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PMT16-01528 City of Menifee Permit No.: PMT16-01628 _ 29714 HAUN RD. Type: Commercial New �ACCELA— MENIFEE, CA 92586 MENIFEE Date Issued: 09/28/2016 PERMIT Site Address: 28349 BRADLEY RD, MENIFEE, CA Parcel Number: 377-230-013 92586 Construction Cost: $3,999,993.20 Existing Use: Proposed Use: Office Description of CONSTRUCTION OF CITY OF MENIFEE FIRE STATION NO.7, 8120 SO FT Work: Owner Contractor CITY OF MENIFEE R I C CONSTRUCTION CO INC 29714 HAUN RD. 10675 EAST AVENUE SUITE 1 MENIFEE,CA 92586 HESPERIA, CA 92345 Applicant Phone:7602447749 CITY OF MENIFEE License Number.747268 29714 HAUN RD. MENIFEE, CA 92586 Phone:9516726777 Fee Description ON Amount t81 Power Apparatus 1 150.00 Services, Switchboards, Control Centers&Panels 4 732.00 Services, Switchboards, Control Centers&Panels 1 283.00 Receptacle, Switch, Outlet&Fixture 246 1,341.00 Pale or Platform Mounted Fixtures 6 208.00 Plumbing Fixtures and Vents,fixtures 29 246.00 Grease Interceptor 1 116.00 Gas System 1 116,00 Water Heater 2 166.00 Plan Check Fee 205 205.00 Sewer 1 150.00 Air Handling/Condensing Units Non-SFR 6 1,098.00 Hood Served by Mechanical Exhaust 1 219.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 90 90.D0 Additional Plan Review Building 3,604 3,603.94 GREEN FEE 1 160.00 SMIP COMMERCIAL 1 1,120.00 New Construction Permit Fee 1 18,399.97 General Plan Maintenance Fee-Building 1 0.00 General Plan Maintenance Fee-Mechanical 1 65.85 General Plan Maintenance Fee-Plumbing 1 39.70 General Plan Maintenance Fee-Electrical 1 135.70 General Plan Maintenance Fee-New 1 920.00 Construction $29,692.16 AA_Bldg Permit_Template.rpt Page 1 of 2 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from Iicensure underthe Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: n License Class A cP PS License No. 7 C6 L'1 9)'I Ig By my signature below I acknowledge that,except for my personal residence Expires I h&17 Signature P�L 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 1 WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by u 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 this permit is w,w,�,,leeinfo.ca.xav/calaw.html. issued Polity# W L q.I(.& 1 i� 9 _7 1)6 Date D I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which a By my signature below I certify to each of the following:I am the property this permit is issued.My workers 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 6/� r with all applicable city and county ordinances and state laws relating to Carrier+FlM��r Prnn �.d vs�-✓a C.�J✓5 ' j0.. CD building construction.I authorize representatives of this city or county to Policy#W C-146&)�g 7 00 Expires 01^� enter the above identified property for inspection purposes. (This section need not to he completed is the permit Is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT o I certify that in the performance of the work for which this permit is issued, O D' I shall not emolov 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 HAZARDOUS MATERIAL DECLARATION subject to the workers 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 ore Applicant �� Date 4— Zy1 _1L mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes le No 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 forguidelines CONSTRUCTION LENDING AGENCY o Yes is No 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) u Yes eJ No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous material reportin checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 o yes Jo p Business and Professions Code).Any city or county that requires a permit to Date 1 ^ 2��Lto construct,alter,improve,demolish or repair any structure,prior to its PR ERTY OWNER OR AUTHORIZED AGENT Issuance,also requires the applicant forthe permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION.REPAIR AND PAINTING(RRP) 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 Iicensure 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($500). managers who do the paint-disturbing work themselves or through their ❑I,as owner ofthe property,or my employee with wages as theirsole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-SOD-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improvesthe property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because: 01,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement BUILDING ,,&�-"Menifee ''(� G DATE 5 LD PERMIT/PLAN CHECK NUMBER TYPE: (J COMMERCIAL O RESIDENTIAL (D MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL * NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK }' 1 r-e p i (J- YD PROJECTADDRESS �YC'l�ll� Y)I CA n ASSESSOR'S PARCEL NUMBER 2-��j� ��-'`� LOT /7TRACCT OWNER NAME C� D I've �—IZC. du n srvV ADDRESS 114� -1f�A1Li V-) IfZ_ k �V ^—Q�- `�-\ [h Ck I�S-z$ (`, PHONE �S1 — 01 J-- UI�I 1 1 EMAIL A -e `-' `'no \"TC,,P_ US APPLICANT NAME S G-.. G , —c cI tj� ADDRESS PHONE Gc� I— ��-- G�I I D` ' `,, EMAIL ✓SG I�S C� S+Ic l oc .C L\y CONTRACTOR'S NAME I O� IM�I�Le- OWNER BUILDER? O YES O NO BUSINESS NAME ADDRESSI ,p " o(�P-l i C G7,1_! As- PHONE yll ��k�_ �' —ll�l-I� EMAIL J ' kare �-GF� Yll,{:vvY�}ULi IV7 . I CONTRACTOR'S STATE LIC NUMBER �`-'1� c�(g�+ LICENSE CLASSIFICATION VALUATION$ 4 yy-) SO,FT ��}'�� L SQ FT 'e I9vF j APPLICANT'S SIGNATURE SIGNATURE DATE OTYSTAFFUSEONLY DEPARTMENT DISTRIBUTION 1 CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT AMOUNT O00-7 0CASH 0CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZEDLETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.(IS InspectionRequestLine951-246-6213 fEf— F LE KJO, 511•- / v r >;GG 4II GFfi.q1 tz