PMT18-01504 City of Menifee Permit No.: PMT18-01504
29714 HAUN RD.
< -�CC.F-6�. MENIFEE,CA 92586 Type: Sign -Permanent
MENIFEE Date Issued: 04/11/2018
PERMIT
Site Address: 29947 ANTELOPE RD, MENIFEE, CA Parcel Number: 340-620-012
92584 Construction Cost: $7.400.00
Existing Use: Proposed Use:
Description of INSTALL 2 SETS OF ILLUMINATED CHANNEL LETTER AND LOGO AT 3' H X 1810"W, INSTALL 2
Work: WALL PLAQUES 2'5"H X 1'6"W, INSTALL 2 DIRECTIONALS 4'H
Owner Contractor
KPISH GOYAL DYNAMITE SIGN GROUP INC
41805 ALBRAE STREET 3080 E 29TH ST
FREEMONT, CA 94538 LONG BEACH, CA 90806
Applicant Phone:5625957725
DYNAMITE SIGN GROUP INC License Number: 994192
3080 E 29TH ST
LONG BEACH,CA 90806
Phone:5625957725
Fee Description QtV Amount(S1
Sign Permit 8 310.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 129 129.07
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 1.00
General Plan Maintenance Fee- Building 1 15.50
$483.57
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 contractor(s)pursuant to the Contractors State License Law).
Chapter-9(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 m Iic nse ism full farce and ff the following reason:
License Class Ucens By my signature below I acknowledge that,except for my personal residence
Expire 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
have built as an owner-builder if it has not been constructed in its entirety by
o 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 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 this per Iis ed.
www,leainfo.ca.zov/calaw.html.
policy %sJ
Date
❑I have and will maintain workers compensation Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Cade,for the performance of the work for which o 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: A y application and the information I have provided Is correct.I agree to comply
v `/� 1 with all applicable city and county ordinances and state laws relating to
Carrier
rr�^l 5 _ building construction.I authorize representatives of this city or county to
M%-/Policy I��Z,92 res enter the above identified property for inspection purposes.
(This section need not to be completed Is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
❑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 became subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should became HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Cod orthwit omply with those provisions. _ I Will 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 sp ofied on the Hazardous Materials Information Guide.
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes �o
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($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidell es
CONSTRUCTION LENDING AGENCY oyes 7pNo
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer bound}ry of a school?
(Section 3097 Civil Code) o Yes o O.
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the
Contractors License Law for the reason(s)indicated below by the California Health&Safety Cade,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 haz o(�sma erial reporting. 1 �,[)
Business and Professions Code).Any city or county that requires a permit to W J Date`'I—
construct,alter,improve,demolish or repair any structure,prior to Its PROPERTY OWNER OR AEITHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRPI
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensure receiving$am pensation 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-BOD-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 1,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
IS & SAFETY PERM IT/PLAN CHECK APPLICATION
�Meniee
DATE 0310 210 21 8 PERMIT/PLAN CHECK NUMBER '- D -V I"1
TYPE: ❑✓ COMMERCIAL []RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑✓ SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION []DEMOLITION ❑ELECTRICAL []MECHANICAL
[-]NEW [-]PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Install 2 sets of illuminated channel letter and Logo at Th x 18'10"w
install 2 wall plaques 2'5"h x 1'6"w,install 2 directionals 4'h
PROJECTADDRESS 29947 Antelope Rd
ASSESSOR'S PARCEL NUMBER 5H 1) "I.Q 2O - d 12 LOT TRACT
PROPERTY OWNER'S NAME Kpish Goyal
ADDRESS 41805 Albrae St Freemont CA 94538 City Of Menifee
PHONE (510)270-3412 EMAIL kpish@vintnersdist.com IIngep
APPLICANT NAME AKC Permit Cc APR V 2 2018
ADDRESS 15197 Lighthouse Lane Lake Elsinore CA 92530
9Q !
PHONE (951)471-8419 EMAIL info@akcservices.net Vu
CONTRACTOR'S NAME TNT/Dynamite Sign Group OWNER BUILDER? ❑YES ✓❑NO
BUSINESS NAME TNT/Dynamite Sign Group
ADDRESS 3080 E 29th St Long Beach CA 90806
PHONE (562)595-7725 EMAIL
CONTRACTOR'S STATE LIC NUMBER 994192 LICENSE CLASSIFICATION C45
VALUATION$ $7.400.00 SO FT 150.52 L SQ FT
APPLICANT'S SIGNATURE '— DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ~. I �.)- I CITYOFMENIFEE BUSINESS LICENSE NUMBER /�1��
BUILDING PLANNING ENGINEERING FIRE GREEN I' SMIP i.Qc �.,- �-(GJ(z
INVOICE ,PAID AMOUNT
AMOUNT '3 OCASH 0CHECK It 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK N 0CREDIT CARD VISAIMC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213