PMT14-01934 ,I
City of Menifee Permit No.: PMT14-01934
29714 HAUN RD. Type: Residential Addition
*9_OCIIEI� MENIFEE, CA 92586
wmumannn MENIFEE Date Issued: 07/24/2014 1
PERMIT
Slte Address: 28353 SUNGLOW RUN LN, MENIFEE, CA Parcel Number: 372-502-011
92584 Construction Cost: $4,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 492 SO FT SOLID AND LATTICE PATIO COVER WITH NO ELECTRICAL
Work:
Owner Contractor
STEVE DO
28353 SUNGLOW RUN LANE
MENIFEE, CA 92584
Applicant License Number:
STEVE DO
28353 SUNGLOW RUN LANE
MENIFEE, CA 92584
Phone: 9513779437
Fee Description Oft Amount I$)
Deck/Patio, non-standard 1 133.00
SMIP RESIDENTIAL 1 1.00
$162.00
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_Permll_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 ❑ 1 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
Business and Professions Code,is available upon request when this application is
❑ have and will maintain workers' compensation insurance, as required submitted or at the following Web site:http'llwww leginfo ca gov/calaw htLnl.
section 3700 of the Labor Code, for the performance of the work for which this s
permit is issued,My workers'compensation insurance carrier and policy number are:
roperty Owner or Authorized Agent Date
Carrier
Expires Policy#
❑ By 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 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-
❑ I 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 -� l
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 rtY 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, ❑YEg OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑NO GREATEREQUAL TO OR H E
UNTS
SPECIFIED ON THE HAZARDOUS
MATERIALS
CONSTRUCTION LENDING AGENCY INFORMATION GUIDE?
1 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 ❑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 reason(s)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 INFORMATION GUIDE AND THE SCAQMD PERMITTING
❑YES
Section 7000)of Division 3 of the Business and Professions Code)or that he or CHECKLIST. I UNDERSTAND MY REQUIREMENTS
she is exempt from licensure and the basis for the alleged exemption. Any
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to [I NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE, B C MATERIAL R 5533 AND 25534 CONCERNING
HAZARDO❑ 1, as owner of the property, or my employees with wages as their sole
compensation, will do ( ) all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code; X
The Contractor's State License Law does not apply to an owner of a property
who, through employees' or personal effort, builds or Improves the property,
provided that the improvements are not intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF 1V ENIFEE PLCK Na: �It�
29714 Haun Road t'1"1N::Q,
34
Date: Date:
Menifee, CA 92586 7y 1
Phone: (951)672-6777 Amount Amou�t; ^— "
Fax:(951)679-3843 Ck#: Ck#: YJ�+l1
5'p
Building Combination Permit
Is 1
To Be Completed By Applicant
Legal Description: a Planning Case: F: L: Rt: R:
Property Address: Assessor's Parcel Number.
-2a3h3 SUF IOL,) Lo (owe Mtf_nt ee t� -eJb 0�
Projectfrenant Name: Unit#: Floor#:
Name: Phone No. Faz No.
Property �e O 5y _3ni _c� 3
Owner Address: �s Unit Number Zip Code S San ow un lan>a pt7i 1S
Email Address:
Name: Phone No. Fax No.
Applicant Address: Unit Number Zip Code
Email Address:
Name: Phone No. Fax No.
Contractor Address: City State Zip Code
Contractors City Business License No. Contractor's Ciry State of California License No. Classification:
Number of Squares:
Square Footage N F t J qZ r'r'�Description of Work. ( � 'F . Cost of Work:$
Applicant's Signature �r
To Be Campleteil:By.City Staff Only
Indicate As R-Received or N/A-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 ❑ Gen Tech/Solis Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8'G x 11)
❑ Foundation Plan ❑ Plumbing Plan ❑ Structural Calculations
❑ Cross Section ❑ Single Line diagram for star.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate Ll New Construction Alteration* Addition* MeenslMethods
Work Type: Repair" Retrofit* Revision to Exisfing Permit' Requlred4 YES NO
Proposed Building Use(s): 7q H
Existing Building Use(s):
#Buildings: If Units: #Stories: Will the Building Have a Basement?
Y of N
Bldg. Code Occupancy Group Indicate Indicate if Indicate all Geo-tech.HaZ.Zone
At Project Sprinklered YES or NO
Completion: Construction that apply: Coastal Zone
Type(s): C of 0 YES or NO Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. I Planning Comm.Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit Special Case:Bldg_
OfficialApproval
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safety I Permit Specialist I City Planning I Civil Engineering I EPWM-Admin Transpodation Mgmt. Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
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