PMT18-01150 City of Menifee Permit No.: PMT18-01150
29714 HAUN RD.
�CCELh? MENIFEE,CA 92586 Type: Commercial Alteration
MENIFEE Date Issued: 0512112018
PERMIT
Site Address: 29101 NEWPORT RD,Suite#103, Parcel Number: 364-390-005
MENIFEE, CA 92584 Construction Cost: $150,000.00
Existing Use: Shell Retail Proposed Use: Retail
Description of INTERIOR TENANT IMPROVEMENT FOR BLITZER'S PREMIUM FROZEN YOGURT SHOP 1200 SO
Work: FT
Owner Contractor
STATER BROS JJC PROJECT MANAGEMENT GROUP INC
301 S TIPPECANOE AVE 843 HIGHRIDGE STREET
SAN BERNARDINO, CA 92408 RIVERSIDE,CA 92506
Applicant Phone: 9517894800
,CA License Number:827698
Phone:3107508939
Fee Description Qtv Amount t$1
Tenant Improvement Building 1 696.00
Services, Switchboards, Control Centers&Panels 1 183.00
Receptacle, Switch, Outlet&Fixture 90 561.00
Plumbing Fixtures and Vents,fixtures 8 141.00
Building Permit Issuance 1 27.00
GREEN FEE 1 6.00
SMIP COMMERCIAL 1 42.00
New Construction Permit Fee 1 690.00
General Plan Maintenance Fee-New 1 34.50
Construction
$2,380.50
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_Permit_Template.rpt Page 1 of 1
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 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 -6 &S C-10 License No. CJ2.7 U!�!o(� 8y my signature below I acknowledge p y personal residence
T � a that,except for
Expires o i 19 Signature in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLA ION improvements covered by this permit.I cannot legally sell a structure that I
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 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 worker's 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
this permit is Issued. www.leginfo.ca aovycalaw htm1.
Policy g Date
�(I have and will maintain worker's compensation Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which D 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 owner's behalf.I have read this
number are: application and the Information I have provided is correct.I agree to comply
Carrier'SCZ-F with all applicable city and county ordinances and state laws relating to
Policy g qaQ is (D-77 Expires Q ` ( o building construction.I authorize representatives of this city or county to
t, 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 OR AUTHORIZED AGENT
D I certify that in the performance of the work for which this permit is issued,
I shall not emalov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If ✓
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 shal orthwith co lymp with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant It' = Date mixture containing a hazardous material equal to or greater that the
amoun specified on the Hazardous Materials Information Guide?
WARNING F U SE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes ANo
UNLAWFU ,AND SE
SUB1ECi AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the intended use of the building by the applicant or future building
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMDj?See permitting checklist
for guid lines
CONSTRUCTION LENDING AGENCY ❑Yes ANo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 10D0 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 Ao
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Cade).Any city or county that requires a permit to DYes , No ^
construct,alter,Improve,demolish or repair any structure,prior to its (�L1f„ —lam — Date
Issuance,also requires the applicant for the permit to file a signed statement PROPERTY 01p NhR OR AUTHORIZED AG ENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVA ION.REPAIR AND PAINTING IRRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
and 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
an Applicant 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
than($500). required practices.This includes rental property owners and property
managers who do the paint-disturbing work themselves or through their
❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at
not Intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a
property who,through employees'or personal effort,builds or Improves the D An EPA Lead-Safe Certified Renovator will be responsible for this project
property provided that the improvements are not Intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of
completion,the Owner-Builder will have the burden of proving that it was Firm Certification No
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
D I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RAP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION �✓ MENIFEE
DATE: 2j-jN-l$ PERMIT/PLAN CHECK NUMBER 1( 'a 1150
PLANNING CASE NUMBER
TYPE: XCOMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION )I ALTERATION O DEMOLITION CIk ELECTRICAL 3'MECHANICAL
O NEW (R PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK jtAT5feI0jZ 7F;(4Anlr
PROJECTADDRESS 2.1110 f%W f'T lLtS- 03 ZIP q?-s"
ASSESSOR'S PARCEL NUMBER -72751 -o2$- o(o-'f LOTT �TRRACT
OWNERNAME `,131abPr Copp. - 'J�!rm5,
ADDRESS 2973,� PvvT'(ntetL 1.NL. )YI FP1IFE CIlk 121Z6_�rt/
PHONE LM - 313--213k EMAIL �1�orlrari , �oPPQf3t-I daOA-1
APPLICANT NAME " k wgittir
ADDRESS )ISz E , -7'P4 ST e0k-CP�?40 CP- 01 )•7LRU
PHONE 2jo `7$-D - S93g EMAIL `11�{�iL�bF7 pt32QC�AMfiIL•CDn7
CONTRACTOR'S NAME OWNER BUILDER? O YES)''NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ 1�,vow,�° SQFT II L00 LSQFT
APPLICANT'S SIGNATURE DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE Lt�_CA�. 5 al fg
INVOICE TOTAL �� jU GREEN �J� SMIP �
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE k NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofmenifee.us
L
-- Coanty of RWenitle
DEPARTMENT OF ENVIRONMENTAL HEALTH
FOOD ESTABLISHMENT PLAN APPROVAL NOTICE
Sarvlco RequuatO ntl]9p Oa:n 121/ta _
praccl Nam., BIfI3Ma FrOLen Yt�lat Address 2310t Ncepart Rua_d. Alen!eq 925W CA
Plans Submultpd by _Fnl WIiM{ Pn 316750$wm
Orvna SAA .— Addiass SAA PhM SAA
The Plans are no aPProvod subject to the conditions listed below and the aMched ooroplLTnee sheet
i ProOdpwa arms arclg:aa=lntercnploc'nai� riGnaranw lettom at Limn of pan Olck� p,
2) All Aniahes to be aenrod onslla dim it Ino raqucad mspectens.
CONSTRUCTION INSPECTIONS:Contact the PWn Cnocker tw a Preliminary{mpectlon*hen Mns:nxt oa a
apornximaloy 8:n wmplolo,wth PIUmp:'Ip.rou; -mWaho^,and mugn oquip.nitnt Installed Requp6l!�'
Inepoctian should bo made at toast fvo I5)%Wkmg ca]s In Wan",
A FINAL INSPECTION MUST as made upon cornPlomm of ALL work Inctudog finished eeWJs APPROVAL to
Operate a^a"not be grantu'd.Or remode1414 areas apP-osod to apmato.unld tw taoiliy,has passed are FINAL
INSPECTION.and'APPLICATIONTO OPERAI E-has ba'np OoWd and PERMIT FEES ham boon Paid.
Request(a Inspect GA should be needs at bast five($I working days In advance.
PLANS CHECKED BY Jd!t LC enkl_REHS Phan 951-7664624
I pa:nowledge the cenectbns noted"rein and as iMicated on I"Plans and ourm to iowrpaale t"m during
sign:twc — -Dale -
1 = Ibmu: Iti4 Mmn<u PAmSPeag. ALrrsiJ<ac.+ AS+mda-:..
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Peprnr-rne N'tS Su wwacamhiuA.
City of Menifee
Building Dept.
MAY 2 1 2018
' Received