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PMT17-03083 City of Menifee Permit No.: PMT17-03083 29714 HAUN RD. Type: Commercial New dcXCCEOA MENIFEE,CA 92586 MENIFEE Date Issued: 04/30/2018 PERMIT Site Address: 29787 ANTELOPE RD, Suite#114/6/8/20, Parcel Number: 340-620-011 MENIFEE,CA 92584 Construction Cost: $586,976.00 Existing Use: Proposed Use: Retail Description of CONSTRUCT SHELL SHOP BUILDING AT MENIFEE LAKES PLAZA 5200 SQ FT Work; SUITES 114, 116, 118&120 Owner Contractor MENIFEE LAKES PLAZA, LLC MOOREFIELD CONSTRUCTION INC 3636 BIRTH ST#200 600 N TUSTIN AVENUE SUITE#210 NEWPORT BEACH, CA 92660 SANTAANA, 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 1$1 Services, Switchboards, Control Centers&Panels 3 549.00 Services, Switchboards, Control Centers& Panels 1 283.00 Receptacle, Switch, Outlet&Fixture 80 511.00 Plumbing Fixtures and Vents,fixtures 2 116.00 Grease Interceptor 1 116.00 Gas System 1 116.00 Plan Check Fee 205 205.00 Plan Check Fee 280 280.00 Plan Check Fee 308 307.50 Sewer 1 150.00 Air Handling/Condensing Units Non-SFR 4 732.00 Building Permit Issuance 1 27.00 GREEN FEE 1 24.00 SMIP COMMERCIAL 1 165.00 New Construction Permit Fee 1 2,700.09 New Construction Plan Check 1 1,755.06 General Plan Maintenance Fee-New 1 135.00 Construction $8,171.65 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 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 contnictor(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 Classtl od 7{ L" ns N By my signature below I acknowledge that,except for my personal residence Expires Q` z5' Signature in which I 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 OECLARATIO Or have built as an owner-builder if it has not been constructed in its entirety by 01 hereby affirm under penalty of perjury one a 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 fallowing website: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. www.leeinfo.ca.eov/caiaw.html. Policy ft Date ❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 370D of the Labor Code,for the performance of the work for which 0 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��- /+/�z application and the information I have provided is correct.I agree to comply Carrier l.Y�/'L yV Lei!"� �/W"r L.r`- (,/r`✓rtf(f( % with all applicable city and county ordinances and state laws relating to �J �T�� {�r,�(� building construction.I authorize representatives of this city or county to Policy NO ®KJ T 61_9p�R�'Exoires 3` / '�� 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 01 certify that in the performance of the work for which this permit is issued, I shall not emolav 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 11 w'th t ose 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 sp d on the Hazardous Materials Information Guide? WARNING:F UR )SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes 1101110 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 Districtcons(SC construction or modification permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guldest.Air i 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 Cade) 0 Yes '?,go 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 ealth&Safety Code,Section 75505 and 25534 concerning hazai us ai repo checkmark(s)I have placed next to the applicable Rem(s)(Section 7031.5 _ Business and Professions Code).Any city or county that requires a permit to e 0 r Date /' construct,alter,improve,demolish or repair any structure,prior to its PROPtY 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 KENO A ION.REPAIR AND PAINTING[RRP) 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 receivingcompensation for most work that disturbs and the basis for the alleged exemption.Any violation of Section 7031.5 by P paint in a ply W78 residence or childcare facility a re RRP-certified firms and d property 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 work themselves or through their ❑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( I 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 0 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 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. • • Lori-IfB 101 _.: . L "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-NUMBEROFSQUARES of MAnitee DESCRIPTION OF WORK New Shop Building-Shell Only drawings and Suite 120 Vanilla. i3UiIdIn0 Safety ep Included Architectural,Structrural and MEP. E? PROJECT ADDRESS 29787 Antelope Road,Suite 114.116,118$120 r ASSESSOR'S PARCEL NUMBER 340-020-042 LOT TRACT PROPERTY OWNER'S NAME Menifee Lakes Plaza LLC ADDRESS 3636 Birth Street,Suite 200,Newport Beach,CA 92660 PHONE (949)660-1300 EMAIL louismiramontes1948@gmail.com APPLICANT NAME Olga L.Ruiz ADDRESS 111 Pacifica,Suite 280 PHONE (949)553-1117 EMAIL oruiz@mcgarchitecture.com CONTRACTOR'S NAME Fred Stephenson OWNER BUILDER? ❑YES❑✓NO BUSINESS NAME Moorefield Construction ADDRESS 600 N.Tustin Ave.Ste 210 PHONE (714)972-0700 EMAIL ftephenson@moorefieldconstrucBon.com CONTRACTOR'S STATELIIC NUMBER LICENSE CLASSIFICATION VALUATION$ Cjaoq 0 SO FT 5,200 sq f L SQ FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP INVOICE PAID AMOUNT AMOUNT I 1 O CASH O CHECK# O CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT I O C45H O CHECK# O CREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd.Menifee,CA 92586 951-672-6777 www.citycfinenifee.us Inspection Request Line 951-246-6213 FIRST RELEASE FORM ASS 2270 Trumble Rd a P.O.Box 8300 o Perris,Ca 92572-8300 �� EAMRN T.951-928-3777 ® F.951-928-6177 aot;anaRAk TEn emwd.org � otsr 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@oox.net REQUESTING AGENCY AND APPLICANT PLEASE NOTE: This "FIRST RELEASE" is being,issued to allow applicant to pull permits with your agency and ODES NOT 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 Issuing the 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) 0 Waste Discharge Application ®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(951)928-3777 ext2081 for more information. CR 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. 0 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. 9 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. 7i Vanessa Buenrostro New Business Development 0 410 5/2 0 1 8 EMWD Repr entative Signature Printed Name Department Date NBD-002 REV.08/17/16