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PMT18-01589 City of Menifee Permit No.: PMT18-01589 29714 HAUN RD. Type: Commercial Alteration �CCELA—> MENIFEE,CA 92586 MENIFEE Date Issued: 0 4/0 512 01 8 PERMIT Site Address: 27220 SUN CITY BLVD,MENIFEE,CA Parcel Number: 337-310-029 92586 Construction Cost: $25,000.00 Existing Use: Proposed Use: Description of REMOVE AND REPLACE CRACKED 10 TRUSSES PER STRUCTURAL DRAWINGS,VONS Work: Owner Contractor ALBERTSON'S INC STEVE JULIUS CONSTRUCTION INC 1421 MANHATTAN AVE 230 CALLE PINTORESCO FULLERTON, CA 90621 SAN CLEMENTE,CA 92673 Applicant phone:9493697820 SHANE HANKINS License Number.553607 STEVE JULIUS CONSTRUCTION INC 230 CALLE PINTORESCO SAN CLEMENTE,CA 92673 Fee Description Otty. Amount IEl Building Permit Issuance 1 27.00 Inspections not specified 129 129.07 GREEN FEE 1 1.00 SMIP COMMERCIAL 1 7.00 General Plan Maintenance Fee-Building 1 6.45 $170.52 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 builiding operations being carded on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise staled,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_Pe"il Templatespl 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 700D)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 Class 7`J 3j o ? Licens o. By my signature below I acknowledge that,except formy personal residence Expires '— f^ /� 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 DECLARATION have built as an owner-builder if it has not been constructed in its entirety by a ❑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 perfo mance of work for which www.leginfo.ca.gov/calaw.html.permit is issued. J4�rJ 3 Policy# )001 73ALLJ-F--r Date ❑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: application and the Information I have provided is correct.I agree to comply Carrier NS a crru� c with all applicable city and county ordinances and state laws relating to A building construction.I authorize representatives of this city or countyto Policy# 7Go0o17739/71 Expires 5-2—? 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 ❑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# workers compens 1Qn laws of lifo r a,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to thew rs compe ati provisions of Section 3700 of the Labor Code,I shall f Jwi[h comp) i provisions. Will the applicant or future building occupant handle hazardous material or a Applica 12 Date mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? W ING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes ❑No LAWFUL,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 guidelines CONSTRUCTION LENDING AGENCY o Yes o No 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 boundary of a school? (Section 3097 Civil Code) u Yes ❑No 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 Contractors 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 Code).Any city or county that requires a permit to oYes o No Date construct,also reuiresimprove, applicantsh forrepair any mistructure, signed to PROPERTY OWNER 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 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 licensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section 7032.5 by residence or childcare facility to be RRP-certffied 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($500). managers who do the paint-disturbing work themselves or through their ❑1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure Is www.eoa.gov/lead or contact the National Lead Information Center at not Intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a property who,through employees'or personal effort,builds or improves the ❑An EPA Lead-Safe Certified Renovator will be responsible for this project property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that It was not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RAP rule please fill out the RRP Acknowledgement. per yid W _ - r• __ l DATE - 3 - PERMIT/PLAN CHECK NUMBER TYPE: COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA oA' of Me ffee SUBTYPE: O ADDITION ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL Building Eept. O NEW O PLUMBING ORE-ROOF APPLICATION NAME S "NG k/PJ5 DESCRIPTION OF WORK ALt-, L -LJ - 1-' ov o c7�L/leE Q'/Z1k-'1z5V /qoece ved -r/t-u55 Pbt s�L �crv2r,� J�e L,� rvGs //� ,,�� PROJECTADDRESS -7 O SVcJ CLI i-UO MtMIFEL UJ7 � ASSESSOR'S PARCEL NUMBER ✓� 1- (7'cot) LOT TRACT OWNER NAME Pq-r F}C�7LT-$ Oh1S : �C, /'� ADDRESS `,7 � �{ �I /U e- 1-rn7 AJ CA- PHONE -7I q- 3 0o - 6193 EMAIL M4-jT, ffpl A/I9 t' 0 CitJM APPLICANT NAME E_ A-:> /' _ ADDRESS 2 0 G N 77J2 b,5'C Cl I,L.G�q 6N�Zr L.tt 73 PHONE 9Sl !D L2- EMAIL < IbW L/N5 u5CpwSTIWE /tAJ CONTRACTOR'S NAME C t tIS 9(�C(�iyl OWNER BUILDER? O YES NO BUSINESS NAME 5' WL ✓Li U55 Co�S 7wC t ©n! ADDRESS 23o C -r e E /-1 nr jT/Re5-c-0 TzF 34 9a673 PHONE `-63�/-�fa�y EMAIL Sx !< NS ULCUSGDn1$�C��✓ CONTRACTOR'S STATE LIC NUMBER 2;3 G O -7 LICENSE CLASSIFICATION VALUATION$ 2L aD d SQ FT 0 L SQ FT APPLICANT'S SIGNATURE DATE —5 0 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE SMIP GREEN INVOICE ]� PAID AMOUNT AMOUNT O• ./� 1 OCASH OCHECK II OCREDRCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK# O.CREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO LICENSE NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 HDun Rd. 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