PMT16-02618 City of Menifee Permit No.: PMT16-02618
29714 HAUN RD. Type: Commercial Alteration
<CCELA— MENIFEE, CA 92586
MENIFEE Date Issued: 1112812016
PERMIT
Site Address: 30143 HAUN RD, MENIFEE, CA 92584 Parcel Number: 360-080-062
Construction Cost: $148,515.40
Existing Use: Proposed Use: Restaurant
Description of TENANT IMPROVEMENT FOR CREAMISTRY 1,045 SF
Work:
Owner Contractor
RICH DEVELOPMENT ORCHID CONSTRUCTION&FACILITY SERVICES
600 N TUSTIN AVE,#150 INC
MENIFEE, CA 92584 1107 E CHAPMAN AVENUE
Applicant Phone: 7147442446
MENIFEE, CA License Number.915838
Fee Description gyt Amount ISl
Services, Switchboards, Control Centers& Panels 1 183.00
Receptacle, Switch,Outlet&Fixture 67 446.00
Plumbing Fixtures and Vents,fixtures 10 151.00
Grease Interceptor 1 116.00
Gas System 1 116.00
Water Heater 1 83.00
Sewer 1 150.00
Air Handling/Condensing Units Non-SFR 1 183.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 1,491 1,490.56
GREEN FEE 1 6.00
SMIP COMMERCIAL 1 42.00
New Construction Permit Fee 1 683.17
General Plan Maintenance Fee-Mechanical 1 9.15
General Plan Maintenance Fee-Plumbing 1 30.80
General Plan Maintenance Fee-Electrical 1 31.45
General Plan Maintenance Fee-New 1 34.16
Construction
$3,782.29
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 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_Perrnit_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 u I am exempt from licensure underthe Contractors State License Law for
Professions Code and my license is in full forte and effect. the following reason:
License Class ��Ucense o. �! � By my signature below l acknowledge that,except for my personal residence
Expires �- Signature in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legallysell a structure that I
ORKER'S COMPENSATION DECLARATION have built as an owner-builder iflt has not been constructed in its entirety by
o 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 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 wehsite:
by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.leeinfa.ca.aav/calaw.html.
G'
Policy# V T61 r?/7/' Date
o 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 ❑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
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Polity# Expires _ 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 notemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSEs#��
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 forth iH'r m I w' those provisions. �] Will the applicant or future building occupant handle hazardous material or
A scant Date �—or r�1�� mixture containing a hazardous material equal to or greater that the
amounts sped on the Hazardous Materials Information Guide?
ARNING:FAILURE TO SECURE RKER'S COMPENSATION COVERAGE IS o Yes o
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL PINES 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 for guidelines
CONSTRUCTION LENDING AGENCY o Yes �tTo
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) o yes OJOS'
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
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material r p ng.
Business and Professions Code).Any city or county that requires a permit to Yes
Date
construct,alsoalter,improve, applicantemolish for pair any
mistructure,prior signed its O N OR A H IZED 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.REPAI 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 licensure receiving compensation for most work that disturbs paint in apre-1978
and thebant for the alleged exemption.
th applicant
nviolation tochM penalty of not by residence or childcare facility to be RRP-certified firms and comply wfth
than
Applicant fora 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
a 1,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. D No EPA Lead-Safe Certified Firm is required for this project because:
❑I,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 role please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Y
lddzIR
.Menifee
nDATE 08/10/2016 PERMIT/PLAN CHECK NUMBER
TYPE: ❑✓ COMMERCIAL []RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA [-]SIGN
SUBTYPE: [—]ADDITION ❑ALTERATION ❑DEMOLITION [Z]ELECTRICAL ❑✓ MECHANICAL
❑NEW ❑✓ PLUMBING ❑RE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK Tenant Improvement to install new ice cream parlor. Scope of the project includes, new
restroom,prep area,counter,ceiling,lighting, plumbing and new ducting.
PROJECT ADDRESS 30143 Haun Rd., Menifee,CA
ASSESSOR'S PARCEL NUMBER 9ap0_ ()C(9>0jp9 LOT TRACT
PROPERTY OWNER'S NAME Rich Development Company
ADDRESS 600 N.Tustin Ave.,Suite 150,Santa Ana, CA 92705
PHONE (714)835-3311 EMAIL
APPLICANT NAME David Kang
ADDRESS 16520 Bake Parkway,Suite 100, Irvine,CA S2618
PHONE (949)533-4117 EMAIL dkang@cdiarc.com
CONTRACTOR'S NAME OWNER BUILDER? DYES ✓❑NO
BUSINESS NAME Orchid Construction
ADDRESS 1107 E.Chapman Ave.,Suite 102, Orange,CA 92866
PHONE (714)744-2446 EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ $ � %tACj � (3 J-j0Q FT 1,045 L SQ FT
APPLICANT'S SIGNATURE C_� DATE 08/10/2016
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT I I 1 0CASH 0CHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED '%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.usInspection Request Line 951-246-6213
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