PMT16-03230 City of Menifee Permit No.: PMT16-03230
29714 HAUN RD. Type: Commercial Alteration
<ACCELX�- MENIFEE,CA 92586
MENIFEE Date Issued: 09/30/2016
P E R M I T
Site Address: 27491 ETHANAC RD,MENIFEE, CA Parcel Number: 331-110-011
92585 Construction Cost: $0.00
Existing Use: Proposed Use:
Description of HOURLY INSPECTION FOR CERTIFICATE OF OCCUPANCY FOR"MIRANDA TIRES&WHEELS"
Work:
Owner Contractor
HARVINDER SINGH
27491 ETHANAC RD
MENIFEE,CA 92585
Applicant License Number
MIRANDA TIRES&WHEELS
CA
Fee Description Qty Amount($1
Building Permit Issuance 1 27.00
Inspections not specified 129 129.07
$156.07
The issuance of this permit shall not prevent the building official from thereafter requidng the correction of emors 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_Permit Template.rpt Page 1 of 1
CITY OF IMENIFEE
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).
Chapterg(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractoes State Litcense Law for
Professions Code and my license is in full force and effect. the following reason:
License Class License No. By my signature below I acknowledge that,except for my personal residence
Expires_Signature in which I on ust 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
o I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understa nd that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's 7D44 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 welisite:
by Section 3700 of the Labor Code,for the performance of work for which www.IegInfo.ca.aav/caIaw.htmI.
this permit is issued.
Policy It PROPERTY OWNER OR AUTHORIZED AGENT Date
ci I have and will maintain worker's 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 It Expires_ enter the above ide t'fi d rity for inspection purposes.
(This section need not to be completed is the permit is for one-h undred 7Z7 Date
dollars($100)or less �GENT
a I 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 with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS a Yes o No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended me 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 perinitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGEN ci Yes ci 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) oYes ciNo
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 exemptfrom 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 aYes a No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,Improve,demolish or repair any structure,priorto 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 cbIldcare 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 p ractices.This includes rental property owners a nd 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 theirsole employees.For mom information about EPA's Renovation Program visit:
compensation,will do( )all of or( I portion of the work,and the structure is ww%v.epa.aov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LFAD(5323).
Code;The Contractoes 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,th rough employeeV 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 Certificaflon No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. in No EPA Lead-Safe Certified Firm is required for this project because:
a 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 RAP rule please fill ou t the RR P
Acknowledgement.
CEAfIFICATE OF OCCUPANCY & TENANT DISCLORE APPLICATION
11"'WeInifee
DATE
BUSINESS NAME
BUSINESS ADDRESS a-4 F:�ha no C,
NAM E(S)OF BUSINESS OWNERS 2,shek �Akmnc\a
PHONENUM13ER
5E).0-7a EMAIL
OWNEROFBUILDING 7JWV11Vf,)E7— -,5I-AJ(Qh
OWNER OF BUILDING ADDRESS 7-1 �q/ r-[k(CiricLC 'kj. MerX;FeP_ L/70 925
INTENDED BUSINESS USE T�ce SV-Iop
IS THIS A NEW BUSINESS IN THE CITY OF MENIFEE? YES NO (CIRCLE ONE)
ARE YOU THE FIRST TENANT TO OCCUPY THIS SPACE? YES NO (CIRCLEONE)
IS THE BUILDING EQUIPPED WITH FIRE SPRNKLERS? YES (9 (CIRCLE ONE)
SQUAREFOOTAGE .5 P0 NUMBER OF EMPLOYEES 2-
NUMBER AND LOCATION OF RESTROOM FACILITIES /L
• LISTANYTOXIC CHEMICALS, FLAMMABLE/COMBUSTIBLE LIQUIDS OR GASES USED OR
STORED WITH MSDS SHEETS AND QUANTITIES OF EACH BELOW OR ON A SEPARATE
ATTACHED SHEET(S);
• ARE YOU MAKING ANY IMPROVEMENTS TO THE SUITE OR BUILDING OTHER THAN PAINTING,
PAPERING, FLOOR COVERING, MOVABLE CASES,SHELVING OR PARTITIONS NOT OVER 5'9'
HIGH?
YES (CIRCLEONE)
Applicant agrees that the Certificate of Occupancy shall be posted in a conspicuous ocation,and will
operate subject to the City'issuance of the Certificate of Occupancy.
I, llzqf�%e� KyoAkA Ductr-ve hereby agree to comply with the above-
described terms in this A fi of Certificate of Occupancy.
SIGNATURE pp= DATE
APN L-a b4 PERMIT NUMBERI IF"TRO
INVOICEAMOUNT OCCUPANCYGROUP
16
cn C\j
(5
ce)
c
C: 46
CU
ja..r- E co
E 0 M
>
0 0 CL
z 2 a) C)
ca 00
U) 0 a)
CL
'n Co co
-C�
LL
2 :5
uj co
LO a) 0) < U)
LL C*4 �2 (L
L>� (D z
cn 0 C: " <
U) U) M Z z
< a) CL 0 LLI LU
IL
Lu Z U) 5
ct3 0 (n
w < w
LL tri W - 0
LL 45 -0 0
z — a) C: 0)
W8Z m
w a) LO
LL :5 co
a) LO
99 0 0 cn C\j
0)
LL o
z z 0 0 (D 0
a) Of
w :3
_r_ C:
ca
U)
_0
a. 1� U) 'R c
W m L.Li a) (D
c w
04 0 (1) a- _0
M-0 =s CD
0 L) C)
It J� >
C) C.) [,- ce)
-a 0 C\l cu
N CO T- c 1).
m
9
�j
w w
M ca z m m z
L)
C\l
tr- z
(n z r &j
'E z F- Ir U) LL
w
4) 2 w
a) m 0. R 0
6
U) > -a ._ -i W 0 w
0 m t�= D Lu w a U U)
E 0 M a. a.
vTso� &U