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PMT16-01323 City of Menifee Permit No.: PMT16-01323 29714 HAUN RD. Type: Commercial Alteration �AICCE J/ MENIFEE,CA 92586 MENIFEE Date Issued: 04/2712016 PERMIT Site Address: 29800 BRADLEY RD, Suite#120, Parcel Number: 336-180-012 MENIFEE, CA 92586 Construction Cost: $0.00 Existing Use: Restaurant Proposed Use: Office Description of HOURLY INSPECTION FOR CERTIFICATE OF OCCUPANCY FOR"FILIPINO LAW GROUP" Work: Owner Contractor NORDEN REALTORS FILIPINO LAW GROUP 23781 VIA FROMISTA 29800 BRADLEY RD#120 MISSION VIEJO,CA 92691 MENIFEE,CA 92586 Applicant Phone:9513016699 MARLON BALDOMERO License Number: 16-PEOP-00018 RLIPINO LAW GROUP 29800 BRADLEY RD#120 MENIFEE, CA 92586 Phone: 9513016699 Fee Description gty Amount ISI Building Permit Issuance 1 27.00 Inspections not specified 129 129.07 General Plan Maintenance Fee-Building 1 6.45 $162.52 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 carded 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 vdthin 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_Sldg_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 contractors)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 Class License No. By my signature below I acknowledge that,except for my personal residence Expires Signature in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I 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 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 workforwhich www.leeinfo.ca.Rov/calaw.html. this permit is issued. Policy q Date ❑I 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 with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy If Expires bovei ro e r inspection purposes. (This section need not to be completed is the permit is for on—s a Date h/ dollars($100)or less PRO R O ORIZED 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 If 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 Date mixture contain)9B'�hazardous material equal to or greater that the amounts_sp!e�if`ied on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes *40 UNLAWFUL,AND SHALL SUBJECFAN 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 ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist In guidelin CONSTRUCTION LENDING AGENCY ❑Yes o I hereby affirm that under the penalty of perjury there is a construction WIII 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 boun of a school? (Section 3097 Civil Code) ❑Yes o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the Califomia Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 haza "us materi a ortin . Business and Professions Code).Any city or county that requires a perm? es �7 Dale construct,alter,improve, applicant f repair any structure,prior PR OWNER OR UTHORIZED AGENT issuance,also requires the applicant for the permit to file a si- emen[ that he or she is licensed pursuant to the provisions of the Contractors 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 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 than($500). required practices.This includes rental property owners and property managers who do the paint-disturbing work themselves or through[heir ❑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.gov/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 CERTIFICATE OF OCCUPANCY APPLICATION 0- Menifee DATE yL` �� lv` P'E,RnMIT NUMBER �1' 1�/I�y/, 1OI �� ✓ BUSINESS NAME T �r2i�l/�Xe v�u) Q:716eJ' TYPE OFF�BUSINESS e Zrlaep ADDRESS � 8Da ��ZDi�-�i/ D• �mO / /�/�� r / �� c�So NAME OF BUSINESS OWNER(S) ADDRESS(IF DIFFERENT FROM ABOVE) /�/ V ,n PHONE �%�� / 4�01 ,1/6J //�� EMAIL A11fe 141V X901V&iP, Z Y2'J7�� C� OWNER OF BUILDING ��D N / XC fz_%711S ADDRESS "-\q7 /� ��DILI/ S/ /y/�SS�G1 / V1c5/�J 10- PHONE (SW,) 737 � 71 EMAIL DESCRIBE EXACT USE OF BUILDING: 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. hereby agree to comply with the above-described terms in this Application for Certificate of Occupancy. DATE © �� APPLICANT CITY STAFF USE ONLY (PLEASE SIGN DATE IF APPROVED) BUS LICENSE DATE HEALTH DEPT DATE BUS LIC.NUMBER FIRE DATE PLANNING DATE EMWD DATE ENGINEERING DATE BUILDING DATE ENGINEERING INSPECTION(INCLUDE VERIFICATION OF BMP's BUILT PER PLANS/WQMP) REF WQ/SW N APPROVED BY DATE City of Menifee Building & Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.citycfinenifee.us Inspection Request Line 3;3(0 - I Sotl-) - 0 l a. .. u `� a • • ' • itiil ��!r`t 1 v 1 I Q +r • f ,