PMT18-01081 City of Menifee Permit No.: PMT18-01081
29714 HAUN RD. Type: Commercial Alteration
CCLI:? MENIFEE, CA 92586
MENIFEE Date Issued: 04/13/2018
PERMIT
Site Address: 26926 CHERRY HILLS BLVD, Unit#D, Parcel Number: 337-320-016
MENIFEE, CA 92586 Construction Cost: $5,399.20
Existing Use: Proposed Use:
Description of ADD ADA RESTROOM TO EXISTING SUBWAY RESTAURANT
Work:
Owner Contractor
CHERRY HILLS PLAZA, LLC
26834 CHERRY HILLS BLVD
MENIFEE, CA 92586
Applicant License Number:
, CA
Phone: 9514405996
Fee Description O—t y Amount($)
Receptacle, Switch, Outlet&Fixture 5 136.00
Plumbing Fixtures and Vents,fixtures 2 116.00
Building Permit Issuance 1 27.00
Inspections not specified 129 129.07
Additional Plan Review Building 225 225.00
Additional Plan Review Building 129 129.07
GREEN FEE 1 1.00
SMIP COMMERCIAL 1 2.00
$765.14
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.
CONDITIONS
Condition Comment
1 SPRINKLER TI PLAN
REQUIRED
2 SPRINKLER TI PLAN
REQUIRED
AA_Bldg_Permit_Template.rpt Page 1 of 1
I
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
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect.
the following reason:
License Class License No.
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
WORKER'S COMPENSATION DECLARATION improvements.covered by this permit.I cannot legally sell a structure that I
❑I hereby affirm under penalty of perjury one of the following declarations:I have built as an owner-builder if it has not been constructed in its entirety by
licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's
compensation,issued by the Director of Industrial Relations as provided for 7044 of the Business and Professions Code,is available upon request when
by Section 3700 of the Labor Code,for the performance of work for which this application is submitted or at the following website:
this permit is issued. www.le in a. ov . rml.
Policy#
l'
Date
❑I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER R AU ORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which ❑By my signature Belo 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 I have provided is correct.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
Policy# building construction.I authorize representatives of this city or county to
Expires enter the above identified ro��� Ply for inspection purposes.
(This section need not to be completed is the permit is for one-hundred ) '�
dollars($100)or less I Date
❑I certify that in the performance of the work for which this permit is issued, I PROPERTY OWNER AUTH IZED AGENT
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
,vorker's compensation laws of California,and agree that if I should become
subject to the workers compensation provisions of Section 3700 of the Labor =HAZARDOUS MATERIAL DECLARATION
.ode,I shall forthwith comply with those provisions. I Will the applicant or future building occupant handle hazardous material or a
kpplicant Date mixture containing a hazardous material equal to or greater that the
VARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS amouI Yesnt#speocified on the Hazardous Materials Information Guide? _
INLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES / '
ND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the intended use of the building by the applicant or future building
DDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
J SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES ( Coast Air Quality Management District(SCAQMD)?See permitting checklist
INSTRUCTION LENDING AGENCY for guidelines
❑Yes X' No
Iereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
nding agency for the performance of the work which this permit is issued outer boundary of a school?
ection 3097 Civil Code) 1 o Yes lo&o
NNER BUILDER DECLARATIONS
I have read the Hazardous Material Information Guide and the SCAQMD
ereby affirm under penalty of perjury that I am exempt from the i permitting checklist.I understand my requirements under the State of
ntractors License Law for the reason(s)indicated below by the ; California Health&Safety Code,Section 25505 and 25534 concerning
�ckmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
siness and Professions Code).Any city or county that requires a permit to as
istruct,alter,improve,demolish or repair any structure,prior to its / - Date
lance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER OR AU T ORIZE AGENT
t he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION REPA R AN PAINTING IRRP)
!rise Law(Chapter 9(commencing with Section 7000)of Division 3 of the 1
iness and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978
1pplicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with
1($500). required practices.This includes rental property owners and property
managers who do the paint-disturbing work themselves or through their
3s owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
pensation,will do( )all of or( )portion of the work,and the structure is www.ep La��ov/lead/lead or contact the National Lead Information Center at
ntended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
a;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
erty who,through employees'or personal effort,builds or improves the
erty provided that the improvements are not intended or offered for Certified Firm Name:
If,however,the building or improvement is sold within one year of
)letion,the Owner-Builder will have the burden of proving that it was Firm Certification No.:
uilt or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
s owner of the property am exclusively contracting with licensed
actors to construct the project(Section 7044,Business and Professions
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.
CDC
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