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PMT14-00996 City of Menifee Permit No.: PMT14-00996 29714 HAUN RD. ' CCE1.1-' MENIFEE, CA 92586 Type: Residential Plumbing MENIFEE Date Issued: 05/02/2014 PERMIT Site Address: 25337 HIGH NOON CT, MENIFEE, CA Parcel Number: 358-460-004 92584 Construction Cost: $300.00 Existing Use: Proposed Use: Description of APPROX. 18 L FT GAS LINE FOR FUTURE FIRE PIT/BBQ Work: Owner Contractor MANNIE RIVERA 25337 HIGH NOON CT MENIFEE, CA 92584 Applicant License Number: MANNIE RIVERA 25337 HIGH NOON CT MENIFEE, CA 92584 Phone: 6198239501 Fee Description - Qtv Amount M BUltdln81 �SSU 17CB'"et -•7 z".rs�g ,',F€^- ;', g r v �1 s, s^ .* -'c f Inspections not specified 116 116.00 �G♦�Ea,�N�;ei„��,"'f4�.�:1 ��kLya x�V�A � ""z 7 r' m`� anr�' �n f�1OQ.^. $144.00 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 thereunderwhen 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,orwhere 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 I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044,.Business and Professions Professions Code and my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property License Class License No. who builds or improves thereon, and who contracts for the projects with a Expires Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ I am exempt from licensure under the Contractors'State License Law for the ❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason: 1 have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that, except for my personal residence in compensation,issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of Section 3700 of the Labor Code, for the performance of work for which this improvements covered by this permit, I cannot legally sell a structure that I have permit is issued. Policy# built as an owner-building if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the ❑ 1 have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htto//www.Ieginfo.ca.aov/QaIaw.htmI. permit is issued.My workers'compensation insurance carrier and policy number are: Carrier Property Owner or Authorized Agent Date Expires Policy# / FYBy my Signature below, I certify to each of the following: I am the property Name of Agent Phone# //////owner or authorized to act on the property owner's behalf. I have read this (This section need not be completed if the permit is for application and the information I have provided is correct. I agree to comply one-hundred dollars($100)or less) with "fi 'cable city and county ordinances and stale laws relating to building c str coon. authorize representatives of this city or county to enter the above- 0 1 certify that in the performance of the work for which this permit is issued,I �de0 ied pro rty for the inspection purposes. shall not employ any persons in any manner so as to become subject to the _7 �r workers'compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor P pertyw er or Authorized Agent Date Code,I shall forthwith comply with those provisions. City Business License# Date; Applicant; WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING ($100,000), IN ADDITION TO THE COST OF COMPENSATION, pYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑NO EQUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE? agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE 3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE - Lender's Name OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address ❑NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDE LINES OWNER BUILDER DECLARATIONS I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME: License Law for the reason(s)indicated below by the checkmark(s)I have placed OYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter, improve, demolish, ❑NO SCHOOL? or repair any structure, prior to its 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 License Law (Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL Section 7000)of Division 3 of the Business and Professions Code)or that he or OYES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL ffEPOR1 ING. compensation, will do( )all of or( )parting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for 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 not built of improved for the purpose of sale). CITY OF MENIFEE PLCK No: F it 41 14-0 4 Haun Road I14-0b Menifee, CA 92586 1 /4 Phone: (951)672-6777 Amount Amount: Fax:(951)679-3843 Ck#: Ck#: I � Building Combination Permit To Be Completed By Applicant Legal Desaiplion:' — J Planning Case: F: L: RtILL : R Pro Addr s: Assessor's Parcel Number. roject/Tenaan�ntgqNa��me: �. � ^ Unit #: Floor#: N///,.ryy'WgIE P n ^Oct 3— Fax No.A Property ft9 ,t0&// Owner OD,tf �T �fj.�l!(�� UnitNumbey/ Zip NanjU>� n Phone No. Fax No. Applicant Address: Unit Number Zip Code Email Address: Name: /1 Phone No. Fax No. Contractor Address: (/ City State Zip Code Contractor's city Business License o. Contractor's City State of CaIlifom at License No. Classification Number of Squares: Sq ge ptipn /ror �5 / !Ale- /t Al o / �TZO �--�j Cost of Work: ht' Sig _ /`- u Y.c-- Date: To Be Completed By:C fly:Ste Only Indicate As R-Received or fly Ste Applicable 5 Completes sets of fully dimensioned,drawn to sale plans which include: 1 set of documents wiicn include ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Goo Tech/Soils Report(on cd only) ❑ Plat/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 Y x 11) ❑ Foundation Plan El Structural Calculations ❑ Cross Section ❑ plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP ❑ Floor Plan ❑ SWctural Framing Plan&Details ❑ Shorin Plan 9 ❑ Sound Report-Residential Class Code: Indicate New Construction Alteration' Addition' Means/Methods Work Type: Repair' Id Retrofit' Revision to Existing PermlP Required? YES NO Proposed Building Use(s): Existing Buildirg Use(s): #Buildings: #Units: #Stories: Will the Building Have a Basement? Y of N Bldg. Code Occupancy Group Indicate if YES or NO Indicate Indicate allNGeo-tech.Haz.Zone At Project Construction Spdnklered that apply: Coastal Zone Completion: Type(s): C Of O Noise Zone Required? YES or NO Listed on Historic Resources Inventory CITY PLANNING STAFF ONLY APPROVALS: Costal Commis Arch.Revieav Board Landmark Comm. Planning Comm.Zoning Administrator Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrof[I Sperm Casa:Bldg 0lfcial Acenval Expedite Project(s): Child Care City Project Green Building I Landmark I Affordable Housing For Staff Use Only BuildinglSalely Permit Specia{ist City Planning Civil Engineenng- EPWM-Admin Transportation Mgmt. Rent CoNrol THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY PERMIT NO. SITE PLAN NAME PHONE( ) SITE ADDRESS ASSESSORS PARCEL NUMBER City &Safety Dept. menifee Provide North Arrow REAR PROPERTY LINE Building 0 2 2014 Received I — I I fi S `� SB D E E P K P O i R P O _ P R CITY ONIFEE E R BUILDINI�ND SAFETY DE ARTME�T T PLAN APPROVAL Y L L I � N REVIEWED BY N E DATE E `Approval of these plans shall not be constr Ito be a permit for,or an approv , vio a ion o any provisions of the federal,state or city V regulations and ordinances. This set of approved plans must be kept on the jtv jobsite until completion. �J FRONT" PROPERTY LINE v_1ggnama Pn 1 of 9