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PMT17-02918 City of Menifee Permit No.: PMT17-02918 29714 HAUN RD, "ACCELA3- MENIFEE,CA 92586 Type: Commercial Alteration " "" MENIFEE Date Issued: 08/17/2017 PERMIT Site Address: 28075 BRADLEY RD, MENIFEE, CA Parcel Number: 337-302-009 92586 Construction Cost: $0.00 Existing Use: Proposed Use: Description of HOURLY INSPECTION FOR C OF 0"TOTAL IMPACT MARTIAL ARTS" Work: Owner Contractor PRIME PROPERTIES 29826 HAUN ROAD,#305 MENIFEE,CA 92586 Applicant License Number: MENIFEE, CA Fee Description City Amount fEl Building Permit Issuance 1 27.00 Inspections not specified 129 129.07 $156.07 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_Bldg_Pepnit_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 perjury that I am under provisions of with a licensed mntractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exemptfrom 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 1 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 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 Cade,for the performance of work for which www.leginfo.ca.goy/calaw.htmi.permit Is issued. Policy# Date ❑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 ❑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 build' g construction.I authorize representatives of this city or county to Policy# Expires ent a above identified property for Inspection purposes. (This section need not to be completed is the permit is for one-hundred Date (_� V7 / dollars($100)or less PROP ER OR AUTHORIZED AGENT ❑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 IS ❑Yes ❑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 ❑No 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 ❑No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I 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 hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Ayes ❑No Business and Professions Code).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 forthe permitto file a signed statement that he or she Is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRP) 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($500). managers who do the paint-disturbing workthemselves orthrough their _ ❑1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of provingthat it was not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. CERTIFICATE OCCUPANCY 1 APPLICATION AUG 17 201i Received ;len'fee Aw� : �-� -� -cam M DATE �)-2 11 PERMIT SNUMBER - BUSINESS NAME �i SL�YY111(v�H—TVV� . IICLAF1'TYPEOFBUSINESS►�`Gt' AI`t�L F-+S ADDRESS AD l-e N T ' C,q q2 T S CO., NAME OF BUSINESS OWNER(S) ADDRESS(IF DIFFERENT FROM ABOVE) 1 r PHONE( J�� a-�� EMAIL �(5"I k 1 ��C'. G�I✓� OWNER OF BUILDING A m iyet- at P ADDRESS 'I�_j$'L b dais.- e( M4 r 2 r Z(o PHONE �S� `�F, � - L�� EMAIL DESCRIBE EXACT USE OF BUILDING: rAG�� 4 L � _> �F'4 i/V .�� I All S AA�I ,we a PREVIOUS USE OF BUILDING/SUITE APPLICANT ACKNOWLEDGEMENT Applicant agrees that the Certificate of Occupancy shall be posted in a conspicuous location,and will operate subject to the Ci s issuance of the Certificate of Occupancy. I, hereby agree to comply with the above-described terms in this App ertificate of Occupancy. DATE APPLICANT BUS LICENSE DATE HEALTH DEPT DATE BUS LIC.NUMBER FIRE DATE PLANNING DATE EM W D DATE ENGINEERING DATE BUILDING DATE ENGINEERING INSPECTION(INCLUDE VERIFICATION OF BMP's BUILT PER PLANS/WQMP) REF WQ/SW N APPROVED BY DATE City of Menifee Building&Safety Deportment 29714 Houn Rd, Menifee, CA 92586 951-672-6777 www.cityofinenlfee.us inspection Request Line City of Menifee 29714 Haun Road, Menifee, CA 92586 Phone: (951)672-6777 Fax. (951)672-6777 www.cityofrnenifee.us STATEMENT OF OPERATIONS Provide a written statement outlining the nature of the business to be conducted within the stated location. Your response should give a detailed description of the proposed use and shall include, but it is not limited to : A detailed description of the business Hours and days of operation Number of employees Storage needs (Include storage location, and type of materials stored) Vehicles used or stored 4-� li v Signature Date CERTIFICATE OCCUPANCY APPLICATION Y..�..1 Menifee DATE S Z 3 — 1—] PERMIT NUMBER ZG BUSINESS NAME7Ch:\r_�_\ Tnnncs c i :Re 1541'0V^^1C�TYPE OF BUSINESS MQ g ADDRESS Z-ib7S 17C rQA\2\�a c-ck. AD n\� ,P_Q c—A- o17 sq,c, NAME OF BUSINESS OWNER(S) ADDRESS (IF DIFFERENT FROM ABOVE) PHONE a.� �-R IG -Zg7 \2 EMAIL OWNER OF BUILDING &Y\/-, ADDRESS PHONE n� EMAIL DESCRIBE EXACT USE OF BUILDING: V\s r \r-x0.\ A-i kS SG�oo� PREVIOUS USE OF BUILDING/SUITE APPLICANT ACKNOWLEDGEMENT Applicant agrees that the Certificate of Occupancy shall be posted in a conspicuous location, and will operate subject to the City's issuance of the Certificate of Occupancy. I, c,�c,f I. U S� CkC , hereby agree to comply with the above-described terms in this Application for C ificate of Occupancy. 2 DATE APPLICANT CITYSTAFFUSEONLYAND DATE WAPPROVED) BUS LICENSE DATE HEALTH DEPT DATE BUS LIC.NUMBER FIRE DATE PLANNING DATE EM W D DATE ENGINEERING DATE BUILDING DATE ENGINEERING INSPECTION(INCLUDE VERIFICATION OF BMP's BUILT PER PLANS/WQMP) REF WQ/SW# APPROVED BY DATE Cityo 119eni ee 61111dina u 5o ety Department 297 i4 hlaun Rd. Meni ee, CA 92'z'. City of Safety e I l- f p J Building'& Safety Dept. w^rw.cityolmenifee.0 kispection Request Line AUG 2 3 2017 Received