PMT18-04591 City of Menifee Permit No.: PMT18-04591
29714 HAUN RD.
>*AV MENIFEE,CA 92586 Type: Sign -Permanent
MENIFEE MENIFEE Date Issued: 0 9/2 012 01 8
PERMIT
Site Address: 26905 NEWPORT RD 101, MENIFEE, CA Parcel Number: 360-030-025
92584 Construction Cost $6,000.00
Existing Use: Proposed Use:
Description of INSTALL ILLUMINATED CHANNEL LETTERS FOR 2 SIGNS FOR BRACES BY GARCIA
Work: ORTHODONTIST OFFICE 242"X 36"& 18"X 187"WITH DISCONNECT SWITCH-TOTAL SIGN AREA
84 SQ FT
Owner Contractor
SPATH CO SOUTHWEST SIGN MAINTENANCE INC
8446 CAMINO SANTA FE#205 40475 VISTA MURRIETA
SAN DIEGO, CA 92121 MURRIETA,CA 92562
Applicant Phone:9516962413
SOUTHWEST SIGN MAINTENANCE INC License Number: 845405
40475 VISTA MURRIETA
MURRIETA, CA 92562
Phone:9516962413
Fee Description 01rt Amount f81
Sign Permit 2 190.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
SMIP COMMERCIAL 1 2.00
$220.00
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 License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exemptfrom licensure under the Contractors State License Lawfor
Professions Code
'and
�my license is in full force and effect.`_[`1 � the following reason:
( .License Class "i s �License No. O Ll J 07 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
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
❑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.html.
this permit is issued.
Policy# 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 with all applicable city and county ordinances and state laws relating to
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 �' �f' /J_A Date
dollars($300)or less ROPPEHR+TY OWNER OR AUTHORIZED AGENT
ert fy that in the performance of the work far which this permit is issued,
shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become tFfAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall,(Yq��[h`(y,�th�i comply
/with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date C mixture containing a hazardous material equal to or greater that the
amounts ecified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE Is ❑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
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit t construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management
District District(SCAQMD)?See permitting checklist
for guid lines
CONSTRUCTION LENDING AGENCY ❑Yes 1;0
1 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 14No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that am exempt from the permitting checklist.I understand my requirements under the State of
California Health al Safety Cade,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hardous m terial reporting.
4TN s
Business and Professions Cade).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PRO 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[RRP)
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
❑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.epa.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).
Cade;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible forthis 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:
in 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 RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: < PERMIT/PLAN CHECK NUMBER O�
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: O COMMERCIAL O RESIDENTIAL MMULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: OADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
ONIEW OPLUMBING ORE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK L' I C I n
OCCUPANCYGROUP G CONSTRUCTION TYPE SPRINKLERS YES ONO
PROJECTADDRESS �/O /DS NeUJOYY4. 0 IN / &tj / t/'CtL ZIP /d�y
ASSESSOR'S PARCEL NUMBER aUO2o3c'e LOT TRACE
OWNERNAME L C(}
ADDRESS n -"e ,
PHONE lJ ' ZI Z-�5 EMAIL
APPLICANT N E
l AM t
ADDRESS PO -7 S Q' LCY/^l r
PHONE EMAIL S (0
CONTRACTOR'S NAME OWNER BUILDER? AYES O NO
BUSINESS NAME�5D ' -/ -� I nj ; -Tell C
ADDRESS
mr-
PHONE / ,EMAIL
CONTRACTOR'S STATE LIC NUMBER NUYJ-� LICENSE CLASSIFICATION GL4 S
VALUATION$ C,m, �I- SQFFT� Ct � LSQFT p
APPLICANT'S SIGNATURE I `' l,l,t',fU- Ui ( JLI,c/k-piCn DATE
CITYSTAFF USE ONLY Ew__w_
DEPARTMENT DISTRIBUTION ACCEPTED BY: (�(•1 CITY OF MENIFEE BU5INESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE1Y w
INVOICE TOTAL ow�(�, GREEN _ SMIP ,CID
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
1911
� ;owE
www.cityofinenifee.us Olt), Of Menefee Jp�
Building Dept, ENIFEE
SCE 2018
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