PMT18-03439 City of Menifee Permit No.: PMT18-03439
29714 HAUN RD.
11AF MENIFEE, CA 92586 Type: Commercial Demolition
MENIFEE MENIFEE Date Issued: 07/10/2018
PERMIT
Site Address: 26740 MCCALL BLVD, MENIFEE,CA Parcel Number: 335-171-013
92586 Construction Cost: $28,000.00
Existing Use: Proposed Use:
Description of DEMO EXISTING 4700 SQ FT COMMERCIAL BUILDING
Work:
SCAQMD NOTIFICATION NUMBER:519779
Owner Contractor
BESHAY& FONG PROPERTIES SENERGY
41760 IVY STREET 29910 MURRIETA HOT SPRINGS
MENIFEE, CA 92586 #G521
Applicant Phone: 9516777295
SENERGY License Number:802746
29910 MURRIETA HOT SPRINGS
#G521
MURRIETA, CA 92563
Phone:9516777295
Fee Description gty. Amount 1E[
Building Permit Issuance 1 27.00
Demolition Permit 1 140.00
GREEN FEE 1 2.00
SMIP COMMERCIAL 1 8.00
$177.00
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,.a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA Bldg,_,Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or Improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State Ucense Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class Q License No. �rf�W 6 By my signature below I acknowledge that,except for my personal residence
Expires 11_36-1$f Signature in which I must have resided for at least one year priorto completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLA TION 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 worker's 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 www.leginfo.ca.gov/calaw.htmi.permit is Issued.
Policy# 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 ❑By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's 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
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy# Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($300)or less PROPERTY OWNER OR AUTHORIZED AGENT
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#
worker's compensation laws of California,and agree that If I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. WIII the applicant or future building occupant handle hazardous material or a
Applicant Date 7`Ion mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FA RE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes Alo
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES WIII 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)7 See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guiders
CONSTRUCTION LENDING AGENCY oYes two
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) ❑Yes 901a
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
California Health&Safety Code,Section 25505 and 2SS34 concerning
Contractor's License Law for the reason(s)indicated below by the hazardous mat net reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ,Ayes ❑N
Business and Professions Code).Any city or county that requires a permit to Date 7—I v—1 re
construct,alter,improve,demolish or repair any structure,prior to its PROPE 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRP)
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 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.aov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-900-424-LEAD(5323).
Code;The Contractor's 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 Contractor's 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: 7- to - ! PERMIT/PLAN CHECK NUMBER)' W ) - 0 JW�l
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: 0 COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: (j)ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW ®PLUMBING ORE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK T�)C 70 f% 1-S I-A)G III
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS O YES ONO
//
PROJECTADDRESS p� 776 �h1�CA2/ /.31L✓,� ZIP /
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME f �/ 5 �iNGy yGP(2, ;� L LG
ADDRESS 1 I-7GO -T;V S 7-
PHONE �/� EMAIL fu.,� -pj
APPLICANT NAME 5� 3/gta/L.
ADDRESS o9-9 .V12U�-
PHONE q P—q16•- 5'et(o EMAIL
CONTRACTOR'S NAME ✓��C`�L'_G*' 3j/ AEA= OWNERBUILDER7 ®YES®NO
BUSINESS NAME
ADDRESS C'/ �7IO �� Z '"7 -4% 2t�S % SDI
PHONE q f'/ EMAIL ,7
CONTRACTOR'S STATE
LIC NUMBER SR.) ' /W 7 fICENSE CLASSIFICATION
VALUATION$ * '24 DI sc. vl FT 7aD L SO FT
APPLICANT'S SIGNATURE DATE 7-/o - /q
CITY STAFF USE ONLY RLINArEW I
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF NIENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING npAfERING FIRE
INVOICETOTAL GR EN SMIP
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE N NOTARIZED LETTER 0 YES O NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofmenifee.us
FNWNIF�
i
South Coast Air Quality Management District I Notification Number
21865 Copley Drive,Diamond Bar,CA 9176SA182 519779
Phone:(909)396-2336
www.agmd.gov
Rule 1403 Notification of Routine Demolition
I
Please maintain a copy of this Notification at the job site,either electronic or paper. )
Project Type 0) co
(D C
w O
Project Type Demolition Project Urgency Routine C tV ate„
n ^
Completed By Harry Graun Phone Number (909)239-3574 , rT D(W
C) "O
J Contractor Information a)I w m
U �
Company Name PACIFIC DEMOLITION,H F G PAC Address 28690 CAPANO BAY CT
EXCAVATION
City MENIFEE State CA
Zip 92584
CSLB License# 902479 OSHA REG#
Supervisor#1 Harry Graun Phone I (909)239-3574
Site Information
Site Name 26770 McCall Blvd Menifee Project# I 1
Site Street# 26770 Street Name j McCall Blvd
Cross Street Site County Riverside
City Menifee State CA Q
Zip 92586
Contact Name Scott Barone Contact Phone (951)B16-9840
i
Site Owner Beshay and Fong Property LLC Owner Address 41856 Ivy Street Suite 201
City Murrieta State I CA
Zip 92562
Project Start Date 7/20/2018 Project End Date 8/3/2018
Project Work Shift(s) Day Building Sze in Sq.ft ! 4700
Number of Floors 1 Building Age(years) 30
Number of Building/Dwelling Units 1 Building Prior Use i Commercial
Asbestos Survey Yes Asbestos Found I Yes
Asbestos Removed Yes Building to be Demolished Yes
Describe Work Demolish building Describe Work Location 26770 McCall BI Menifee
Project Information
Demolition Information 'y
All Asbestos containing materials must be removed prior to any demolition activity
Asbestos Removal Company I and C Environmenta Date of Asbestos Removal 3/5/2018
Amount Of Asbestos Removed 94 MIN(sq'ft) i
Size of Demolition Project in sq.ft 4700 Work Practices at Demolition Site Spray Water,Tarp Trucks/Bins '`��
Contingency Demolition plan Stop Work,Isolate Work Area,Notify
Owner,Stabilize,Secure,Characterize
Waste,Survey
Waste Information
Waste Transporter Pacific Demolition
Address 28690 Capano Bay Ct City Menifee
State CA Zip 92584
Landfill El Sobrante
Address 10910 Dawson Canyon Rd City Corona
State CA Zip 92883
Fee Payment
Sze of Demolition Project in sq.R I 4700
Tracking Number ! 3312693
Project Size Fee 192.40
Additional Fee j 0
Total Fee j $
192.40
Payment Made ' $192.40
Balance Due $0
By clicking the Sign&Submit button,I certify that an individual trained in
the provisions of SCAQMD Rule 1403 and the Asbestos NESHAP(CFR
Title 40,Part 61,Subpart M)will be onsite during the demolition or
renovation and evidence that the required training has been accomplished
by this person will be available for inspection during normal business
hours.In addition,I certify that all of the information contained herein
and information submitted with this Notification is true and correct