PMT17-03082 City of Menifee Permit No.: PMT17-03082
29714 HAUN RD. Type: Commercial New
<ACCEL/!.. MENIFEE,CA 92586
MENIFEE Date Issued: 04/30/2018
PERMIT
Site Address: 29751 ANTELOPE RD 100/214, MENIFEE, Parcel Number:
CA 92584 Construction Cost: $446,553.28
Existing Use: Proposed Use: Retail
Description of CONSTRUCT SHELL BUILDING PARCEL 1 AT MENIFEE LAKES PLAZA 3,956 SQ FT
Work: SUITES 100, 102&104
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 Qtv Amount fEl
Services, Switchboards, Control Centers&Panels 2 366.00
Services, Switchboards, Control Centers&Panels 2 566.00
Receptacle,Switch, Outlet&Fixture 25 236.00
Gas System 1 116.00
Plan Check Fee 205 205.00
Plan Check Fee 280 280.00
Sewer 1 150.00
Air Handling/Condensing Units Non-SFR 3 549.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 1,736 1,735.76
GREEN FEE 1 18.00
SMIP COMMERCIAL 1 126.00
New Construction Permit Fee 1 2,054.15
New Construction Permit Fee 1 2,054.15
New Construction Plan Check 1 2,670.40
General Plan Maintenance Fee-New 1 102.71
Construction
$11,266.17
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_Permit_Template.rpt Page 1 of 2
I
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 1 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 Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Clas,5 L' ns N
By my signature below 1 acknowledge that,except for my personal residence
Expires `- Signature in which I must have resided for at least one year prior to completion of
I/Iimprovements covered bythis permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECIARATIO have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under penalty of perjury 47
one o the fallowing 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 syiyw.Ieeinfo.ca eov/calaw.html.
this permit is issued.
Policy# Date
o I have and will maintain worker's compensaton 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 owner's behalf.I have read this
number are: r 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
'1 1 V� �7 building construction.I authorize representatives of this city or county to
Polity aq ? TL�l>7sOoR�'Exoires )' ��•��� enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundr d Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
O 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 It
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 f hwit mpl w ththose provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date TS mixture containing a hazardous material equal to or greater that the
amounts sppified on the Hazardous Materials Information Guide?
WARNING:F UR D SECURE WORKER'S COMPENSATION COVERAGE Is ❑Yes o
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 forguideli
CONSTRUCTION LENDING AGENCY ❑yes ONo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 10DO 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 'Pri4o
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 reasons)indicated below by the Californi_ ealth&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable Rem(s)(Section 7031.5 hhazzer us at repo
Business and Professions Code).Any city or county that requires a permit to e °
construct,alter,improve,demolish or repair any structure,prior to its Date
issuance,also requires the applicant for the permit to file a signed statement PRO E O R OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA REND A ION.REPAIR AND PAINTING(RRPI
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 Iicensure receiving compensation for most work that disturbs paint in apre-3978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence orchildcarefacilitytoheork that
and comply With
than
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
O 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.eoa.eov/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. O No EPA Lead-Safe Certified Firm is required for this project because:
O 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 rill out the RRP
Acknowledgement.
rs..�
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE DATE 08/31/2017 PERMIT/PLAN CHECK NUMBER -Q wsp
TYPE: ❑✓ COMMERCIAL []RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA [-]SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL El MECHANICAL
❑✓ NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK New Pad Out Parcel 1 -Shell Only.Included Architectural,Structural and MEP
PROJECT ADDRESS 29751 Antelope Rd,Suite 100,102&104
ASSESSOR'S PARCEL NUMBER 340-020-042 LOT TRACT
PROPERTY OWNER'S NAME Menifee Lakes Plaza LLC
City of Menifee
ADDRESS 3636 Birch Street,Suite 200. Newport Beach,CA 92660 Building & Safety Pt,
PHONE (949)660-1300 EMAIL Iouismiremontesl948@gmail.com
� j Lull
APPLICANT NAME Olga L.Ruiz
ADDRESS 111 Pacifica,Suite 280 Receive
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@moorefieldconstrucfion.com
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ 44 Q_ 3 ,�;* SO FT 3,956 sf. L SQ FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE PAID AMOUNT AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Haun Rd.Menifee,CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
FIRST RELEASE FORM
2270 Trumble Rd • P.O.Box 8300 a Perris,Ca 92572-8300 � dDrTm=
FASUxN
T.951-928-3777 a F.951-928-6177 WMUNICIPAL
WATO
emwd.org e Y P
Requesting Agency: City of 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 constitute a
release for Certificate of Occupancy.
• Subsequent EMWD "FINAL RELEASE' or 'CLEARANCE" is to be requested by the applicant noted above and will he
submitted to your office prior to your agency issuing the Certificate of Occupancy.
• Other:
Your cooperation in this matter Is greatly appreciated. It is extremely Important that these procedures are followed for
EM W D 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)
®Waste Discharge Application
0 Plans
EMWD isto provide: IN WATER and/or ®SEWER SERVICE(S). The provisions of serviceare contingent upon the applicant
completing the necessary arrangements in accordance with EMWD rules and regulations:
FEES REQUIRED:
® New Business Fees Due Call(951)928-3777 ext 2001 for more information.
9 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 ext6203 48 hours prior to backfilling to schedule.
❑ interceptor Installation Call(951)928-3777 ext 6203 to schedule.
INTERCEPTOR STATUS:
❑ No Interceptor is required.
0 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.
Vanessa Buenrostro New Business Development 0 410 5/2 0 1 8
EmwD Representative signature Printed Name Department Date
NM002
REV.08/17/16