PMT16-04253 City of Menifee Permit No.: PMT1 6-04253
29714 HAUN RD. Type: Sign-Permanent
<A-CCELA-> MENIFEE, CA 92586
MENIFEE Date Issued, 12/2012016
P E R M I T
Site Address: 30095 HAUN RD,MENIFEE, CA 92584 Parcel Number: 360-080-053
Construction Cost: $3,000.00
Existing Use: Proposed Use:
Description of INSTALLATION OF 2 ILLUMINATED CHANNEL LETTER SIGNS FOR"CHINA BROS"
Work:
Owner Contractor
RICH DEVELOPMENT 88 SIGN CORP
1000 N WESTERN AVE,#200 1906 DOREEN AVENUE
SAN PEDRO, CA 90732 SOUTH EL MONTE, CA 91733
Applicant Phone:6264428033
DAN LUONG License Number:702474
88 SIGN CORP
1906 DOREEN AVENUE
SOUTH EL MONTE, CA 91733
Fee Description Qtv Amount($1
Sign Permit 2 190.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 9.50
$227.50
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of emors 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,Bldg_Pemtil-Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereono 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 fcommencing 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 reason:
License Class— License No. 04 By my signature below I acknowledge that,except for my personal residence
Expires Signature in which I must have resided for at least one year prior to completion of
I 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:T 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. wv�w.Ieainfo.ca.gov/caIaw.Ickhl.
Policy It Z:�2��,� Date
PROPERTY OW OR AUTHORIZED AGENT
ci I have and will maintain workees compensation insurance,as required by �01
section 3700 of the Labor Code,for the performance 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 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 with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives ofthis city or countryto
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
doll rs($100)or less
PltblrWOW OR AUTHORIZED AGENT
e
7,rtify that in the performance of the work for which this permit is issued, 74
1 shall not empi any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If
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 use provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applicant Date amounts specified on the Hazardous Material,Information Guide?
WARNING:FAILURE TO Slii?URE WORKER'S COMPENSATION COV�R�GE IS 0 Yes 0 K.
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 SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ci Yes ci*
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) o Yes a�(
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCACMD
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 items)(Section 7031.5 oYes o
Businessand Professions Code).Any city or county that requires a permi to 17,6
construct,alter,improve,demolish or repair any structure,prior to its ��z� —Date V, A/
issuance,also requires the applicant for the permit to file a signed statement PROPERTY b"Eft OR AU' �T
thathe orsheis licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIi AND PAINTING(RRP1
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
than($500). required practices.This includes rental property owners and property
managers who do the paint-disturbing workthemselves or through their
0 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( )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 for sale.(Section 71344,Business and Professions 1-800-424-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 forthis project
property who,through employeeso 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
completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.:
not built or improved for the purpose of sale. a No EPA Lead-Safe Certified Firm is req ulned for th is project because:
a 1,as owner of the property a in 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 RRIP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
-Menifee
DATE PERMIT/PLAN CHECK NUMBER f'M[(O- 04a5-15)
C/OMMERCIAL ORESIDENTIAL 0MULTI-FAMILY OMOBILEHOME CPOOL/SPA OSIGN
TYPE: 0
SUBTYPE: DDITION 0ALTERATION ODEMOLITION OELECTRICAL OMECHANICAL
(7NEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES—
DESCRIPTION 0 F WORK Wll-(( �.4f
Lal4zz�/-7)
PROJEcTADDRESS 7,089 E14:1)IV a 10
ASSESSOR!S PARCEL NUMBER LOT TRACT
OWNER NAME ru 04 115fte)S.
ADDRESS 5jZn� t?j) .
PHONE EMAIL
APPLICANT NAME -DAIL/ - Z-t&/U(r�j
ADDRESS b74!��L� O�) .---2A- 79(-, C11 -
PHONE EMAIL
CONTRACTOR'S NAME OWNERBUILDER? OYESONO
BUSINESS NAME
ADDRESS C)A
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ 3 ov--6 SO FT LSQFT 2-C],
APPLICANT'S SIGNATURE e��)� ",� — DATE 1/12
M2120M - &-;7 f
DEPARTMENT DISTRIBUTION 1 10 MIP CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN S
INVOICE ol,,,,-7
AMOUNT 0 tV I PAIDAMOUNT OCASH 0CHECK4 0 CREDIT CARD VISAVMC
PLAN CHECK FEES I PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
LOWNER BUILDER VERIFIED OYES 0 NO DL NUM13ER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www,cityofmenifee.us Inspection Request Line 951-246-6213
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