PMT14-01483 i
i
City of Menifee Permit No.: PMT14-01483
29714 HAUN RD.' Type: Residential Alteration
GCi-1- MENIFEE, CA 92586
c°'"""`"'`R t MENIFEE Date Issued: 0 712 2/2 01 4
PERMIT
Site Address: 30544 GLASPELL CT, MENIFEE, CA Parcel Number: 360-091-033
92584 Construction Cost: $11,911.32
Existing Use: 1 &2 Family Residence Proposed Use:
Description of ROOM ADDITION/KITCHEN REMODEL
Work:
Owner Contractor
ROBERT MCCARY MITCHELL CONSTRUCTION
30544 GLASPELL COURT 30938 YOUNG DOVE ST
MENIFEE, CA 92584 MENIFEE, CA 92584
Applicant Phone: 9512266201
JONATHON MITCHELL License Number: 928421
MITCHELL CONSTRUCTION
30938 YOUNG DOVE ST
MENIFEE, CA 92584
Fee Description QQrt Amount I$1
Plumbing Fixtures and Vents, fixtures 2 116.00
"P�pl�glRePlPing��lwgl6 Fam y 9slde ga r�� x.,r ��.� � r,,� 1 �`*` s� �t�sy63:00
Sewer 1 150.00
Additional Plan Review Building 225 225.00
SMIP RESIDENTIAL 1 2.00
� sm wi"•�SCSF�a^ t,R'T r Z d 'h�."c^ r.. a T:7 s
$959.79
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.
CONDITIONS
Condition Comment
1 FEE LIMIT
AA_Bldg_Permit_Templale.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 a d my license is n full f r e and ffect. Code:The Contractor's License Law does not apply to an owner of a property
License Class=License I who builds or improves thereon, and who contracts for the projects with a
Expires��JJ-Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATI DECLARATION ❑ I am exempt from licensure under the Contractors'State License Law for the
❑ I hereby affirm under penalty of perjury one of the following declarations:
following reason:
I 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. built as an owner-building if it has not been constructed in its entirety by licensed
Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the
❑ I have and will maintain workers' compensation insurance, as required by Business and ofessions 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 o' t t ollowing Web site:htta'I/www leainfo ca aov/calaw html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Prop ne Authorized Agent Date
Carrier
Expires Policy#
y 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 applicable city and county ordinances and state laws relating to building
cortstructio . I 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 identified rop y for the inspection purposes.
shall not emoloJ any persons in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of ection 3700 of the Labor Pro Owner or Authorized Agent I Date
Code,I shall forthwith comply with those provision 00 T
ty Business License#
Date;_7—d-�—r Applican/CRIMINAL
AZ
WARNING: FAILURE SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER T 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, []YES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE �,,�` MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES tKO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
INFORMATION GUIDE?
I hereby affirm that under the penalty of perjury there is a construction lending
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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address 9>1 DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS PRINT NAME:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the reason(s)indicated below by the checkmark(s)I have placed []YES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable items)(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, SCHOOL?
or repair any structure, prior to its issuance, also requires the applicant for the
permit to fie a signed statement that he or she is licensed pursuant to the I HAVE READ THE HAZARDOUS MATERIAL
provisions of the Contractor's State License Law(Chapter 9 (commencing with
Section 7000)of Division 3 of the Business and Professions Code)or that he or f INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. 1 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($500).) CODE,
SECTIOOUS N 25505I�E5533 AND
25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole
compensation, will do( )all of or( )porting of the work, and the structure is PROPE WIN R AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code; X
The Contractor's Slate License Law does not apply to an owner of a property
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
Menifee PMT14-01483
06/19/14
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Menifee PLAN CHECK NO.: PMT14-01483
PREPARED BY: Ray Fuller DATE: 06/19/14
BUILDING ADDRESS: 30544 Glaspell Ct.
BUILDING OCCUPANCY: R3 TYPE OF CONSTRUCTION: VB
BUILDING AREA Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Addition ? 115
Remodel Three 130
Bathrooms
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code MNF Manual Input
71l
Type of Review: ❑ Complete Review ❑ Structural Only
ElRepetitive Fee El Other
Repeats L � 2.5 Hrs. @
EsGil Fee $90.00 $225.00
" Based on hourly rate
Comments: Hourly fee include Cal Green Fee of hour.
Sheet 1 of 1
macvalue.doc+