PMT14-01508 i
I
City of Menifee Permit No.: PMT14-01508
29714 HAUN RD.
_ A > MENIFEE, CA 92586 Type: Residential Re-Roof
c"'"'"°""`w``' MENIFEE Date Issued: 06/16/2014 j
I
PERMIT
Site Address: 28893 CARMEL RD, MENIFEE, CA 92586 Parcel Number: 337-215-013
Construction Cost: $12,000.00
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING LAYER, INSTALL NEW 50YR ASPHALT SHINGLES
Work:
Owner Contractor
JEAN LEBLANC PACIFIC HOME WORKS INC
28839 CARMEL ROAD 1602 LOCKNESS PLACE
MENIFEE, CA 92586 TORRANCE, CA 90501
Applicant Phone: 3105341033
PACIFIC HOME WORKS INC License Number: 784477
1602 LOCKNESS PLACE
TORRANCE, CA90501
Fee Description l3yt Amount
Inspections not specified 98 98.00
$126.00
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifcations or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other -
ordinance of City of Marilee.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_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 and my license is in fug'forrceland effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class - 2bf6- License ... who builds or improves thereon, and who contracts for the projects with a
Expires 7 15'z Signature ,,_..�� licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSA�' ION DECLARATION ❑ I am exempt from licensors 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 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:htlp'//www.leginfo.ca.gov/calaw.htmi.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier /,,-" 4 �,. Property Owner or Authorized Agent Date
r _
Expires 114/4<1 Policy#
❑ By my Signature below, I certify to each of the following: I am the property
Phone# authorized to act on the property owner'
s behalf. I have read this
Name of Agent owner or authonz p p Y
(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 all applicable city and county ordinances and state laws relating to building
construction.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 property for the inspection purposes.
shall not employ 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 Section 3700 of the Labor Property Owner 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, DYES OCCUPANT HANDLE 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
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 AYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
_ FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address L1 NO 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 reasons)indicated below by the checkmark(s)I have placed ❑YES 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 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 AYES 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
E S I ON 25505
550 25533 AND 25534 CONCERNING
HAZARDO❑ 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 PROPERTY OWNER ORAUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code; X
The Contractor's State 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).
CITY OF ML13YFEE PLCK No: Permit No:
29714 Haun Road
City of Menifee Date: Date:
Menifee, CA 925 ilding & safety Dept. ill9II
Phone: (951)672-6;77 Amount: Amount: 51
Fax:(951)679-3843 jUN 16 20% Ck#: Ck#:'
Building Com bi nation R@MoVed
To Be Completed By Applicant
Legal Description: n Planning Case: F: L: Rt: R
Property Address:a�a3 's Parcel Number.Assessor .
Project/Tenant Name: Unit#: Floor#:
Name: Phone Fax No.
Property Address: �r� / Q / q Unit Number �— h Zip ode
Owner .� 9 Cam✓ /'Gl ✓^�C r` <e75�g de
Email Address:
Name: `� Ph NO. Fax No.
r
Applicant Address: Unit Number Zip code
/-� (s 21)0 e� F C 2 13 a
Email Address:
Z
Name: '^ p Phone No.
K``C lyd✓1-ekJD��S 1 C r 6 7, YN., 077 Fax No.
Contractor Address: �d5 O� (71� 1 St Zip Code
ng 2 f
contractors ity Business icense o. Contractor's Cil pState of California License No. Classificali m
77 11
Number of Squares:
Square Footage t-, 00
Description of Work: RL _ n o - l Cost of Wo :�pir O O
Applicants Signator K - [u -.
Date:
To Be Completed.By City Staff Only
Indicate As R-Received or NIA-Not Applicable
5 Completes sets of fully dimensioned.drawn to sale plans which include: 1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Gea Tech/Soils Report(on cd only)
❑ Plot/Site Plan Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8'A x 11)
Foundation Plan ❑ Structural Calculations
El Foundation Cross Section ❑ Plumbing Plan
❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan It Details ❑ Sharing Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration` Addition' Means/Methods
Repair" _ Retrofit* Revision to Existing PermlP Required? YES NO
Ll
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units-. #Stories: Will the Building Have a Basement?
