PMT17-03081 City of Menifee Permit No.: PMT17-03081
_ 29714 HAUN RD.
�CCELX—> MENIFEE,CA 9258E Type: Commercial New
MENIFEE Date Issued:
04/30I2018
PERMS 1
Site Address: 29787 ANTELOPE RD, Suite#105, Parcel Number:
MENIFEE, CA 92584 Construction Cost $1,748,476.08
Existing Use: Proposed Use: Retail
Description of CONSTRUCT MAJOR BUILDING"BARONS MARKET'SHELL AND TENANT IMPROVEMENT 18,324
Work: SO FT AT MENIFEE LAKES PLAZA
Owner Contractor
MENIFEE LAKES PLAZA, LLC MOOREFIELD CONSTRUCTION INC
3636 BIRTH ST#200 600 N TUSTIN AVENUE SUITE#210
NEWPORT BEACH, CA 92660 SANTA ANA, CA 92705
Applicant Phone:7149720700
FRED STEPHENSON License Number:397892
MCG ARCHITECTURE
600 N TUSTIN AVENUE SUITE#210
SANTA ANA,CA 92705
Phone: 9495531117
Fee Description ON Amount t51
Services, Switchboards, Control Centers&Panels 7 1,281.00
Services, Switchboards, Control Centers&Panels 1 283.00
Receptacle, Switch, Outlet&Fixture 401 2,116.00
Plumbing Fixtures and Vents,fixtures 61 406.00
Grease Interceptor 1 116.00
Gas System 1 116.00
Water Heater 1 83.00
Plan Check Fee 280 280.00
Plan Check Fee 265 265.25
Sewer 1 150.00
Air Handling/Condensing Units Non-SFR 6 1,098.00
Hood Served by Mechanical Exhaust 2 438.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 3,398 3,398.16
GREEN FEE 1 70.00
SMIP COMMERCIAL 1 490.00
New Construction Permit Fee 1 8,042.99
General Plan Maintenance Fee-New 1 402.15
Construction
$19,062.55
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_Pennil_Template.rpt Page 1 of 2
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 contractor(s)pursuant to the Contractors State License Law).
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 Class13{ U ns N ! By my signature below I acknowledge that,except for my personal residence
Expires Q` :S' tq Signature in which 1 must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATIO improvements covered by this permit.I cannot legally sell a structure that 1
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 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 svvnv leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy p Date
D 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 o By my signature below I certify to each of the following:I am the property
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: �'I/f^ application and the information I have provided is correct.I agree to comply
Carrier
ljji�� V lzo"' u_ ` with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy r�) 2161 tY Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for onhundrild
dollars($100)or less Date
PROPERTY OWNER 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 e
workers 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 f hwit mplyw'th those provisions. Will the applicant or future building occupant handle hazardous material or a
�
T r mixture containing a hazardous material equal to or greater that the
Applicant .� Date amounts spFAed on the Hazardous Materials Information Guide?
WARNING:F UR )SECURE WORKER'S COMPENSATION COVERAGE 15 o Yes
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 S100,0001,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(SC construction
or See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Air
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) o Yes jlo
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
Contractors License Law for the reason(s)indicated below by the CalPIT
&Safety Code,Section 25505 and 25534 concerning
hazrepo
checkmark(s)I have placed next to the applicable items)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to RA(12 Date
construct,alter,improve,demolish or repair any structure,prior to its PROpE 0 R 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 REND A ION.REPAIR AND PAINTING IRRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation far most work that disturbs paint in a comply
th
an Applicant for a permit subjects the applicant to a civil penalty of not more residence ra cites.This
facility es be rental
property
firms and d prop rty
required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
01,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( I portion of the work,and the structure is www.el)a.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 Contractors State License Law does not apply to an owner of a o 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:
❑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 Ucense 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.
P;,
Menifee
DATE 08/31/2017 PERMIT/PLAN CHECK NUMBER
TYPE: ❑✓ COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN
SUBTYPE: [-]ADDITION []ALTERATION [-]DEMOLITION ❑ELECTRICAL [-]MECHANICAL
❑✓ NEW []PLUMBING ❑RE-ROOF-NUMBER OF SQUARES CI Y Of Menifee
New Mao Y DB t.
