PMT14-02411 City of Menifee Permit No.: PMT14-02411
I
29714 HAUN RD.
" CCE1. MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 09/08/2014
PERMIT
Site Address: 28380 PACIFIC CT, MENIFEE, CA 92585 Parcel Number: 333-510-011
Construction Cost: $4,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 12'x 80' SOLID AND 12'x 15' LATTICE ALUMAWOOD PATIO COVER, 1 FAN, 4 LIGHTS
Work:
Owner Contractor
PIO GEVONA PSLQ INC
28380 PACIFIC COURT 28910 RANCHO CALIFORNIA RD
MENIFEE, CA 92585 #206
Applicant Phone: 9517954260
LUIS BENTIVENGO License Number: 919885
PSLQ INC DBA GREEN BEE
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description QQty Amount($1
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
$298.00
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 staled,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 licens
Chapter 9(commencing with section 7000)xf Division 3 of the Business and
Professions Code my license is in f fyN o ef�, contractors to construct the project(Section 7044, Business and Professlo
License Class License o. 1 Code:The Contractor's License Law does not apply to an owner of a props
Expires_ — (o Signatur s or p
who build improves thereon, and who contracts for the projects with
licensed contractor(s)pursuant to the Contractors State License Law),
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensors under the Contractors'State License Law for tl
❑ 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
compensation,issued by the Director of Industrial Relations as Provided for by
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 he,
Poll # built as an owner-building if it has not been constructed in its entirety by licens(
contractors. I understand that a copy of the applicable law, Section 7044 of U
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:htt a/www.Is info.ca. ov calaw.him].
permit is issued.My workers'compensation insurance carrier and policy number are:
r�
Carrier Property OwnerorAulhonzed Agent
,1 Date
Expires policy# 1 3
Name of Agent t 0-1n. 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 thy.
(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 state laws relating to bui[din
161"certify that in the performance of the work for which this permit is issued, I Identifiedlon property for1Zee preventatives of this city or county to enter the above
shall not simple, 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 6`/yp subject to the workers'compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those p isi Property Owner or Authorize ent
a Date
Date; /� 7 Applicant; City Business License# ✓S O J
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 OYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR
LABOR CODE, INTEREST,AND ATTORNEYS FEES MIXTURE CONTAINING A HAZARDOUS MATERIAL
CONSTRUCTION LENDING AGENCY /ONO EQUAL ED OR GREATER THAN THE AMOUNTS
I hereby affirm that under the penalty of perjury there is a construction lending SPECIFIED ON THE HAZARDOUS MATERIALS
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
OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
OWNER BUILDER DECLARATIONS "J NO GU DISTRICT(S AQMD) SEE PERMITTING CHECKLIST FOR
I hereby affirm under penally 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
OYES 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, Z NO BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
or repair any structure, prior to its issuance, 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
she is exempt from licensure and the basis for the alleged exemption. Any f 'ES INFORMATION GUIDE AND THE SCAQMD PERMITTING
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to CHECKLIST. I UNDERSTAND MY REQUIREMENTS
a civil penalty of not more than ($500).) ONO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
❑ I, as owner of the property, or my employees with wages as their sole CODE, SECTION 25505 25533 AND 25534 CONCERNING
HAZARDOUS MATERIAL AEPORI,
ING.
compensation, will do ( )all of or( ) porting of the work, and the structure is
not intended or offered for sale.(Section 7044, Business and Professions Code; PROPERT yyNER OR AUTHO IZED AGENT
The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property,
Provided that the improvements are not intended or offered for sale. If, however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF ME 7FEE PLCK No: Permit No:
t of Menifee _
29714 Haun ROa(�lildillg & smfaty Clapt' Date: Date: ��
Menifee, CA 92586 S vA
Phone: (951)672-6777SEP 0 8 Will Amount: Amount:
Fax:(951)679-3843 Ck#: Ck#
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R:
Property Address: 1 Assessor's Parcel Number:
Zg3d� l c� c� - "
Project/Tenant Name: Unit#: Floor#:
Name: x.b Phone%07 2 r C Fax No.
Properly Address: (� r Unit Number
��JJ OO Zi
Owner 'Z o `� `� 2 I P Code
Email Address:
Name: ` £ "\t �� Phone No.
'Nf-- 378 Fax No.
J 7
Applicant Address: Unit Number Zip Code
Email Address:+
l..�r t3 1rC,�/1,!?e�-2.SQ c'll'l�+{.. Co •v�
Name: Phone Nos f_ Fax No.
I • b
Contractor Address: City�� State Zip Cpde
z j-5 D
-Contractors ifity business License No. Contractor's City St f a16n' Li e No. Classification:
l
Number of Squares:
Square Footage I u) Lk
b
Description of Work: - Cost of Work:$
Applicant's Signature Date:
—del
To Be-0ompleted 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 ❑ Goo TecWSoils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 Y:x 11)
❑ Foundation Plan ❑ Structural Calculations
❑ Cross Section ❑ Plumbing Plan
❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate Ll New Construction Alteration` Addition' MeansWethods
Work Type: Repair' Retrofit' 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 0 Noise Zone
Required? YES or NO
Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board I I Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project I lElec.Vehicle Charger Landmark Seismic Retrofit Pecial ase',ado
OPoa.1 Approval
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Buildingf3afety Permit Specialist City Planning Civil Engineering EPWM-Adman I Transportation Mgmt. Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Pio Gevona
Plot plan 28380 Pacific Ct.
Not to Scale Menifee, 92585
951-973-8441
180 In Alumawood LATTICE & 240 In SOLID Top Patio Cover.
attached to the house and to existing concrete. (1 ) Fan and (4) Lights
Building & Safety Dept
SEP 0 8 2014 �
' . 1 -ER CRACK Received CL
hy,,�:rPF(7M REQUIRED O
U
U
U.
31' 0
1, - - 2(
12'
LATTICE SOLID
O
T
CITY OF MENIFEE
��a�QBUILDING AND SAFETY DEPA TMENT
PLAN APPROVAL
REVIEWED BY J
Driveway DATE
'Approval of these plans shall not be construed to be a permit for,or an
approval of,any violation of any provisions of the federal,state or city
regulations and ordinances. This set of approved plans must be kept on the
jobsite until completion.
Sidewalk
Pacific Ct.