PMT14-02412 City of Menifee Permit No.: PMT14-02412
29714 HAUN RD.A;k- �L—A> MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 0 910 812 01 4
PERMIT
Site Address: 27156 SAWYER RD, MENIFEE, CA 92584 Parcel Number: 360-061-005
Construction Cost: $3,000.00 -
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 15'x 23' SOLID ALUMAWOOD PATIO COVER WITH 1 FAN, 5 LIGHTS
Work:
Owner Contractor
SARAH ROWBOTHAM PSLQ INC
27156 SAWYER ROAD 28910 RANCHO CALIFORNIA RD
MENIFEE, CA 92584 #206
Applicant Phone: 9517954260
LUIS BENTIVENGO License Number: 919885
PSLQ INC
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description Qty Amount
.�C��I?ta feS Nifc 1...Qul�.�.,rtlel�&1F�"Ire^,.:. t •?"'6 - ' : QO:..
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
$303.00
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_Templatexpt 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),nf Division 3 of the Business and
Professions Code my license is in f fo gn�;?et. contractors to construct the project(Section 7044, Business and Professio
License Class 1 License o. ZJ ff Code:The Contractor's License Law does not apply to an owner of a grope
Expires--?— Signatur who builds or improves thereon, and who contracts for the projects with
P� w 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 t
❑ I hereby affirm under penally 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 hat
Poll yl 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 it
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 :/www,le info.ca. ov/Calaw. t I.
permit is issued.My workers'compensation insurance carrier and policy number are:
v^1
Carrier f p .2 Property Owneror Authonzed Agent
1 Date
Expires � 1 j - policy#
Name of Agent 1t 0_11� Phone# (oCx__/& _L;1 ❑ 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
certify that in the performance of the work for which this permit is issued, d ntifiedlpoperty for 1Z e i PrP pureeentativespur of this city or county to enter the abovE
shall not employ any Persons in any manner so as to become subject to the poses.
workers' compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those p isi Property Owner or AuthorizedA4ent Date
Date; /� y Applicant; City Business License# c,
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 OR
LABOR CODE, INTEREST,AND ATTORNEYS FEES /❑ MIXTURE CONTAINING A HAZARDOUS MATERIAL
CONSTRUCTION LENDING AGENCY / NO 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
DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
10 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
next to the applicable item(s) (Section 7031.5. Business and Professions Code: DYES WE
WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
THE PROPOSED BUILDING OR MODIFIED FACILITY
Any city or county that requires a Permit to construct, alter, improve, demolish, -E N0 BE
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
ES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑NO a civil penalty of not more than($500).) UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
El I, as owner of the property, or my employees with wages as their sole CODE, SECTION 25505 25533 AND 25534 CONCERNING
HAZARDOUS MATERIAL FAEPORI,
ING.
compensation, will do ( ) all of or( )porting of the work, and the structure is PROPERTY
not intended or offered for sale.(Section 7044,Business and Professions Code; ('N`E�R OR AUTHO/gIZED AGENT
The Contractor's State License Law does not apply to an owner of a property XAI
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale, If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF M NI E' E City Of Ntenifee PLCK No: Permit No:
aMLA
29714 Haun Road Building & Safety Dept - la
Date: Date
Menifee, CA 92586 �k L-t
Phone: (951)672-6777 SEP 0 8 20M Amount: Amount:
Fax:(951)679-3843 a 7W�`
p Ck#: Ck#:
i
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R
Property Address: 2'7 1 Assessor's Parcel Number:
Project/Tenant Name: Unit#:'�` Floor#:
a r�
Name: w �w� Pho e No. Fax No.
Property Address:
Owner 'Z'7t )V �w._. tT Zt' Unit Number Zip Code
Email Address: T
Name: PhorGe No Fax No.
v LS J�1 0 `-� ^�� � e
Applicant Address: Unit Number Zip Code
Email Address I
Name: Phone No. Fax No.
Contractor Address:,a o� O r r� 4� City T�� Stated Zip C4de�s Q
ontractor's i7ny nusitLey;Ltgns� Contractor's City Sld�of 4alifcgrniaLiLicense No. Classification: ?
Number of Squares:
Square Footage
Description of Work: 1S Z C A J ,� Cost of Work:$
Applicant's Signature
Date:
o 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 ❑ Geo Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8%x 11)
❑ ❑ Cross Section ❑ Structural Calculations
Foundation Plan
❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan I ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' MeansWethods
Work Type:HRepair' 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 Indicate all Geo-tech. Haz.Zone
Al Project Sprinklered YES Or NO that a
Completion: Construction pply: Coastal Zone
Type(s): C Of O YES or NO Noise Zone
Requiretl7 Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board I Landmark Comm. I Planning Comm.Zoning Administrator
Fee Exempt: City Project I Elec.Vehicle Charger I Landmark Seismic Retrofit pedal case:eldg.
Official Approval
Expedite Projecl(s): Child Care City Project Green Building Landmarkl I Affordable Housing
For Staff Use Only
Buildingl5alety I Permit Specialist Cily Planning Civil Engineering EPWM-Admen I Transportation Mgml. Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Sarah Rowbotham
Plot plan 27156 sawyer Rd.
Not to Scale Menifee, Ca. 92584
619-456-5370
345 sq. ft. of Alumawood Solid Patio Cover Attached to the house and:
the concrete slab.. 1 fan & 5 lights.
O
U `
City of Menifee ,, ,
,tl I' ACI� Building & Safety Dept. W
INSPECTION REQUIRED 241 SEP 0 8 2014 LL
.R tr O
23' �.
1 '
CITY OF MENIFEE [� oPQ
BUILDING AND SAFETY DEPARTME
PLAN APPROVAL
REVI D E IS
*Approval of these plans shall not be construed to be a permit for,or a Driveway
approval of,any violation of any provisions of the federal,state or city
regulations and ordinances. This set of approved plans must be kept o the
jobsite until completion.
Sidewalk
Sawyer Rd.