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PMT17-03639 City of Menifee Permit No.: PMT17-03639 29714 HAUN RD. Type: Commercial New �/-C:CELA-. MENIFEE, CA 92586 s"""" MENIFEE Date Issued: 0 413 012 01 8 PERMIT Site Address: 29787 ANTELOPE RD,Suite#100& 103, Parcel Number: 340-620-004 MENIFEE, CA92584 Construction Cost: $1,267,374.81 Existing Use: Proposed Use: Retail Description of CONSTRUCTION OF SHELL AND TENANT IMPROVEMENT MAJOR 1A AND 1B AT MENIFEE LAKES Work: PLAZA 13,283 SO FT,TO INCLUDE MEP AND REFRIGERATION Owner Contractor MENIFEE LAKES PLAZA LLC MOOREFIELD CONSTRUCTION INC 3636 BIRTH STREET, SUITE 200 600 N TUSTIN AVENUE SUITE#210 NEWPORT BEACH, CA 92660 SANTA ANA, CA 92705 Applicant Phone:7149720700 FRED STEPHESON License Number:397892 MCG ARCHITECTURE 600 N TUSTIN AVENUE SUITE#210 SANTA ANA, CA 92705 Phone:9495531117 Fee Description gyt Amount t$1 Services,Switchboards, Control Centers& Panels 4 732.00 Services,Switchboards, Control Centers& Panels 1 283.00 Receptacle, Switch, Outlet&Fixture 193 1,076.00 Plumbing Fixtures and Vents, fixtures 8 141.00 Gas System 2 232.00 Plan Check Fee 315 315.00 Sewer 2 300.00 Air Handling/Condensing Units Non-SFR 7 1,281.00 Building Permit Issuance 1 27.00 Additional Plan Review Building 2,769 2,769.24 GREEN FEE 1 51.00 SMIP COMMERCIAL 1 355.00 New Construction Permit Fee 1 5,829.92 General Plan Maintenance Fee-New 1 291.50 Construction $13,683.66 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 Pemnit_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 o 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 Clas,5 ns N 1 By my signature below I acknowledge that,except for my personal residence Expires ` 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 DECLARATIO have built as an owner-builder if it has not been constructed In its entirety by ❑I hereby affirm under penalty of perjury one o 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 www.Ieminfo.ca.gov/caIaw_htmI.permit is issued. sv Policy If Date ❑1 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 ❑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: application and the information 1 have provided is correct.I agree to comply Carrier '�'L1"i/�/ ( (-1 r`✓!(�.�f % with all applicable city and county ordinances and state laws relating to �/� building construction.I authorize representatives of this city or county to Policy aft; 0-8 r L- Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundrild dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT o I 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 g workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 37DO of the Labor Code,I shall f hwit mpl with provisions. Will the applicant or future building occupant handle hazardous material or a Applicant j Dater mixture containing a hazardous material equal to or greater that the amounts s!scWed on the Hazardous Materials Information Guide? WARNING:F UR 1 0 SECURE WORKER'S COMPENSATION COVERAGE IS o Yes PrNo UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES WIII 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(SCAOMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guild eI* CONSTRUCTION LENDING AGENCY DYes No I hereby affirm that under the penalty of perjury there is a construction WIII 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 -P-90 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California ealth&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazel us at repo ' checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 e O v _ Business and Professions Code).Any city or county that requires a permit to {p1 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 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 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 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 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: 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. \111r & SAFETY PERM IT/PLAN APPLICATION v,4enifee DATE 10.12.17 PERMIT/PLAN CHECK NUMBER M-T17- o-�covi TYPE: Z COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL ❑✓ NEW ❑PLUMBING ❑RE-ROOF-NUMBEROFSOUARES DESCRIPTION OF WORK New Major Building 1A and 113 Shell and Tenant Improvement drawings. Included Architectural,Structrural, MEP and refrigeration. PROJECT ADDRESS 29787 Antelope Road, Suite 100& 103 ASSESSOR'S PARCEL NUMBER 340- �� 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? OYES ✓❑NO BUSINESS NAME Moorefield Construction ADDRESS 600 N.Tustin Ave. Ste 210 PHONE (714)972-0700 EMAIL ftephenson@mocrefieldconstruction.com CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ �p,l`7 /�•�( So.FT 13,283 BE L SQ FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION 5�^ CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE L4- AIDAMOUNT AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 N ED FIRST RELEASE FORM 2270 Trumble Rd a P.O.Box 8300 a Perris,Ca 92572-8300 �� EasrERw T.951-928-3777 a F.951-928-6177 �w` � �D:v�rat emwd.org e • . OMMU 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: kfoco@cox.net REQUESTING AGENCY AND APPLICANT PLEASE NOTE: • This "FIRST RELEASE" is being•issued to allow applicant to pull permits with your agency and NO 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) ®Waste Discharge Application G 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 ext 2081 for more information. N 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 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 interceptoris 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 ,fequirements have been met. If ou have any questions,please call EMWD at(951)928.3777 extension 2081. Vanessa Buenrostro New Business Development 0 410 512 01 8 EMWD Bepr entative Signature Printed Name Department Date NOD-002 REV.09/17/16