PMT17-02706 City of Menifee Permit No.: PMT17-02706
29714 HAUN RD. Type: Sign-Permanent
<A-CCEL/-0' MENIFEE,CA 92586
MENIFEE Date Issued: 0 810 212 01 7
PERMIT
Site Address: 26925 NEWPORT RD, MENIFEE, CA Parcel Number: 360-030-001
92584 Construction Cost: $6,500.00
Existing Use: Proposed Use:
Description of MOVE&REPLACE 4 ARCO CHANNEL LETTER SIGNS ON CANOPY STRUCTURE, NEW FASCIA&
Work: BLUE LED GASOLINE
Owner Contractor
TESORO MARKETING CO. DONCO&SONS INC
19100 RIDGEWOOD PKWY 4582 E EISENHOWER CIR
SAN ANTONIO,TX 78259 ANAHEIM, CA 92807
Applicant Phone:7142540099
EDDIE VIDALES License Number:435616
DONCO&SONS INC
4582 E EISENHOWER CIR
ANAHEIM,CA 92807
Fee Description Pht Amount($1
Sign Permit 4 214.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 10.70
$252.70
.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 conl cts for the projects
with a licensed contractor(s)pursuant to the Contnctots5tate 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 Contractor's Stile License Law for
Professions Code and my license is in full force and effect the following reason:
License Class_ G 1 O License No. �f`
� 8y my signature below I acknowledge that,except farmlpersonal residence
Expires Z—z.i I Signature in which I must have resided for at least one year prior facompletiom of
WORKER'S COMPENSATION DEC TION improvements covered by this permit.I cannot legallystga structure that I
have built as an owner-builder if it has not been construed in its en tirety by
❑I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the apptable law,Section
have and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,is available hwn 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 Cade,for the performance of work for which -this permit is issued. www.leeinfo.ca.eov/celaw.html.
Policy# Date�—
❑I have and will maintain workers compensation insurance,as required by 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 followi ilam the proPety
this permit is issued.My workers compensation insurance carrier and policy owner orauthonzed to act on the property owners beh,,I have rea d this
number are: application and the information I have provided is corre ree to comply
- with all applicable city and county ordinances and stateg to
Cartier S �V tin PP ty tY relating
q [(�i�c��— building construction.I authorize representatives of thisrc or county to
Poli
cY —( I_C Expires enter the above identified property for inspection purp".I
(This section need not to be completed is the permit is for one-hundred Date--
dollars($100)or less
PROPERTY OWNER OR AUTHORIZED AGENT
rtify that in the performance of the work for which this permit is issued,
shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of Califor ia,and agree that if should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation revisions of Section 3700 of the Labor
Code,I shall forthw' amp y'with tho a provisions. Will the applicant or future building occupant handle%LJ5 mate rial ora
Applicant Date d Z mixture containing a hazardous material equal to orgret,,t at the
amounts sp ed on the Hazardous Materials Informat4fiV fide?
W :FAILURE SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes irrNo
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicantorlve buildir+J3
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modifpan from S outh
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR
_IN SECTION370_6 OF THE LABOR CODE,INTEREST,AND.ATTORNEYS FEES. Coast Air Quality Management District(SCAQMD)7 See p5Cting cha cklist
--for guideli
CONSTRUCTION LENDING AGENCY ❑Yes ❑No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within feet of it:Y+e
lending agency forthe performance of the work which this permit is issued outer bou9daTy of a school?
(Section 3097 Civil Code) o Yes ❑No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide agl, SCAQh✓g D
i hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements undo State o7F
California Health&Safety Co ,Section 25505 and 25534�erning
Contractors License Law for the reason(s)indicated below by the hazardou�, ial reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 eye N qq Business and Professions Code).Any city or county that requires a permit to Date G
construct,alter,improve,demolish or repair any structure,prior to its 0 NER OR AUTHORIZED AGENT I
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 All
License Law(Chapter 9(commencing with Section 70001 of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule req:t ntract� rs
Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs pairt�re-197 B
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms arcyply wit�t
th Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This Includes rental property ownent ert
than($500). ;, p Y
managers who do the paint-disturbing work themselvesoy�gh th.��ir
❑1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renova& m vis st:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.xov/lead or contact the National Lead Inform
aM,-,ter at:
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 responsi"is prv�ect
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 prrtt ause:
❑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 pleaseft,,,J e RFC_ J :P
Acknowledgement.
� Wenifee
DATE PERMIT/PLAN CHECK NUMBER 0710
TYPE: COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 696GN
SUBTYPE: O ADDITION &.ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
-;@:!kEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK I l.� 2d L L L ZLo
py,1 CAA uC �C�n.� a
PROJECTADDRESS "- .j/eCp 4>
ASSESSOR'S PARCEL NUMBER (�/� E/y� LOT TRACT
OWNER NAME
ADDRESS L0 c7 7
PHONE al0- ldZ6. EMAIL
APPLICANT NAME L '
ADDRESS L SGw
PHONE '7/y- L.i.(Jq -39 -7 1 EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES NO
l
BUSINESS NAME b p c_O S
11 e
ADDRESS CA 1z,8c;7
PHONE �]I�J — 'y-7 rj- co �9 �/ EMAIL C�> y.,
CONTRACTOR'S STATE LIC NUMBER Lf_-z' G (Z3 LICENSE CLASSIFICATION 12,10(c.4sku,
VALUATION$ (oi `�(�C� SO FT L SO FT(,
APPLICANT'S SIGNATURE DATE (3 Z — 7
DEPARTMENT DISTRIBUTION CITY OF MEENIIFFEEE BUSINESSLICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE F•/ PAIDAMOUNT
AMOUNT .� I I OCASH OCHECKH OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT I OCASH OCHECKH 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee,CA 92586951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213