Y of N
Bldg. Code Occupancy Group Indicate Indicate if YE$pr NO Indicate all Geo-tech.Haz.Zone
At Project Sprinklered [hat a
Completion:
Construction pp y: Coastal Zane
Type(s): C of O YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch-Review Hoard Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit Special case:Bldg.
OmcialApproval
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safety I Permit Specialist City Planning I Civil Engineering EPWM-Armin Transportation Mgmt. ReN Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Prescriptive Certificate of Compliance: Residential CF-IR-ALT
Residential Alterations (Page 3 of 5)
Project Name Climate Zone# #of Stories
CwIC /r9
L-
ROOFING PRODUCTS(COOL ROOFS)§1510912
When the area of exterior roof surface to be replaced exceeds more than 50%of the existing roof area,or more than 1,000 fr,whichever is
less,the new roofing area must meet the roofing product"Cool Roof'requirements of§151(b)1117,151(b)1Hfi,or 151(h)MIL
Check applicable alternative or exception below if'the roof alteration is exempt from the rool'ingproduct "Cool Roof'requirements.Note:if anv
one of the alternatives or exception below is checked,the Aged Solar Reflectance and Thermal Emittance requirements far roofing products in
§118(i)are not applicable.Do not fill table below.
LJ Cool Roofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or 2:12 pitch.
[]Cool Roofs Not Required in Climate Zones l through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less
than 5lb/ftz.
Alternatives to§152(b)l Hi and§152(b)Hii,Steep-slope roof(pitch>2:11)
❑ Insulation with a thermal resistance of at least 0.85 hrft°FBm or at least a 3/4 inch air-space is added to the roof deck
over an attic;or
Existing ducts in the attic are insulated and sealed according to§151(f)10;or
F�I'In climate zones 10, 12 and 13,with 1 tt'of free ventilation area of attic ventilation for every 150 tia of attic floor a,Aity of Menifee
where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or wilding & Safety Dept.
❑ Building has at least R-30 ceiling insulation;or
❑ Building has radiant barrier in the attic meeting the requirements of§151(02;or JUN 16 MIN
❑ Building has no ducts in the attic;or
❑ In climate zones 10, 11, 13 and 14,R-3 or greater roof deck insulation above vented attic. Received
Exception to§152(b)1Hiii,Low-slope roof(pitch<_2:12)
Building has no ducts in the attic.
Other Exceptions
❑Roofing area covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria.
Roof constmctions that have thermal mass over the roof membrane with at least 25 Ib/ttZ is exem t from the below Coot Roof criteria.
Note:If no CRRC-I label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise,
Check the applicable box below if Exem t from the Roofing Products"Cool Roof'Re uirement:
Roof Slope Product Weight Product Aged Solar Thermal
CRRC Product ID Number < 2:12 >2:12 < 5lb/ft2 > 51b/ftz Typez Reflectancet'a Emittance SRI5
C ® 0 ❑ ,� Qt o
❑ ❑ ❑
El ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑'
1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Councils Rated Product Directory at mim.coalroofs.orelnroductslsearcli pho
1.Indicate the type ofproduci is being used for the rooftop,i.e.single-ply roof,asphalt roof,metal roof etc.
t, If the Aged Reflectance is not available in the Cool RooJ'Rating Council's Rated Product Directory then use the Initial Reflectance valuefroni the same
directory and use the equation(0.2+0.7(p,,,,,I—0.2)to obtain a calculated aged value. {Fhere p is the Initial Solar Reflectance.
4.Check box if the Aged ReJlectance is a calculated value using the equation above.
5.Calculate the SRI value by using the SRI-Morksheet at htm:lltvrvw.enerrrv.ca.govltileldland enter the resuhing value in the SRI Column above and attach acopy of
the SRI-Min Lheet to the CF-IR.
o apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in§118(i)4. Select the applicable coating:
Aluminum-Pigmented Asphalt Roof Coating I❑Cement-Based Roof Coating then
Regiso ation Number: - - Registration Date/Tlnte: - HERS Provider. -1
7008 Residential Compliance Forms March 2010