DESCRIPTION OF WORK Major Building(Barons Market)Shell and Tenant Improvement drawings
Included Architectural,Structrural,MEP and refrigeration. 5 2017
PROJECT ADDRESS 29787 Antelope Road,Suite 105
ASSESSOR'S PARCEL NUMBER 340-020-042 LOT TRACT
PROPERTY OWNER'S NAME Men'Ifee Lakes Plaza LLC
ADDRESS 3636 Birth Street,Suite 200,Newport Beach,CA 9266D
PHONE (949)660-1300 EMAIL louismiramontesl946@gmail.com
APPLICANT NAME Olga L.Ruiz
ADDRESS I I I Pacifica,Suite 280
PHONE (949)553-1117 EMAIL oruiz@mcgarchitecture.com
CONTRACTOR'S NAME Fred Stephenson OWNER BUILDER? ❑YES❑✓NO
BUSINESS NAME Moorefield Construction
ADDRESS 600 N.Tustin Ave.Ste 210
PHONE (714)972-0700 EMAIL ftephenson@moorefieldconstrue0on.com
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ I71 4!�(.}� yD SO FT 18,324 sq f L SQ FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION OFTY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAIDAMOUNT
AMOUNT I I I 1 OCASH 0CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDITCARD VISA/MC
OWNER BUILDERVERIFIED OYES O NO DLNUMBER 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
7J
FIRST RELEASE FORM
2270 Trumble Rd o P.O. Box 8300 u Perris,Ca 92572-8300 + xw
T.951-928-3777 o F.951-928-6177
emwd.org
Requesting Agency: Cityof Menifee—email:brivera@cityofinenifee.us;ccarlson@cityofinenifee.us
APPLICANT INFORMATION:
Business Name: MENIFEE LAKES PHASE 2(SHELL BUILDINGS)
Service Address: 29787,29751,29857,29881 ANTELOPE RD,MENIFEE,CA 92584
Contact Name: KEITH FRANCIS
Contact Phone: (714)743-5701 ext. Contact e-mail: kfcco@cox.net
REQUESTING AGENCY AND APPLICANT PLEASE NOTE:
• This "FIRST RELEASE' is being.,issued to allow applicant to pull permits with your agency and Q9 S_d0I constitute a
release for Certificate of Occupancy.
• Subsequent EMWD "FINAL RELEASE' or "CLEARANCE" is to be requested by the applicant noted above and will be
submitted to your office prior to your agency issuingthe Certificate of Occupancy.
• Other:
Your cooperation In this matter Is greatly appreciated. It Is extremely important that these procedures are followed for
EMWD to meet federal and state requirements.
Eastern Municipal Water District has reviewed and accepted the following as of 03/01/2018
❑Application for Service (date)
R Waste Discharge Application
10 Plans
EMWD is to provide: ®WATER and/or ®SEWER SERVICE(S). The provisions of service are contingent upon the applicant
completing the necessary arrangements in accordance with EMWD rules and regulations:
FEES REQUIRED:
® New Business Fees Due Call(9S1)928-3777 ext2081 for more information.
® Source Control Fees Due Call(951)928-3777 ext 6203 for more information.
INSPECTION REQUIRED:
❑ Sewer Lateral Call(951)928-3777 ext 4372 48 hours prior to backfilling to schedule.
® Backflow Prevention Call(951)928-3777 ext 4938 to schedule.
® Rough Plumbing Call(951)928-3777 ext 6203 48 hours prior to backfilling to schedule.
❑ Interceptor Installation Call(951)928-3777 ext 6203 to schedule.
INTERCEPTOR STATUS:
❑ No interceptor is required.
® Current interceptor is acceptable. Size: 1,500GALLON
❑ New interceptor to be installed. Size:
IF ANY INSPECTIONS ARE REQUIRED: Eastern Municipal Water District must inspect the service connection(s), the installed -
backflow prevention, and/or the plumbing prior to backfilling to verify that the accepted plans have been followed and that
,requirements have been met. If ou have any questions,please call EMWD at(951)928-3777 extension 2081.
1 U Vanessa Buenroslro New Business Development 0410512018
EMWD Repr sentative Signature Printed Name Department Date
NBD-002
REV.08/17/16
Molly Binnall ^ ' JED
From: Rueda, Enrique <ERueda@RIVCO.ORG>
Sent: Thursday, February 22,2018 5:19 PM
To: Ruiz, Olga
Subject: RE: Barons -Menifee- Cold Brew& Kombucha dispenser- NSF Certification
Hello Olga,
As we had written on the conditions letter created on 1/25/18 for your approved plans;
As agreed upon by contact person, plan have been approved under the condition that proposed Beverage-Air
Portable Draft Beer Dispensers (kegerators) are not approved for serving Kambucha tea and/or Cold Brew
coffee by this Department. Prior to Preliminary Inspection, operators must submit specification sheets
stating/verifying units are designed to hold and serve mentioned products under NSF or ETL
approval/certification.
