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PMT17-03829 City of Menifee Permit No.: PMT17-03829 29714 HAUN RD. �CCFLA—> MENIFEE, CA 92586 Type: Commercial Alteration SO— MENIFEE Date Issued: 12/28/2017 PERMIT Site Address: 30464 HAUN RD, MENIFEE, CA 92584 Parcel Number: 360-690-020 Construction Cost: $12,000.00 Existing Use: Proposed Use: Description of INSTALLATION OF INTERIOR RACKING SYSTEM FOR PETCO Work: Owner Contractor DONAHUE SCHRIBER REALTY GROUP 5694 MISSION CENTER DR SAN DIEGO, CA 92108 Applicant License Number: MENIFEE,CA Fee Description CRY Amount($) Building Permit Issuance 1 27.00 Inspections not specified 129 129.07 Additional Plan Review Building 55 55.00 GREEN FEE 1 1.00 SMIP COMMERCIAL 1 4.00 General Plan Maintenance Fee-Building 1 6.45 $222.52 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 building 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. CONDITIONS Condition Comment 1 FIRE PERMIT APLBldg_PermR Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe projects I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuantto 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 eff//f�ect. �) the following reason: License Class / License No. q-3 S3 By my signature below I acknowledge that,except for my personal residence Expires 7v Signature S 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 DECLARATION have built as an owner-builder if it has not been constructed in its entirety by ❑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 Cade,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 w,ww.lezinfp.ca.eov/calaw.html. this permit is issued. Policy a = Date 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•ar��e: application and the information I have provided is correct.I agree to comply Carrier 1C'-e h �o t !'!SUlCf C-Q ` O with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy#TUJC,3ton2 2 Expires Z j / IV en above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred - IQ Date dollars($100)or less PROPERTY OWNER OR AUTHOR2ED AGENT ❑I certifythat in the performance of the work forwhich this permit is issued, I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE p 7 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 she'"' Cwith comply 'th those provisions. Will the applicant or future building occupant handle hazardous material or a A li nt / h Date j2 2 / mixture containing a hazardous material equal to or greater that the pp amounts spf Red on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WO R'S COMPENSATION COVERAGE 15 ❑Yes cYtJ1 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 _ __for-guidelin — --- CONSTRUCTION LENDING AGENCY ❑Yes rTlo 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 bounoary of a school? (Section 3097 Civil Code) ❑Yes No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of hereby affirm under penalty of perjury that I am exempt from the California Contractor ha rdps License Law for reason(s)indicated below by the p Health al Safety Code,Section 25505 and 25534 concerning clous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 s Business and Professions Code).Any city or county that requires a permit to Date c]— 28fi7 construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORqED 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 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 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 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.zoy/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. ❑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. I��I�L�IIItiGfdi WARM mlwIw/pL/mXN�l©n)L��< L-JE] Menifee DATE: lQ 4� l�' PERMIT/PLAN CHECK NUMBER TYPE: _COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA OSIGN SUBTYPE: O ADDITION ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES I e Ifee DESCRIPTION OF WORK 1 N 0 I Q- �'1 kN O EAPT ept. Y%w � �� PROJECTADDRESS ZIP caw 2017 ASSESSOR'S PARCEL NUMBER aU0• loolb•P9an LOT TRACT Reepived OWNER NAME Ish D l�,(GJ ADDRESS Ckw-D %w pq C�pa)- a'\•- "w\O M -AugscloqLA axlerction6mi-ex PHONE LV&11 3a G AW EMAIL APPLICANTNAME YW ADDRESS � PHONE _ lU"1� V,OV U�"l"� EMAIL '�lkl1 tj{-71'' 11d��Y��W•ljOl�' ` CONTRACTOR'S NAME OWNER BUILDER? O YES O NO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ g I vvo SQ FT L SQ'F`T ^, APPLICANT'S SIGNATUREAOM DATE DEPARTMENT DISTRIBUTION R CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: PERMIT FEE SMIP GREEN PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE 4 NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofmenifee.us 1''Ch 140 atoar,SuitB S2 Sart ARto1510,TH 7�282 PitBae:L'9�-979.8139� SERVICES INC. a8:T1D-561-@6ii From: John Beckcom President Merchco Services Inc. 140 Heimer Road, Suite 500 San Antonio TX,78232 To whom it may concern, This letter will serve as authorization for agent listed below, to act on behalf and represent Merchco Services Inc. in matters of obtaining permits, licenses, or, documents necessary to conduct business in the city of: Menifee California City State 1 935453 Rosie Sanchez California Contractors License L L, 1— 12/6/17 oh Beckcom- erchco Services Inc. Date CAROLYN BECKCOM gopR;�,Poo Public.state of Texas Not0IY 14s COMM.Expires 02-09-2020 Notary ID 128877884 nnm"