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PMT17-00531 City of Menifee Permit No.: PMT17-00531 29714 HAUN RD. Type: Sign-Temporary �ACCELA? MENIFEE,CA 92586 MENIFEE Date Issued: 0 3101/2 01 7 PERMIT Site Address: 24686 SILVER STONE CT, MENIFEE, CA Parcel Number: 358-700-025 92584 Construction Cost: $800.00 Existing Use: Proposed Use: Description of INSTALL TEMPORARY SIGN FOR"THE RIDGE" 14'6"x 4' Work: Owner Contractor RICHMOND AMERICAN FUSION SIGN &DESIGN INC 5171 CALIFORNIA AVE,#120 680 COLUMBIA AVE IRVINE, CA 92617 RIVERSIDE, CA 92507 Applicant Phone: 9516829660 DAVID HAFFTER License Number..894662 FUSION SIGN &DESIGN INC 680 COLUMBIA AVE RIVERSIDE, CA 92507 Fee Description City Amount 1El Sign Permit 1 190.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 129 129.07 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 1.00 General Plan Maintenance Fee-Building 1 9.50 $357.57 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 carded 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_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects iI hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuantto the Contractors'State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from Iicensure under the Contractors State License Law for Professions Code d y license is in f�uullll'f_qr�and effe the following reason: License Class Ziceer No. 1 l� CJ 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 improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARA have built as an owner-builder if it has not been constructed in Its entirety by 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 i ve and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,is available upon request when Icompensation,Issued by the Director of Industrial Relations as provided for this application is submitted or at the fallowing website: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.leginfo.ca.eov/calaw.html. Policy R Date have and will maintain workers compensation Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT ection 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I certify to each of the fallowing:I am the property this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this ' number are: N application and the information I have provided is correct.I agree to comply Carrier 1� "7 with all applicable city and county ordinances and state laws relatingto building construction.I authorize representatives of this city or county to Polity R�(�-(Tr—,O 11_b_Qxpires ig enter the above identified property for inspection purposes. (This section need notto be completed is the permit is f r one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑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 theLAZAR Bj1SINE55 LICENSE fi,/_ n O I workers compensation laws of California,and agree that if I should becomeARDOUS MATERIAL DECLARATION subject to the workers compensati provisions of Section 3700 of the Labor od I shall forthwith.ce p ywith t ose provisions. l the applicant or future building occupant handle hazardous material or a Ap icon[ Date 1 ture containing a hazardous material equal to or greater that the ounts specified on the Hazardous Materials Information Guide? WARNING:F E TO SECURE WO KER'S COMPENSATION OVERAGE ISes yQ - UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIESintended AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),INl the require use of the building by the applicant or future building ADDITION 70 THE COST OF COMPENSATION,DAMAGES AS PROVIDED FORupant require a permit for the construction or modification from South IN SECTION 3706 OF THE LABOR[ODE,INTEREST,AND ATTORNEYS FEESst Air Quality Management District(SCAQMD)?See permitting checklist guidelines CONSTRUCTION LENDING AGENCY es �1'Na— I hereby affirm that under the penaltyof perjurythere isaconstructionl the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issueder boundary of a school?(Section 3097 Civil Code) es NoOWNER BUILDER DECLARATIONS ve read the Hazardous Material Information Guideand the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the mitting checklist.I understand my requirements under the State of Contractors License Law for the reasons)indicated below by the ifornia Health&Safety Cod Section 25505 and 25534 concerning rdous material reporting.checkmark(s)I have placed neM[o the applicable items)(Section 7031.5Business and Professions Code).Any city or county that requires a permit too No construct,alter,improve,demolish or repair anystructure,priorto itsDate issuance,also requires the applicantfor the permittofile a signed statementPER OW AUT OR ED AGENT that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRPI 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)orthat he or she is exemptfrom Iicensure 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 an Applicantfor a permit subjects the applicant to a civil penalty of not more residence ra childcare facility to be rental propertyfied firms and comply with than($500). required practices.This Includes rental property owners and property managers who do the paint-disturbing work themselves or through their ❑I,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( )portion of the work,and the structure is www.eva.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a ❑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 ur improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors 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 will DATE t �1 _ PERMIT/PL,\.'J CHECK IJUMBER 52) TYPE: ❑COMMERCIAL _]RESIDENTIAL ❑iV U Tl-FAPdILY []iVICIBILii HOME ❑POGL/SPA R35IGN SUBTYPE: []ADDITION ❑ALTERATION []DEMOLITION []ELECTRICAL ❑MECHANICAL ❑NEW ❑PLUMBING ❑P,E-RGGF-NUMBER OF SQUARES City of c — y-- epf. DESCRIPTION OF WORK J oo In n PROJECTADDRESS �i�� q,T � F 'H`)QAA �vlc 2-Ye, CS ✓4'.�' fI`III�➢ ASSESSOR'S PARCEL NUMBER 6b'0&45 LOT TRACT ZO'Z.S PROPERTY OWNER'S NAME ADDRESS ✓I 11 11 1G A1JP'LY �g/ _wloe t CA -y 4 of 1 PHONE EMAIL APPLICANT NAME _&e'itovi 11 yyyyy�� j C�ll� �,i SA✓� ADDRESS ( � n(L/x/I hiO. _.� iy. n'—C-`A '•Z�10 PHONE �S i &13 2 /Fj�o EMAIL �r?.,,, -r,d�.• `-7/(A;,I , C 0/4-1 I CONTRACTOR'S NAME ejict � �- I�?_r11 OWNERBUILDER? ❑YESE*O BUSINESS NAME ��`QN �i IeA in `-- ADDRESS (OQ)0 C tDly l?iLl._!.jv'� 'G IC PHONE EMAIL -n g. I "--1 CONTRACTOR'S STATE LIC NUMBER 8916 6 Z _ LICENSE CLASSIFICATION c- S VALUATION$ 9500 SQFT _ LSQFT APPLICANT'S SIGNATURE DATE: -_ fit,. - --- ----------`-- — — -------- DEPARTMENT DISTRIBUTION I CITY r-�/y-Iv�ltCNNJFFEEB INESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN � '_ SMIP "✓�fL INVOICE I Q PAIDAMOUNT AMOUNT ��lJ -1 CISH - CHECK M O CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT CASH 'J CHECK B C CREDIT CARD VISA/MC OWNER BUILDER VERIFIED YES C) NO DL NUMBER NOTARIZED LEI-iER ) YES i:� NO i City of IVlenifee Building&Safety De?artment 2ti ;"-= /n., .Li.MEn fee, CA 92586 951-672-6777 vww.cityofinen feP-js ln;v;;t; ,.: ::,t=c,L..;l Line S'S 1-246-6213