PMT17-01016 City of Menifee Permit No.: PMT17-01016
29714 HAUN RD. T Commercial Alteration
�ICCEll MENIFEE, CA 92586 Type:
MENIFEE Date Issued: 11/0 312 01 7
PERMIT
Site Address: 23960 NORMA DR, MENIFEE,CA 92587 Parcel Number: 350-256-010
Construction Cost: $59,998.12
Existing Use: Proposed Use:
Description of ALTERATION TO EXISTING AS-BUILT COMMERCIAL STORE FRONT
Work:
Owner Contractor
MATHIEU SCHMITT&DONNA GU ,
5057 JADE TER
CHINO HILLS, CA 91709
Applicant License Number:
MATHIEU SCHMITT&DONNA GU
5057 JADE TER
CHINO HILLS, CA 91709
Phone:6264975488
Fee Description QtV Amount($)
Building Permit Issuance 1 27.00
Reinspections/Additional Inspections 387 387.21
Additional Plan Review Building 129 129.07
Additional Plan Review Building 129 129.07
GREEN FEE 1 3.00
SMIP COMMERCIAL 1 17.00
New Construction Permit Fee 1 275.99
General Plan Maintenance Fee-New 1 13.80
Construction
$982.14
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_Permi!_Template.rpt 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 perjurythat 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:
License Class License No. By my signature below I acknowledge that,except for my personal residence
Expires Signature In which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
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:) 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 www,le info.ca. ov law.html.
this permit is issued. 2
Policy# 21 Date
o I 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 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 of this city or county to
Policy# Expires enter the above identified property for inspection purposes. /
(This section need not to be completed is the permit is for one-hundred 4� Date 11 I Lot /
dollars($100)or less PROPEFiVVNERORAN.THORIZED AGENT
o I certify that in the performance of the work for which this permit is issued,
I shall not emolov 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 15 o Yes o 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 FIN ES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ottupan[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(SC construction
or modee ification
checklist
IN SECTION 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Airllnes
Qua
CONSTRUCTION LENDING AGENCY ❑Yes 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) o Yes O No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
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 oYes o No
Business and Professions Cade).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 fRRPI
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 required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
o 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.eoa.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 Contractor's 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 or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because:
01,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.
PERIVIIT/PLAN CHECK A. •
Merifee Lit
DATE PERMIT/PLAN CHECK NUMBER fp -Tn - ololta
TYPE: ❑COMMERCIAL ❑RESIDENTIAL ❑✓ MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑✓ ALTERATION []DEMOLITION []ELECTRICAL ❑MECHANICAL
[—]NEW ❑✓ PLUMBING [IRE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK Combine two units by opening a wall;add washer connections in two apartments
�Y-e -1"Yo1(1
PROJECTADDRESS 23960 Norma Dr,Menifee,CA
ASSESSOR'S PARCEL NUMBER 350-256-010 LOT 35 TRACT 012/057
PROPERTY OWNER'S NAME Mathieu Schmitt&Donna Gu
ADDRESS 5057 Jade Ter,Chino Hills,CA 91709
PHONE (626)497-5488 EMAIL mathieu_schmitt@yahoo.com
APPLICANT NAME Mathieu Schmitt
ADDRESS 5057 Jade Ter, Chino Hills,CA 91709
PHONE (626)497-5488 EMAIL mathieu_schmitt@yahoo.com
CONTRACTOR'S NAME Jeff Stephens OWNER BUILDER? ❑YEONO
BUSINESS NAME California Property Solutions Inc.
ADDRESS 38372 Innovation Ct.,Ste 102, Murrieta,CA 92563
PHONE (951)234-9487 EMAIL calpropsolutions@gmail.com
CONTRACTOR'S STATE LIC NUMBER 964759 {LICENSE CLASSIFICATION General Contractors
VALUATION$ $�5(y000:Q01 j`[0�FT 2N , y—\ L SQ FT 10,000
APPLICANT'S SIGNATURE DATE 04/05/2017
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN '✓� SMIP
INVOICE yam PAID AMOUNT
AMOUNT � I OCASH OCHECKN OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT CASH O CHECK p OCREDITCARD VISA/MC
OWNER BUILD RRI I VEEO O ES O NO DL NUMBER NOTARIZED LETTER O YES C NO
City of Menifee Building&Safety Deportment 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213