PMT16-03134 City of Menifee Permit No.: PMT16-03134
29714 HAUN RD. Type: Commercial Addition
<A—CCELA—> MENIFEE,CA92586
MENIFEE Date Issued: 1010612016
P E R M I T
Site Address: 28995 NEWPORT RD, MENIFEE, CA Parcel Number: 364-030-004
92584 Construction Cost: $4,011.10
Existing Use: Proposed Use:
Description of INSTALL SEISMIC ANCHORING AND SHELVING SYSTEM
Work:
Owner Contractor
DIAMOND BROS FIVE PARTNERSHIP ROCON GROUP INC
29875 MENIFEE LAKES DRIVE 14340 ELSWORTH ST
MENIFEE, CA 92584 STE. 101
Applicant Phone: 9516539992
GLENN WILES License Number: 845912
ROCON GROUP INC
14340 ELSWORTH ST
STE- 101
MORENO VALLEY. CA 92553
Fee Description Qtv Amount
Building Permit Issuance 1 27.00
Inspections not specified 127 127.07
Additional Plan Review Building 105 105.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 1.00
New Construction Permit Fee 1 18.45
General Plan Maintenance Fee-Building 1 6.35
General Plan Maintenance Fee-New 1 0.92
Construction
$286.79
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 Bidg_Permt-Templaterpt 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).
Chapter!)(commencing with section 7000)of Division 3 of the Business and a I am exemptfrom licensure underthe Contrauctor's State License Law for
Professions Code and my license is in full force and effect. the following mason:
License Class 19 Licen No. '3 / Z
By my signature below I acknowledge thatexcept for my personal residence
Expires I Signature:21, UA& 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
u I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applimble 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 www.Ieginl`o.ca.gov/caIaw.htmI.
this permit is issued.
Policy If 9/-6- 9 PROPERTY OWNER OR AUTHORIZED AGENT Date
o I have and will maintain woTkees compensation Insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which ci 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 a uthorized 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 e-AIJ�611J C 5- '//I with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy If Expires 1-7 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
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 forthvid comply with tho e govisions. Will the applicant or future building occupant handle hazardous material or a
Applicant 1'20'� , 'p, I mixture containing a hazardous material equal to or greater that the
4pr —Date I'le-A00k, amounts specified on the Hazardous Materials Information Guide?
V
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS Oyes ONO
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,AN D ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY n 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 th e performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) Oyes ONO
OWNER BUILDER DECLARATIONS I 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 exem pt 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 uYes a No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair anystructure,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 Contractoes 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
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
a n Applicant for a permit subjects the applicant to a civil pena Ity of not more required practices.This Includes rental property owners and property
than($500). managersvilho dothe paint-disturbing work themselves orthrough 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 I )all of or( )portion of the work,and the structure is www.epa.gGy/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,th rough employees!or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Finn 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. o No EPA Lead-Safe Certified Firm is required for this project bemuse:
in 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
& SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
10
DATE PERM IT/PLAN CHECK NUMBER
TYPE: �COMMERCIAL ORESIDENTIAL 0MULTI-FAMILY COMOBILEHOME OPOOL/SPA OSIGN
SUBTYPE: OADDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL
ONEW CIPLUMBING 0 RE-ROOF-NUMBER OF SQUARES—
DESCRIPTION OF WORK Sc-i�5mie- Aue �Aor<; YuG- ISt4-,c) ViAi � m. c"Y "' Menifee
I d' jildipg "I 8"-'rvIy - pt.
PROJECTADDRESS �2v? c/s- e-(A) i::br.,--r rp p) 6ta—r-1w SEP 2 2 2016
ASSESSOR'S PARCEL NUMBER 2*.04- tl)30 -00%4 LOT TRACT e c a ve c
OWNERNAME RAek.) P3"wd Ilbo-5 �sqe Riftm osh�o
ADDRESS
PHONE EMAIL
APPLICANTNAME
ADDRESS Llb C— t-Soic/ald SO 101 MQ1z6luo (/A
PHONE EMAIL
CONTRAcroWS NAME l2b R Lc
OWNER BUILDER? 0 YES(-*%NO
BUSINESS NAME 7ROCOW
ADDRESS
,0 - �4TEI
PHONE '751 37;-1 EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION $ SO FT L SO,FT
APPL Z—zo DATE
OTYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE PAIIAMOUNT
AMOUNT LAILAS cCASH C)CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DLNUMBER NOTARIZEDLETTER 0 YES 0 NO
City of Men ifee 6uilding & Safety Depar tm Ent 29 714 Houn Rd. Men ifee, CA 92586 951-672-6777
www.cityofmenifeeTis Inspection Request Line 951-246-6213