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PMT17-01271 City of Menifee Permit No.: PMT17-01271 29714 HAUN RD. --ACCEL/> MENIFEE,CA 92586 Type: Commercial New MENIFEE Date Issued: 08/07/2017 PERMIT Site Address: 26380 PALOMAR RD, MENIFEE, CA Parcel Number: 331-220-037 92585 Construction Cost: $810,237.25 Existing Use: Proposed Use: Factory-Industrial Description of CONSTRUCTION OF 12.323 SO FT SHELL METAL BUILDING STRUCTURE W/ELECTRICAL Work: Restroom Rehab, ONLY 2 fixtures are being relocated. NO NEW WASTEWATER LINES. Owner Contractor ROMO RNVS, LLC H E HAMMER CONSTRUCTION CORP 11100 BEACH BLVD 32147 DUNLAP BL STE H STANTON, CA 90680 YUCAIPA, CA 92399 Applicant Phone:9094468530 MIKE HAMMER License Number: 300651 H E HAMMER CONSTRUCTION CORP 32147 DUNLAP BL STE H YUCAIPA, CA 92399 Fee Description O_yt Amount 1$1 Discretionary permit other than single family 4 2,130.00 residential on greater than'h Power Apparatus 1 150.00 Power Apparatus 1 150.00 Power Apparatus 1 183.00 Services, Switchboards, Control Centers&Panels 3 549.00 Services, Switchboards, Control Centers&Panels 1 283.00 Receptacle, Switch, Outlet&Fixture 36 291.00 Plumbing Fixtures and Vents, fixtures 2 116.00 Plan Check Fee 103 102.50 Building Permit Issuance 1 27.00 Inspections not specified 516 516.28 GREEN FEE 1 33.00 SMIP COMMERCIAL 1 227.00 New Construction Permit Fee 1 3,727.09 New Construction Plan Check 1 2,422.61 General Plan Maintenance Fee-Building 1 25.81 General Plan Maintenance Fee-Plumbing 1 5.80 General Plan Maintenance Fee-New 1 186.35 Construction General Plan Maintenance Fee-New 1 186.35 Construction $11,311.79 AA_Bldg_Permit_Template.rpt Page 1 of 2 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contrector(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractors 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 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 ❑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 have and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Cade,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. www.lezinfo.ca.golcalaw.html. I Poliq Date ❑I have and will maintain workers compensation insurance,as required liy PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I certify to each of the following:I am the property II 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: 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 r. //��,�,, /' f building construction.I authorize representatives of this city or county to Policyp�?/�Zyy� Expires % ZS 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 ❑I certify that in the performance of the work for which this permit is issued, '�!/1 I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE q `�4/ 1 workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's cam ensation provisions of Section 3700 of the Labor Code,I shall forthw c ly with those provisions. � Will the applicant orfuture building occupant handle hazardous material or mixture containing a hazardous material equal to or greater that the ' Applicant Date amounts specified on the Hazardous Materials Information Guide? ` WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes F{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 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 ❑Yes 1l0 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) ❑Yes IIAgO OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that am exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 Concerning ha rdous materi l: rung. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es ❑No 's'A Business and Professions Code).Any city or county that requires a permit to ,�/(/'/%/ 0 Date construct,alter,improve,demolish or repair any structure,prior to its PROPAW dylliilt 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING(FIRM 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 ❑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.ega.ggv 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 or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑1,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. REQUEST FOR PERMIT ISSUANCE ' Menlfee CITY OF . DEPARTMENT Prior to issuance of Commercial Building Permits, approvals from the departments listed below are required.Approval shall be designated by the original signature of the appropriate department staff.When all appropriate signatures are obtained, please return permit issuance form to the Building & Safety department. Please allow up to 48 hours for processing of building permits.Permit Number: I j� M T-I 7 —D l z, :z I' Project Name: ��2 7;—�ge.4 �i/�s-- Ulm Za/ Z6 3 APN: 33/-Zw --czz-0z-5 Lot: 5F31 -Zzv 0Y0 Address: �•2c, ?j-� e New Commercial: YES NO New Industrial: YES NO Shell Building: YES NO Tenant Improvement: YES NO DEPARTMENT DATE AP O S19tIATURE ENGINEERING 3 /� PLANNING - 7- 1 7 RIVERSIDE COUNTY FIRE '7��4 It-7 By Email �- BUILDING 91-711-7 List of required items to obtain signatures for Permit Issuance: Engineering-Grading Plan Approved, Rough Grade Certification, Soils Compaction Planning- Payment of School Fees, provide receipts, Compliance with all prior conditions, including approval of Minor Plot Plan applications Riverside County Fire- Please contact Riverside County Fire 951-955-4777 Building- Payment of Permit and Plan Check fees,verification of all required signatures CITY OF •D dwak Riverside County Fire Department Office of the Fire Marshal Section PaM Oeaen Rrr 00ce 2300Ma6,,Si $R 1W R.ygpe,U 62601 PO t961)96 717 Faa 1651165Y1666 Once 77-933"s Monpnas PC a 201Pa Msen.U W21 F9131P6 (7601 86 3-0 056 F0(76R.663•7072 Fire Department Clearance/Release Data: u To: cca son@eityofinenrfeaus:bnvera@cityofinenifee.us.mbinnall@cityofinemfee.us Fax- Tract/Parcel Map#: Permit/Lot#: Job Site Address rl Final For Recordation _ Release For Building Permit(s) fl Shell Final Only(No Tenant) 1 l Final For Occupancy rl Release For Residential Sprinkler Installation rl Building Plan Check Fees Paid, Water Requirement Met-if water appl/cable Fl Building Plan Check Fees Not Paid fl Residential Sprinkler Plan Check Fees Paid f l Residential Sprinkler Plan Check Fees Not Paid f—I Other Fees fl Fees Not Required If you should have any questions, please contact the appropriate Ri e C ty Fi2tection Planning office for further assistance. ALfthorizing Signature For Release Fmm G-Rensee Sn N16 Print Name