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PMT16-02128 City of Menifee Permit No.: PMT16-02128 29714 HAUN RD. �/-�CCEL/-> MENIFEE, CA 92586 Type: Sign-Permanent MENIFEE Date Issued: 07/07/2016 PERMIT Site Address: 27701 SCOTT RD, Suite#304, MENIFEE, Parcel Number: 384-180-038 CA 92586 Construction Cost: $6,000.00 Existing Use: Proposed Use: Description of INSTALL 2 ILLUMINATED CHANNEL LETTER SIGNS"HEADLINER BARBERSHOP" Work: Owner Contractor MENIFEE PARTNERS J K PAPPA ENTERPRISES INC 4909 MURPHY CANYON ROAD,#405 26019 JEFFERSON AVE UNIT B SAN DIEGO, CA 92123 MURRIETA, CA 92562 Applicant Phone:9513049993 JERRY PAPPALARDO License Number:935797 J K PAPPA ENTERPRISES INC DBA SIGNARAMA 26019 JEFFERSON AVE UNIT B MURRIETA, CA 92562 Fee Description city Amount($1 Sign Permit 2 190.00 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_Pennt_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contacts for the projects with a licensed contractors)pursuant to the Contactors 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 D I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Cla�ssl C�' Uc;pnsqNo. J 7 By my signature below 1 acknowledge that,except for my personal residence Expires 1 3 1 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 DECLARATION have built as an owner-builder If it has not been constructed in its entirety by ❑1 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 workers 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 y,ww.lezinfo.weov&alaw.html. this permit is issued. / �r < / Date Policy If 10 Y7J�+c�� PROPERTY OWNER OR AUTHORIZED AGENT D I have and will maintain workers compensation insurance,as required by D By my signature below I certify to each of the following:)am the property section 3700 of the Labor Code,for the performance of the work for which 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 with all applicable city and county ordinances and state laws relating to Carrier 1. l`�11 !] building construction.l authorize representatives of this city or county to Policy#�f� (Q�o"l r/Q5 Expires 7 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 o 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 HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Will the applicant or future building occupant handle hazardous material or Code,I shall fort �\ fih comply with thos revisions. \] / mixture containing a hazardous material equal to of greater that the Applicant CA" Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE SECURE WORKER'S COMPENSATION CO ERAGE IS o Yes gy1Ga UNLAWFUL,AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES Will theintended 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 forguideliFes CONSTRUCTION LENDING AGENCY ❑Yes d 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 boupdary of a school? (Section 3097 Civil Code) ❑Yes No OWNER BUILDER DECLARATIONS 1 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 hazardouVmaterial rgporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 as c �� . Y - BusinessandProfessionsCode).Any city or county that requires a permit to (}.BLS-� Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER ER 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 EPA RENOVATION REPAIR AND PAINTING IRRPI License Law(Chapter9(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 o 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/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 D 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 thatthe 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 D No EPA Lead-Safe Certified Firm is required for this project because: not built or improved for the purpose of sale. ❑1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Cade: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 & SAFETY PERMIT/PLAN CHECK AP PLICATION ' -,Menifee DATE -7 PERMIT/PLAN CHECK NUMBER - TYPE: rCOMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION WELECTRICAL VVIECHANICAL O NEW O PLUMBING (OG�RE-ROOF-NUCMBER OF SQUARES DESCRIPTION OF WORK �' QA- Co r City of Menifee Building & Safety De A. PROJECTADDRESS �cri-fl , Q J P Oe � ` Z ASSESSOR'S PARCEL NUMBER -C �7 LOT TRACT OWNERNAME 11 � 0-, NLJ. \ je D Receive ADDRESS (Q© Gn d AC PHONE �O (j - J' I �� EMAIL APPLICANT NAME t C1tr lc>— ADDRESS 9 60n1 G n/t'p(g��j v� �1 � d��e PHONE QQ — ,l Q �(.`' q3 EMAIL ] , Q,`l S G-� 'AO d . CG`0'� CONTRACTOR'S NAME QCC \ 0�I A u� OWNER BUILDER? O YES --N0 BUSINESS NAME 9>3ckk a4NCA R ADDRESS Q S 0 PHONE "t J 0� �`1."t� EMAIL 0— SCCf v w1. C 1)ov1 CONTRACTOR'S STATE LIC NUMBER C 1 LICENSE CLASSIFICATION VALUATION$ ©O SOFT L SO FT APPLICANT'S SIGNATURE C DATE CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP x INVOICE PAID AMOUNT AMOUNT 0CASH 0 CHECK M OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH 0 CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. 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