PMT16-02700 City of Menifee Permit No. PMT16-02700
29714 HAUN RD. Type: Sign-Permanent
MENIFEE, CA 92586
MENIFEE Date Issued: 08/1812016
PERMIT
Site Address: 26025 NEWPORT RD, Sufte#F, Parcel Number: 36D-011-027
MENIFEE,CA 92584 Construction Cost: $1,250.00
Existing Use: Proposed Use:
Description of INSTALL ONE ILLUMINATED CHANNEL LETTER SIGN"VAPOR BARN"
Work:
Owner Contractor
ARYA NEWPORT GROSSING, LLC GIG SIGNS
1762 WESTWOOD BLVD,#446 560 E HOSPITALITY LN#400
LOS ANGELES, CA 90024 SAN BERNARDINO, CA 92408
Applicant Phone: 9094414444
YEK CHHU License Number. 857429
GIG SIGNS
560 E HOSPITALITY LN#400
SAN BERNARDINO, CA 92408
Fee Description 21 Amount
Sign Permit 1 190.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 9-60
$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.
AkB1dg_Perrnit—TernpJate.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 a 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 mason:
LicenseClass ClfS License No. eS"F 921 By my signature below I acknowledge that,except for my personal residence
Expires q�'No - 11 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 a n owner-builder if it has not been constructed in its entirety by
a 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 a nd 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 www.IegInfo.ca.gov/caIaw.htmL
this permit is issued.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
o I have and will maintain workees compensation insurance,as required by
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 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
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy# 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($3.00)or less PROPERTY OWNER OR AUTHORIZED AGENT
/11 certify that in the performance of the work for which this permit is issued,
Ishallnotemplo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
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 wilth those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to orgreater that the
Applicant Y?fe� C41tv Date amounts specified on the Hazardous Materials Information Guide?
WARNING: AILURETO SECURE WORKER'S COMPENSATION COVERAGE IS a Yes 0 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 morillication 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,INTERIEST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY a Yes a 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) in Yes a No
OWNER BUILDER DECLARATIONS I have mad 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
Contractor's License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes allo
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING JRRP)
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 required practims.This includes renta I property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
o 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 I )all of or I )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at
not intended or offered forsale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a a An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through em ployees'or persona I 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. ci No EPA Lead-Safe Certified Firm is required for this project bemuse:
ci 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's 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 APPLICATION
Menifee
DATE k PERMIT/PLAN CHECK NUMBER 0 a-lot)
TYPE: QrCOMMERCIAL ORESIDENTIAL 0MULTI-FAMILY OMOBILEHOME QPOOL/SPA OSIGN
SUBTYPE: OADDITION OALTERATION C)DEMOLITION OELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES_
DESCRIPTION OF WORK e7 L/C� v -,.L.�,�,. ,-,�,,QBUilding & SaiGtYDEPt-
C rlt�,,v C L_ ) AUG 18 2016
PROJECTADDRESS Z � t,2S vjv��,zr�- R,�) -A Received
ASSESSOR'S PARCEL NUMBER '�(00 -0jj!nC);L-A LOT TRACT
OWNER NAME Alt-JA L_�(_ 1-11 oQ jt4%p I L-ACJ4
ADDRESS 99;0 v ou -jz,:ve/,�,Lkv
PHONE jSc) EMAIL
APPLICANT NAME Ve w
ADDRESS II ti 1 5 oe it 14.4 A�e �1 A tk 3:s
PHONE 9 U11 Li�(44 EMAIL
CONTRACTOR'S NAME OWNER BUILDER? 0 YES "0
BUSINESS NAME C_,C
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER g5q 4yz-I; LICENSE CLASSIFICATION r /�c
VALUATION$ �,2,5,o SO FT /S L SO FT 1r-144
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY 1w_
DEPAR1 MENT DISTRIBUTIUN LI IT U�MtNII,tL BUNNE�b LICLNbE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP X
INVOICE PAIDAMOUNT
AMOUNT -Aw I 1 0 CASH 0 CHECK# OCREDITCARD VISAINIC
PLAN CHECK FEES I PAIDAMOUNT I OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
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