PMT17-02881 City of Menifee Permit No.: PMT17-02881
29714 HAUN RD.
�-.C`CEL/? MENIFEE, CA 92586 Type: Commercial Alteration
MENIFEE Date Issued:
08/18/2017
PERMIT
Site Address: 26800 NEWPORT RD, MENIFEE, CA Parcel Number: 338-170-019
92584 Construction Cost: $10,000.00
Existing use: Educational Proposed Use: Educational
Description of BUILDING G
Work:
Owner Contractor
Applicant License Number:
MENIFEE, CA
Fee Description Qtv Amount lSl
Plumbing Fixtures and Vents, fixtures 4 121.00
Building Permit Issuance 1 27.00
Inspections not specified 129 129.07
Additional Plan Review Building 148 148.37
GREEN FEE 1 1.00
New Construction Permit Fee 1 46.00
General Plan Maintenance Fee-Building 1 6.45
General Plan Maintenance Fee-Mechanical 1 0.00
General Plan Maintenance Fee-Plumbing 1 6.05
General Plan Maintenance Fee-Electrical 1 0.00
$484.94
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 building 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_BIdg Peenit_Templatexpt Page 1 of 1
CITY OF VENIIIEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractors)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 o 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 mysignature below I acknowledge that,except for my personal residence
Expires Signature in which I ist have resided for at least one year prior to completion of
improvemen\s 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 worker's 7044 of the Business and Professions Code,is available upon request when
compensation,issued bythe 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 f o' calaw.html.
this permit is issued. www,i=_ainfo4ca,g_ /
Policy q Date L
PFRTV OIlY E kAS7iHORIZED AGENT
❑I have and will maintain worker's compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which ❑By my signat re 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 auth !zed to act on the property owners behalf.I have read this
number are: ap ca ion and he information I have provided is correct.I agree to comply
w h all applicab city and county ordinances and state laws relating to
Carrier b ilding construc on.I authorize representatives of this city or county to
Policy It Expires a erthe above id tiled property for Inspection purpose
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less PROPERTY OWNER ORIZED 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 the CITY BUSINESS LICENSE M
worker's compensation laws of California,and agree that if I should become. HAZARDOUS MATERIAL DECLARATION
subject to the workers 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 IS ❑Yes k X.
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 guidelin s
CONSTRUCTION LENDING AGENCY ❑Yes PJo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed uilding 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) �/es ❑No
OWNER BUILDER DECLARATIONS I have read the Haz dous Material Information Guide and the SCAQMD
hereby affirm under penalty of perjury that I am exempt from the permitting ch ist. understand my requirements under the State of
California H alth&Sa ty Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazardous aterial repo ing.
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5
as
❑ o
Business and Professions Code).Any city or county that requires a permit to Da
construct,alter,Improve,demolish or repair any structure,prior to its PROPERTY OWN AUTH ZED 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 fRRP)
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 Applicantfor a permit subjects the applicant to a civil penalty of not more r wired practices.This includes rental property owners and property
than($500). MOpI'Le ID agers who do the paint-disturbing work themselves or through their
❑1,as owner of the property,or my employee with wages as their s Ot Sa'o employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion _w.e a. ov lead or contact the National Lead Information Center at
not Intended or offered for sale.(Section 704 00-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of f_ `U n An PA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improve V
property provided that the Improvements are not intended or offered for .1 Qj Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of �f� Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it w�i V
not built or 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.