PMT16-02984 City of Menifee Permit No.: PMT16-02984
29714 HAUN RD. Type: Sign-Permanent
<A—CCF-LA-? MENIFEE, CA 92586
MENIFEE Date Issued: 09/0812016
P E R M I T
Site Address: 30107 HAUN RD, MENIFEE, CA 92584 Parcel Number: 360-080-062
Construction Cost: $1,825.00
Existing Use: Proposed Use:
Description of INSTALL ONE ILLUMINATED CHANNEL LETTER SIGN"AMERICA'S BEST EYECARE"AND TWO
Work: MONUMENT PANEL INSERTS
Owner Contractor
RICH DEVELOPMENT TRULITE SIGNS INC
600 N TUSTIN AVE, SUITE 150 2990 HALF MOON CT
SANTA ANA, CA 92705 NORCO,CA 92860
Applicant Phone:95117355525
NICHOLAS NOLTEN License Number.846189
TRULITE SIGNS INC
2990 HALF MOON CT
NORCO, CA 92860
Fee Description Qtv Amount($
Sign Permit 3 190.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 9.50
$227.60
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 building 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 BidgPermit Ternplate.rpt Page I of I
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 o 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 reason:
UcenseClass_ CVJ_ License No. L/ By mysignature below I acknowledge that,except for my personal residence
Expires_ZW;'1Z2 Signature_V inwhich I must have resided for at least one year prior to completion of
improvements covered bythispermit.I cannot legally sell a structurethati
WORKEWS COMPENSATION 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 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 issued. www.leginfo.ca.goy/calaw.htmi.
Policy# Date
,04-have and will maintain worker's 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 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
Carrier (t" with all applicable city and county ordinances and state lam relating to
building construction.I authorize representatives of this city or county to
Policy#qa2 S-60-2dA6 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
a 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#
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 to h "h I I h those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant r;ZZT Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Gulde7
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS in Yes n 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 SECrION 3706 OF THE LABOR CODE,INTEREST;AND ATTORNEYS FEES fbrguidelines
CONSTRUCTION LENDING AGENCY Oyes ONO
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) a Yes o No
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
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes o 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 IRRP)
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
a nd the basis for the a Ileged exemption.Any violation of Section 7031.5 by residence or childca re facility to be RRIP-ceriffied firms and comply with
an Applicant for a permit subjects the applica nt 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 sale 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.goy/lead or contact the National Lead Informatio n Center at
not intended or offered for sale.(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 n 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. ct No EPA Lead-Safe Certified Firm is required for this project bemuse:
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 your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
."Menifee
DATE 08/31/2016 PERMIT/PLAN CHECK NUMBERftnU 00084
TYPE; EICOMMERCIAL []RESIDENTIAL [:]MULTI-FAMILY [:]MOBILEHOME [:]POOL/SPA RISIGN
SUBTYPE: [—]ADDITION EJALTERATION [—]DEMOLITION DELECTRICAL []MECHANICAL
R]NEW [:]PLUMBING [—I RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Install (1)set of channel letters on backer panel and monument panel.
PROJEcTADDRESS 30107HaunRd. Menifee, Ca 991�c
ASSESSOR'S PARCEL NUMBER '95W -OM - 0( pfe4 LOT TRACT E,,IjIIC1I'n"a Df=t"y"Dept.
PROPERTY OWNER'S NAME Rich Development Company-Bart Hollander
SEP 0 8 2916
ADDRESS 600 N Tustin Ave.Suite 150,Santa Ana,Ca 92705
PHONE (714)835-3305 EMAIL Received
APPLICANTINAME NicolasNolten
ADDRESS 2990 Half Moon Cf. Norco Ca 92860
PHONE (951)735-5525 EMAIL trulftesigns@gmaii.com
CONTRACTOR'S NAME Trulfte Signs, Inc. OWNERBUILDER? [—]YESR]NO
BUSINESS NAME Trulfte Signs, Inc.
ADDRESS 2990 Half Moon Ct. Norco Ca 92860
PHONE (951)735-5525 EMAIL trulitesignsggmaii.com
CONTRACTOR'S STATE LIC NUMBER 846189 LICENSE CLASSIFICATION C45
VALUATION$ $ 1,825-00 SO FT 72.47 LSQFT
URE DATE 08131/2016
CffYSTAFF USE OINLY
I)MRtito beroftTICIN SM,P 77=11FEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN
INVOICE PAIDAMOUNT
AMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC
0 CASH 0 CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT
IrOWNER BUILDER VERIFIED 0 YES 0 NO DIL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29 714 Haun Rd. Menifee, CA 92586 951-672-6777
www.citycf,nenilee.us inspection Request Line 951-246-6213
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