PMT14-02195 i
City of Menifee Permit No.: PMT14-02195
�^ 29714 HAUN RD.
Mel- MENIFEE, CA 92586 Type: Residential Electrical
5•
MENIFEE Date Issued: 08/19/2014
i
PERMIT
A
Site Address: 30310 SAN RAFAEL ST, MENIFEE, CA Parcel Number: 360-413-001
92584 Construction Cost: $3,000.00
Existing Use: Proposed Use:
Description of INSTALL 2 NEW CAN LIGHTS,2 VANITY LIGHTS, REPLACE FIBERGLASS SHOWER WITH NEW
Work: TILE SHOWER, MOVE TOILET TO ADJACENT WALL
Owner Contractor
DOUG&DOROTHY HOOVER A A A RESTORATION INC
30310 SAN RAFAEL STREET 29850 2ND STREET
MENIFEE, CA 92584 LAKE ELSINORE, CA 92532-2420
Applicant Phone: 9514715828
KIRK MUNIO License Number: 834839
A A A RESTORATION INC
29850 2ND STREET
LAKE ELSINORE, CA
Fee Description Qtv Amount
Plumbing Fixtures and Vents, fixtures 2 116.00
�BuI dlna Pe ml�l`s�sue2 7, ,
GREEN FEE 1 1.00
$280.00
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 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 CI License Np. who builds or improves thereon, and who contracts for the projects with a
Expires Signatur licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPEN ION D ARATION
❑ 1 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:
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.
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
\kR- 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:htto//www leainfo ca govLtolaw htm1.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier 'r C-h ma-vlam. Property Owner or Authorize Agent Date
Expires 7 1 .--_�(� Policy#
' /j5��G�'� ��(� ❑ By my Signature below, I certify to each of the following: I am the property
Name of Agent L Phone# Tz� owner or authorized to act on the property owner's behalf. I have read this
(This section n d 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 pr yerty 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 roperty Owner or oriz gent Date
Code,I shall forthwith comply with those provisions.
/7 L/ City Business License#
Date; I —� T Applicant
WARNING: FAILURt
TO S RE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UN FUL, AND SHALL
SUBJECT AN EMPLOYER TO CRI AL 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 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 ONO 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) q 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 ❑NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
OWNER BUILDER BUILDER DECLARATIONS
GUIDE LINES
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 DYES 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, D 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 DYES 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL I EPORI'ING.
compensation, will do( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF 1V lENIFElli PLCK No: Permit-No
& safety Dept "16
29714 Haun Road Building Date: Date:
Menifee, CA 92586
Phone: (951)672-6777 AUG 19 2014 Amount: Amount:
Fax:(951)679-3843
Ck#: Ck#:
eCe1Ved
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: RI: R
Property Address,
ddres Assessor's Parcel Number:/ ,,
Projecl/Tenant Name: ram` q��{o Unit#: Floor#:
Name: d'1.` t'�0-.. (ate` Ph7S Fax No.
Property Address: -v ( v) S'l n _ Unit Number Zip Cody-i
Owner t
Email Address:
Name: Phon No
Ie I n 110 A4a a-Mvie �- 4 L -y7I_5
Applicant Address r - i Unit Number Zip C e
•�C �
JJ 9
Email Address: �t �j /,-7
Name: li�Y t ' �` c P o. _SZ.�G F15 Y/1—J 28
Contractor Address Cl State Zip,Qode
�( A fC �S �u JZb 7
-Contractors ny usm -eSs License o. Contr Qf'California License No. Classification:
Number of Squares:
Square Footage
Description of Work: _ h` r?L CJ'A'I /Aq Cost of Work:$
Applicant's Signature Date: (,
To Be Completed Sy City.Staff poly -
Indicate As R-Received or NIA-Not Applicable
5 Completes sets of fully dimensioned,drawn to sale plans which include: i set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on cot only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8'/x 11)
El Foundation Plan El Cross Section El Structural Calculations
❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan I ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' MeanslMethods
Work Type: Repair' 77Retrofit' Revision to Existing Permit' Required? YES NO
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 YES or NO Indicate all Geo-tech.Haz.Zone
Al Project Construction Spdnklered that apply: Coastal Zone
Completion: Type(s): Cot O Noise Zone
Required? YES orNO
Listed an Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: I Costal Commis, Arch.Review Board Landmark Comm. I Planning Comm.Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit pedal Case:ui g.
Official Approval
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safety Permit Specialist Cily Planning I Civil Engineering EPWM-Admm Transportation Mgml. I Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
"-( 2z e AAP,
hne�tfc &I- .
Lake ELW
City of Menife —
? Building & Safety Dept.
2014
McPived
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CITY F ME IF EE ` � 1
BUIL NG A SAFETY DEPARTMENT u
PLATAPP — -- —
REVIEWED BY —
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'Approval of these plans shall c Aede a permit for,or anapproval of,any violation of any provisia state or city
regulations and ordinances. This set of app ialki st be kept on the `.
jobsite until completion. OFFICE COPY
I,
A
Doug and Dorothy Hoover 8-12-14
30310 San Rafael st
Menifee, Ca. 92584
Scope of bathroom project
1 Remove all rotten drywall to studs and replace with new.
2 Remove fiberglass tub shower unit, to install new the tub and shower.
3 Move toilet to adjacent wall.
4 Install 2 new can lights on existing switch.
5 Install new vanity lights on existing switch.
6 Install new rain head shower head.
7 Install new energy star thermostatically controlled fan/light combo at existing location.
8 Install new tile flooring.