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PMT14-02410 City of Menifee Permit No.: PMT14-02410 _ 29714 HAUN RD. 4,^�L MENIFEE, CA 92586 Type: Residential Addition SA., MENIFEE Date Issued: 09/08/2014 PERMIT Site Address: 25295 LONE ACRES RD, MENIFEE, CA Parcel Number: 358-421-009 92584 Constructlon Cost: $2,900.00 Existing Use: 1 &2 Family Residence Proposed use: Description of INSTALL SOLID ALUMAWOOD PATIO COVER WITH 2 FANS Work: Owner Contractor PRISCILLA HEADRICK PSLQ INC 25295 LONE ACRES ROAD 28910 RANCHO CALIFORNIA RD MENIFEE, CA 92584 #206 Applicant Phone: 9517954260 LUIS BENTIVENIGO License Number: 919885 PSLQ INC DBA GREEN BEE 28910 RANCHO CALIFORNIA RD #206 TEMECULA, CA92590 Fee Description Qtv Amount I$1 c IYC , tl � � - ii • �,. Building Permit Issuance 1 27.00 t GREEN FEE 1 1.00 $283.00 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,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 ❑ [, as owner of the property an exclusively contracting with ]loans Chapter 9 (commencing with section 7000),.of Division 3 of the Business and Professions Code my my license is in f to a n, efjest. contractors to construct the project(Section 7044, Business and Professio License Class-�License c �`(,�j Code:The Contractor's License Law does not apply to an owner of a prope Ex ires � _�� � who builds or improves thereon, and who contracts for the projects with P —�L`Y Signatur licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ I am exempt from Iicensure under the Contractors'Slate License Law for it ❑ 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' compensation,issued by the Director of Industrial Relations as provided for by By my signature below I acknowledge that, except for my personal residence Section 3700 of the Labor Code, for the performance of work for which this which I must have resided for at least one year prior to completion permit is issued. improvements covered by this permit, I cannot legally sell a structure that I ha, Poll # built as an owner-building if it has not been constructed in its entirety by license contractors. I understand that a copy of the applicable law, Section 7044 of 9 have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http�11www lepinfo ca eov/calaw html, permit is issued.My workers'compensation insurance carrier and policy number are: Carrier_ a p (2 Property Owner or Authorize Agent Date Expires '1 1 j Policy# Name of Agent t 0_1_� Phone# ❑ By my Signature below, I certify to each of the following: I am the proper owner or authorized to act on the property owner's behalf. I have read th, (This section need not be completed if the permit is for application and the information I have provided is correct. I agree to comp) one-hundred dollars($100)or less) with all applicable city and county ordinances and stale laws relating to buildin consI certify that in the performance of the work for which this permit is issued,I identifedlproperty for authorize representatives of this city or county to enter the above shall not emolov any persons in any manner so as to become subject to the P purposes. workers' compensation laws of California, and agree that if I should become O subject to the workers'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p isio Property Owner or Authorize ant l.� Date Date; /� 7 Applicant; City Business License# WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL HAZARDOUS MATERIAL DECLARATION SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, WILL THE APPLICANT OR FUTURE BUILDING DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA LABOR CODE, INTEREST,AND ATTORNEYS FEES / MIXTURE CONTAINING A HAZARDOUS MATERIAL CONSTRUCTION LENDING AGENCY (❑NO EQUAL TO OR GREATER THAN THE AMOUNTS 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 3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE Lender's Name APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT /D NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR OWNER 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; Any city or county that requires a permit to construct, alter, improve, demolish, BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A or repair any structure, prior to its issuance �NO, also requires the applicant for the SCHOOL? 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 t UNDERSTAND MY REQUIREMENTS violation exempt from Iicensure and the basis for the alleged exemption. Any CHECKLIST.on of Section 7031.5 by any Applicant for a permit subjects the applicant to a civil penalty of not more than($500).) D NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY ❑ I, as owner of the property, or my employees with wages as their sole CODE, SECTION 25505, 25533 AND 25534 CONCERNING HAZARDOUS MATERIAL REPORT ING. compensation, will do ( ) all of or ( ) porting of the work, and the structure is not intended or offered for sale, (Section 7044,Business and Professions Code; PTr�= ENT The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY O ME wl IFL' E PLCK No: Permit No: City of Menifee 29714 Haun Road 8WIding & Safety Dept. Date Date: Menifee, CA 92586 6l lis Phone: (951)672-6777 SEP 0 8 2014 Amount: Amount Fax:(951)679-3843 Ck#: Ck#: Building Combination Permit To Be Completed By Applicant Legal Description: Planning Case: F: L: Rt. R Property Address:Zr 2 o S Assessor's Parcel Number: J 1 n-L �C. r.¢.S ZO, Project(fenant Name: SG; Unit#: Floor#: Name: Ph ne No. o Fax No, Fr 1 5C Ll,c� 1�c �J r, �L` `�rl - z Property Address: Unit Number Zip Code Owner Z g'Z (�,�e roc f�s �2c� 9 z rS l Email Address: Name: V i S �g.�-4-uJ�^ v Phone No.9 y 1-937-b Fax No. Applicant Address: Unit Number Zip Code Email Address: ' l✓.� t5� —E� �rS�JLJ(�-�, C Name: j Phone No. , Fax No. J Contractor Address: ,99910 �F��O i City Stat Zip l:,pgg _, D Contractor's it j ss,LOiceSe o. Contractor's City r Cj§1c egia License No. Classification: 11> tApplicant's quares: `'"I ZJ L7 ge 3� —a of Work: �2 �Z b S`\.r� ��ur✓-u-�'�"� Cost of Work:$ Signature Date: _ To Be Completed 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 ❑ Geo Tech/Soils Report(on ed only) ❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8%x 11) ❑ Structural Calculations ❑ Foundation Plan ❑ Cross Section ❑ 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' MeanslMethcds 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 At Project Construction Sprinklered 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 Commiss Arch,Review Board Landmark Comm. Planning Comm.Zoning Administrator Fee Exempt: City Project I Elec.Vehicle Charger Landmark Seismic Retrofit special ase.atlg. Official Approval Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing For Staff Use Only Buildmg/Safet Permit Specialist Cily Planning I Civil Engineering EPWM-Admen Transportation Mgmt. Rent Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY Priscilla Headrick (` Plot plan 25295 Lone Acres Rd. Not to Scale Menifee, Ca. 92584 LL 951-246-9857 Cl 336 sq. ft. of Alumawood Solid Patio Cover Attached to the house and to LL the concrete slab. (2) ceiling fans. Color to match the house C- ( Latte and Desert Sand ) set at 9' City of Menifee Building & Safety Dept SEP 0 8 2014 16' Received 32' o 0 0 o g1-. CITY OF MENIFEE BUILDING AND SAFETY DEPARTMEN Driveway --WAM PPROUAL REVIE ED BY >, R lit -'� DATE 'Approval of these plans shall not be construed to be a permit for,or an approval of ay violation of any provisens ef the federal,state or city Sidewalk regulations and ordinances, This set of approved plans must be kept on the job5ite until completion. Lone Acres