Our Department must obtain specification sheets from the manufacturer stating that the proposed Kambucha Tea and
Cold Brew Coffee dispensers are NSF approved for mentioned products.The submitted specification sheet are for
equipment dispensing beer products. Please contact me with any additional questions.Thank you.
\P&0NTncN Enrique Rueda
m= �y Environmental Health Specialist III
Riverside County Dept.of Environmental Health
i Food & Pool Construction Program
°o ' o Phone#:951-273-9140
G g
~�of FLN'�� Email: Erueda@rivcocha.ors
M« . .•. •• www.rivcoeh.org
From: Ruiz, Olga [mailto:ORuiz@mcgarchitecture.com]
Sent: Wednesday, February 21,2018 12:25 PM
To: Rueda, Enrique<ERueda@RIVCO.ORG>
Subject: Barons-Menifee-Cold Brew& Kombucha dispenser- NSF Certification
Hello Enrique-
Barons provided the attached information for the Cold Brew and Kombucha dispenser for your review/approval of the
equipment. Thank you,
Olga Ruiz
Project Manager
MCG Architecture
111
111 Pacifies,Suite 280 Irvine,CA 92618
(n 949.553.1117 (F)949.474.7056
http:Hwww.mcoarchitecture.00m Follow us on Linkedln
1
From: Bijan Moossazadeh [mailto:BiianMoossazadeh@BaronsMarket.com]
Sent:Tuesday, February 13, 2018 10:27 AM
To: Ruiz, Olga <0 Ruiz( mcaarchitecture.com>
Subject: Cold Brew& Kombucha dispenser- NSF Certification
Hi Olga,
As requested, please see attached for Health Department.
Best
Bijan Moossazadeh
Vice President
"We've Moved! Our address,phone & far numbers have changed.
Barons Market home office
12420 Kirkham Court
Poway, CA 92064
858.218.2100 x103
858.218.2477 Fax
BiianMoossazadeh@BaronsMarket.com
From: Erica Motes [mailto:emotes(@alirefna.com]
Sent:Tuesday, February 13, 2018 8:26 AM
To: Bijan Moossazadeh<BiianMoossazadeh@BaronsMarket.com>
Cc: Kimberly Jones<kiones@alirefna.com>;Joann LaPort<ilaoort@alirefna.com>
Subject: FW: Hello
Please see the attached documentation form our tap/tower supplier.
All the Best,
�A
gleea %' /'G rej
Vice President of Sales
Beverage Air
Cell: (949)374-4939
E-mail: emotes(a bevair.com
BEVERAGE-AIR
DELIVERING UNMATCHED VALUE&CUALIIY SINCE 1944
an Ali Group Company
From: Kimberly Jones
Sent: Thursday, February 01, 2018 2:21 PM
To: Joann LaPort
Subject: RE: Hello
I gave him the part#406-061A for stainless towers but he states the health dept. wants something in writing ...
2
From: Bijan Moossazadeh fmailto:BiianMoossazadeh(�BaronsMarket.coml
Sent: Wednesday, January 24, 2018 4:39 PM
To: Kimberly Jones
Cc: Ruiz, Olga
Subject: Hello
Hi Kim,
It was nice talking with you today.As explained,we have 8 units of the BM23 dispensers.We are using them in different
stores to serve Cold Brew Coffee and planning to use them in future for Kombucha as well.The Health Department from
the County of Riverside, CA is questioning the use of this unit for Kombucha.They want to be sure that the unit is ETL
and NSF listed and that we obtain a letter from the manufacturer approving the use for serving coffee and kombucha.
Would you please get back to us as soon as you can?
Much appreciated,
Bijan Moossazadeh
Vice President
*We've Mover!! Our address,phone & fimv aumhers have changed.
Barons Market home office
12420 Kirkham Court
Poway,CA 92064
858.218.2100 x103
858.218.2477 Fax
BiianMoossazadehABaronsMarket.com
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iCounty of Riverside California
3