PMT17-03636 City of Menifee Permit No.: PMT17-03636
29714 HAUN RD.
�CCEL/? MENIFEE,CA 92586 Type: Commercial New
MENIFEE Date Issued: 0 4/0 912 01 8
PERMIT
Site Address: 29015 NEWPORT RD, MENIFEE,CA Parcel Number: 364-190-020
92584 Construction Cost: $400,000.00
Existing Use: Proposed Use: Restaurant
Description of NCOM MCDONALD'S RESTAURANT WITH DRIVE-THRU,4,352 SF
Work:
Owner Contractor
STATER BROS MARKET ELEVEN WESTERN BUILDERS INC
1949 ARROYO DRIVE 2862 EXECUTIVE PLACE
RIVERSIDE,CA 92506 ESCONDIDO, CA 92029
Applicant Phone:7607966346
MENIFEE,CA License Number:439908
Fee Description Q,1t r Amount($1
Building 1 1,056.00
Services, Switchboards, Control Centers& Panels 7 1,281.00
Services, Switchboards, Control Centers& Panels 1 283.00
Receptacle, Switch, Outlet& Fixture 160 911.00
Plumbing Fixtures and Vents,fixtures 31 256.00
Grease Interceptor 1 116.00
Gas System 1 116.00
Plan Check Fee 103 102.50
Water Heater 1 83.00
Plan Check Fee 205 205.00
Sewer 1 150.00
Forced-Air or Gravity-Type Furnace or Burner 3 447.00
Air Handling/Condensing Units Non-SFR 3 549.00
Building Permit Issuance 1 27.00
Administrative Fee 116 115.59
Additional Plan Review Building 1,224 1,223.76
GREEN FEE 1 16.00
SMIP COMMERCIAL 1 112.00
New Construction Permit Fee 1 2,610.90
General Plan Maintenance Fee- Mechanical 1 49.80
General Plan Maintenance Fee-Plumbing 1 36.05
General Plan Maintenance Fee- Electrical 1 123.75
General Plan Maintenance Fee- New 1 130.55
Construction
$10,000.90
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 perjurythat 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 D 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.y3wba-
_ By my signature below I acknowledge that,except for my personal residence
Expires S / Signat �/ in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DEC T Improvements covered by this permit.I cannot legally sell a structure that
have built as an owner-builder if it has not been constructed in its entirety by
D I hereby affirm under penalty of perjury one of 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
this permit is issued. www.leeinfo.ca.eov/calaw.html.
Policy# Date
❑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 1 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: application and the information I have provided is carrecL I agree to comply
Carrier�G✓/^1 C%/Ty/6'iz?� with all applicable city and county ordinances and state laws relating to
z building construction.I authorize representatives of this city or county to
Policy#7ZWF.WZ/2[7733 Expires /63///R enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less Date
PROPERTY OWNER DR AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued,
1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE It
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 s orth ith comply with those provisions. WIII the applicant or future building occupant handle hazardous material or a
Applican Date mixture containing a hazardous material equal to or greater that the
amounts specified an the Hazardous Materials Information Guide?
WARNI AILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes erg
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[ODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY ❑Yes ram
1 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 alCo�
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License taw for the reason(s)indicated below by the California Health&Safety Code,Section 2SSDS and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to Date eZ 9 /S
construct,alter,improve,demolish or repair any structure,prior to its PCWV9ff'bl(A0THORIZED 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 IRRPJ
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 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 work themselves or through their
o 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.aov/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 fill out the RRP
Acknowledgement.
''•UILD'ING & SAFETY PERMIT/PLAN CHECK A
� Menifee
DATE: 10/09/2017 PERMIT/PLAN CHECK NUMBER -�
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION 0 DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK New McDonald's restaurant including new building structure with tenant
improvement, drive-through lane and island, grease interceptor, all other work bMM9 Menl e f
Dept,
PROJECTADDRES5 29121 Newport Road, Menifee,CA ZIP 92584
5020 190- -
ASSESSOR'S PARCEL NUMBER 364- LOT TRACT
OWNER NAME McDonald's USA, LLA. Contact Christine Cho t .a
ADDRESS 3800 Kilroy Airport Way, Suite 200, Long Beach, CA, 90806
PHONE 562-753-2001 EMAIL Btafua@bickelgrp.com a�
APPLICANT NAME Brenda Gomez Tafua
ADDRESS 3600 Birch Street, Suite 120
PHONE 949-757-0411 EXT 227 EMAIL Btafua@bickelgrp.com
CONTRACTOR'S NAME To Be Determines OWNER BUILDER? O YES ONO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC�NU►,M�BBER l,� LICENSE CLASSIFICATION
VALUATION$ "o-'w 5y JongStIFT 4,352 L SO FT
APPLICANT'S SIGNATURE DATE 10/09/2017
CITYSTAFF USE ONLY _
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY:
PERMIT FEE D SMIP GREEN lu
PLAN CHECKFEE INVOICETOTAL
OWNER BUILDER VERIFIED OYES `. NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Haun Rd. Men ifee, CA 92586 951-672-6777
www.cityofinenifee.us
FIRST RELEASE FORM
waw
T.95 -928-37 Rd • P.O. Box 8300 • Perris,Ca 92572-8300 e m w d EASTERN
T.951-928-3777 • F.951-928-6177 MUNICIPAL
WATER
emwd.org DISTRICT
Requesting Agency: RvsdHealthDeptforTem/Men-email:llizalde@rivcocha.org
APPLICANT INFORMATION:
Business Name: McDonald's Restaurant
Service Address: 29015 Newport Rd Pad B,Menifee CA 92584
Contact Name: Christine Cho
Contact Phone: (949)50D-5347 ext. Contact e-mail: chdstine.cho@us.mcd.com
REQUESTING AGENCY AND APPLICANT PLEASE NOTE:
• This "FIRST RELEASE" is being issued to allow applicant to pull permits with your agency and DOES 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 12/14/2017 City of Menifee
®Application for Service (date) rJLIIICHng Dept.
0 Waste Discharge Application JAM
® Plans
EMWD is to provide: N WATER and/or ®SEWER SERVICE(S). The provisions of service are gffrVrji r �tji�agph nt
completing the necessary arrangements in accordance with EMWD rules and regulations: KKUS �• �/ "'UI
FEES REQUIRED:
❑ New Business Fees Due Call(951)928-3777 ext 2081 for more information.
❑ Source Control Fees Due Call(951)928-3777 ext 6203 for more information.
INSPECTION REQUIRED:
❑ Sewer Lateral Call(951)928-3777 ext4372 48 hours prior to backfilling to schedule.
❑ Backflow Prevention Call(951)928-3777 ext4938 to schedule.
N Rough Plumbing Call(951)928-3777 ext 6203 48 hours prior to backfilling to schedule.
N Interceptor Installation Call(951)928-3777 ext 6203 to schedule.
INTERCEPTOR STATUS:
❑ No interceptor is required.
N Current interceptor is acceptable. Size: 1,500 gallon
❑ 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 you have any questions,please call EMWD at(951)928-3777 extension 2081.
zM17.12°e,3:3,:s7u W Kiel Maples New Business Development 12/14/2017
EMWD Representative Signature Printed Name Department Date
NBD-002
REV.12/05/16