.gov/lead or contact the National Lead Information Center at
Y P Y 9 1-800-424-LEAD(5323).
compensation,will do ( )all of or( )porting of the work, and the structure is
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however, Certified Finn Name:
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the Firm Certification No.:
purpose of sale).
❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044, Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
• REMO. • • • . • •
Men ifee
DATE PERMIT/PLAN CHECK NUMBER „Q
TYPE: 0 COMMERCIAL 0 RESIDENTIAL O MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA XSIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES fee
DESCRIPTION OF WORK Ste% O L� 9 LLUy✓lY/�1/f�7 �rJ uilIi aza y Dept.
L FEB 0 5 016
PROJECT ADDRESS 2-:7G-'5-4 t4 vU `'l- -7 m T---H i FGE, tl �Z.'i�" e d
ASSESSOR'S PARCEL NUMBER - t_j*& -65S LOT TRACT
OWNER NAME /I /Ii-e a pt R jj- es $ el
ADDRESS 7f7 k S Ll J'Vl ✓ --2E� ell - I CA
PHONE �j'S'I � �3Z �738-e5 EMAIL /(J �'/�Ls/'lY1 . CP/Yl Iq
APPLICANT NAME 5Ej)r)2_S1& 6 -� '
ADDRESS Sz3 EL G! ?2jc_/2/ C (�+_ / 2 '7L I
PHONE EMAIL S�✓� l�vl �y /Y72 � �UNi
CONTRACTOR'S NAME 6 / OWNER BUILDER? O YES ) NO
BUSINESS NAME ;�y� � � G�
ADDRESS s7i3J 2t_ - /�e� -1 CjO� /`-LF��S CA / 2-6-7
PHONE g9_I- EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ t'l �a SQFT y' St��-� LSQFT
APPLICANT'S SIGNATURE DATE 2-`1 I'!�
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE
AMOUNT a•a •� PAID AMOUNT .(50 0CASH 0 CHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 1 0 CASH O CHECK# O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of iWenifee Building &Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
G1T!r pe
CITY OF MENIFEE
' ,MFNIFE�
Planning Department
APPLICATION FOR CONCURRENT PROCESSING
This is an application to request that the review construction plans
concurrently with the Planning Department's processing of the related development application. Please
complete the required information and sign the waiver and assumption of risk, and return the completed
application to the Planning Department,
INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED
PLANNING APPLICATION NO: DATE SUBMITTED:
APPLICATION INFORMATION
Applicant's Name: Jc;�Va2L E-Mail: _ S C'_U� SL9,ISG 1'(�o�N✓1G^;J
Mailing Address: 5 EL- 2Ey G f!
Street
�242+5 L Al
City State ZIP
Daytime Phone No: ( ,O ) 3 —b-I L7 Fax No: ( )
As applicant for the above-referenced project, I/We hereby request that the ❑ Public Works Department
accept construction plans for review concurrent with the Planning Department's processing of the
applicable development applications.
As applicant for the above referenced project, INVe acknowledge that acceptance of plans by the
Department of Public Works for review prior to final action on the proposed project does not explicitly
or implicitly suggest that the project will receive final approval. I/We assume the full risk that the plans
submitted at this time may not ultimately conform to the approved project or any changes necessitated
by the final conditions of approval, or that the subject proposed project may ultimately be denied. I/We
recognize that any fees submitted to the Department of Public Works for the processing of plans may
be nonrefundable if this project is ultimately denied, or if subsequent project redesign or the final
conditions of approval result in the requirement for changes in the plans, and that additional fees may
be required by the Department of Public Works for the processing of plans required due to project
redesign. I/We further acknowledge that acceptance of construction plans and the payment of fees to
the Department of Public Works does NOT obligate the Planning Department to support a proposed
project design.
PRINTED NAME OF APPLICANT SIGNATURE OF APPL(CANT
29714 Haun Road
Menifee, Califomia 92586
(951)672-6777 • Fax (951)679-3843
Form 295-1015(04/09112)
Page 1 of 2
APPLICATION FOR CONCURRENT PROCESSING
DATE:
TO:
FROM: PLANNING DEPARTMENT
RE: REQUEST FOR CONCURRENT PROCESSING
PLANNING APPLICATION NO.
The applicant for the above referenced case has requested that the Department of Public Works accept
construction plans concurrent with the filing of the above referenced planning case. The Planning Department has
no objection to the acceptance of such plans by the Department of Public Works pending a final decision on the
subject planning application. Concurrent review does not explicitly or implicitly suggest that the speck project
design has been found acceptable at this time. The applicant assumes the full risk that a project redesign,
approved conditions of approval, or denial of the project may make the construction plans unacceptable or moot,
and that any or all of the fees for the processing of the plans may be nonrefundable. Acceptance of construction
plans and the payment of fees to the Department of Public Works does NOT obligate the Planning Department to
support or approve a proposed project design.
ADDITIONALLY, NO PERMITS SHALL BE ISSUED BY THE DEPARTMENT OF PUBLIC WORKS PRIOR TO AN
APPROVAL OF THE ABOVE REFERENCED DEVELOPMENT PROPOSAL, AND ISSUANCE OF THE FINAL
CONDITIONS OF APPROVAL BY THE PLANNING DEPARTMENT.
CITY OF MENIFEE PLANNING DEPARTMENT
As applicant for the above referenced project, IMe acknowledge that acceptance of plans by the Department of
Public Works for review prior to final action on the project proposal does not explicitly or implicitly suggest that
this project will receive final approval. I /We assume the full risk that the plans submitted at this time may not
ultimately conform to the approved project or any changes necessitated by the final conditions of approval, or
that the subject proposal may ultimately be denied. I/We recognize that any fees submitted to the Department of
Public Works for the processing of plans may be nonrefundable if this project is ultimately denied or if
subsequent project redesign or the final conditions of approval result in the requirement for changes in the plans,
and that additional fees may be required for the processing of plans due to project redesign. I/We further
acknowledge that acceptance of construction plans and the payment of fees to the Department of Public Works
does NOT obligate the Planning Department to support or approve a proposed project design.
PRINTED NAME OFAPPLICANT SIGNATURE OF APPLICANT
Form 295-1015(04/09/12)
Page 2of2