PMT17-03646 City of Menifee Permit No.: PMT17-03646
29714 HAUN RD. Type: Commercial New
ACCEL/> MENIFEE,CA 92586
MENIFEE Date Issued: 04/30/2018
PERMIT
Site Address: 29787 ANTELOPE RD,Suite#107, Parcel Number: 340-620-004
MENIFEE, CA 92584 Construction Cost: $1,200,383.60
Existing Use: Proposed Use: Retail
Description of CONSTRUCT SHELL AND TENANT IMPROVEMENT MAJOR 3 FOR TUESDAY MORNING, 12,580 So
Work: 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
MOOREFIELD CONSTRUCTION INC
600 N TUSTIN AVENUE SUITE#210
SANTA ANA, CA 92705
Phone:9495531117
Fee Description Qtv Amount 151
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 5 126.00
Gas System 1 116.00
Water Heater 1 83.00
Plan Check Fee 315 315.00
Sewer 1 150.00
Air Handling/Condensing Units Non-SFR 4 732.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 2,624 2,624.08
GREEN FEE 1 49.00
SMIP COMMERCIAL 1 337.00
New Construction Permit Fee 1 5,521.76
General Plan Maintenance Fee-New 1 276.09
Construction
$11,699.93
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_61og_Permil_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 contractors)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 Clas15 ns N By my signature below I acknowledge that,except for my personal residence
Expires ` 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 DECLARATIO have built as an owner-builder if it has not been constructed in its entirety by
❑1 hereby affirm under penalty of perjury 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 www.leginfo.ca-Roy/calaw.htmi.permit is issued.
Policy# Date
in 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 ❑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 application and the information I have provided is correct.I agree to comply
Carrier `�L'i L�!" ✓ K 1""'z(CJ I % with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
PolicYR4 OKJ7r6i.0 d xpires 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#
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 moll w't I ase provisions. WIII 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 sepifted on the Hazardous Materials Information Guide?
WARNING:F UR D 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($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(SC construction
or See permitting checklist
IN SECTION 3706 0E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Air
DW
CONSTRUCTION LENDING AGENCY oYes 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) o Yes 'VI40
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 perjury that I am exempt from the California ealth&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for thea reason(s)indicated below by the hazal us at repo '
checkmark(s)I have placed next to the applicable ftem(s)(Section 7031.5 _
Business and Professions Code).Any city or county that requires a permit to e o r
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 Contractor's State EPA REND A ION.REPAIRAND PAINTING IRRPI
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
❑I,as owner of the property,or my employee with wages as their sale 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.epa.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 ❑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.
Menifee
DATE 10.12.17 PERMIT/PLAN CHECK NUMBER '��OYJ
TYPE: ❑✓ COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOUSPA []SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑✓ NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK New Major Building 3 Tuesday Morning.Shell and tenant improvement drawings.
Included Architectural, Structrural, MEP and refrigeration.
PROJECT ADDRESS 29787 Antelope Road, Suite 107
!bp.2kv d 6Lt
ASSESSOR'S PARCEL NUMBER 34042G-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@moorefieldconstruction.com
CONTRACTOR'S STATE LIC NUMBER t-i LICENSE CLASSIFICATION
VALUATION$ j,,g00, -3n.�—SQFT 12,580sf. LSQFT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREENS SMIP
INVOICE ��//�� PAIDAMOUNT
AMOUNT �(/ IO I 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.cityof,menifee.us Inspection Request Line 951-246-6213
v
s. u_
FIRST RELEASE FORM
2270 Trumble Rd a P.O.Box 8300 a Perris,Ca 92572-8300 EAST""'
T.951-928-3777 ® F.951-928.6177 MUNICIPALWATER
emwd.org a Dt TP=
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
EEQU ESTING AGENCY AND APPLICANT PLEASE NOTE:
• This "FIRST RELEASE' is being,-issued to allow applicant to pull permits with your agency and V9€ 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
10 Plans
EMWD is to provide: ®WATER and/or ®SEWER SERVICE(5). The provisions of service are contingent upon the applicant
completing the necessary arrangements in accordance with EMWD rules and regulations:
FEES REQU IRED:
® 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 ext 4372 48 hours prior to backfilling to schedule.
® BackBaw 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.
C9 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 Buenmstm New Business Development 04/05/2018
tmwD Representative Signature Printed Name Department Date
NBD-o02
REV.08/17/16