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PMT16-02833 City of Menifee Permit No. PMT1 6-02833 29714 HAUN RD. Type: Commercial New 't�kCCEUA_> MENIFEE,CA 92586 MENIFEE Date Issued: 12/2712016 P E R M I T Site Address: 27220 SUN CITY BLVD, MENIFEE, CA Parcel Number: 337-310-029 92586 Construction Cost: $5,000.00 Existing Use: Proposed Use: Description of RE-PLANET SINGLE ROLL-OFF CONTAINER STATE CERTIFIED CRV RECYCLING CENTER Work: FACILITY AT VONS GROCERY STORE Owner Contractor REPLANET, LLC J B INSTALLATIONS 800 N HAVEN AVE#120 30190 SANTA CECILIA DR ONTARIO, CA 91764 TEMECULA,CA 92592 Applicant Phone:9518181859 BRIAN JACKSON License Number:908071 30190 SANTA CECILIA DR TEMECULA, CA 92592 Phone:9515152705 Fee Descripflon ON Amount I$) Building Permit Issuance 1 27.00 Inspections not specified 129 129.07 Additional Plan Review Building 129 129.07 Additional Plan Review Building 129 129.07 Additional Plan Review Building 129 129.07 Additional Plan Review Building 65 64.54 $607.82 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 buillding 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.BIdg_PemtLTempIate.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)pursua nt to the Contractors State License Law), Chapter9(commencing winh section 7000)of Division 3 of the B�smeq and a I am exempt from licensure under the Contractor's State License Law for censeism u '3 Professions Code and my�1' f R fori — 0- - ( the following reason: License Cla -cerise No.-449�E� By my signature below I acknowledge that,except for my personal residence ExpkesSil?/ /W Signature in which I must have resided for at least one year prior to completion or 17 L2apiJ im, r Wments covered by this permit.I cannot legally sell a structure that I WORA4 OM ON DECLARATION * __ have built as an owner-builder if it 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 worker's 7044 of the Business and Professions Code,is available upon reqi;ssft when compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following websfte: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.leginfo.ca.goy/calaw.litmi. Policy# Date ci 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 perfonriance of the work for which o By my signature below I certify to each of the following:I am the property this permit is issued.My worker's cam pensation insurance ca reler 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 corr?ct.I agree to comply Carrier with all applicable city and county ordinances and stare laws relating to building construction.I authorize representatives of this city or county to Policy If 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 les;s PROPERTY OWNER OR AUTHORIZED AGENT ) I certify that in the performance of the work for which this permit is issued, 44 1 sha 11 not em Ploy a ny persons in any ma n ner so as to become subject to the CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should become subject to the worker's compens . rovisions of Section 3700 of the Labor HAZARDOUS MATERIAL DECLARATION Code,I shall fo ith y with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant - Date LZ mixture containing a hazardous material equal to or greater that the amounts specified an the Hazardous Materials Information Guide? MfARNINGAWIt6ift­TOSEerRE WORKER'q COMPENSATION(COVE'dGE IS ciYes oNc, 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 TOONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the :onstruction or modification from South IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management D Arict(SCAQMD)?See permitting checklist forguldelines CONSTRUCTION LENDING AGENCY ciYes allo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building cr 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) ciYes oNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCACLMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I i.nderstand my requirements under the State of Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning hazardous material t-eporting, checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes ci No 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(RRP) License Law(Chapter 9(commencing With Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule r equires 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 a Ileged exem ption.Any violation of Section 7031.5 by residence or childca re facility to be RRP-certifiecl 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 manag2rs who do the paint-disturbing work themselves orthrough their ci 1,as owner of the property,or my employee with wages as their sole empic-/ees.For more information about EPA's Renovation Program visit: compensation,Will do( I all of or( )portion of the work,and the structure is M5Lv epa.goy/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions I-S,'0-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a a �n 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 Issold within oneyearof 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. a No EPA Lead-Safe Certified Firm is required for this project because: o 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 you r project does not comply with EPA RRP rule please fill out the RRP Acknowledgement.