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PMT14-02462 i City of Menifee Permit No.: PMT14-02462 9 29714 HAUN RD. CCEII-A-.' MENIFEE, CA 92586 Type: Residential Addition MENIFEE Datelssued: 09/25/2014 PERMIT Site Address: 31662 TRAMORE CIR, MENIFEE, CA Parcel Number: 358-234-009 - 92584 Construction Cost: $18,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL ENGINEERING SOLID PATIO COVER 36'X 14'AND 14'X 20' STANDARD LATTICE PATIO Work: COVER WITH ELECTRICAL Owner Contractor DAVID DAILY ROBERTS CONSTRUCTION 31662 TRAMORE CIRCLE 35801 DUSTER ROAD MURRIETA, CA 92562 Applicant Phone: 9518974941 KEN ROBERTS License Number: 561515 ROBERTS CONSTRUCTION 35801 DUSTER ROAD MURRI ETA, CA 92562 Fee Description r3ty Amount 1$1 Gas System 1 116.00 I c Deck/Patio, standard 1 83.00 D Pat'p,. -s' and Additional Plan Review Building 74 74.19 Addlh ,a�: an R a`ew�B ' g• 3 r, ,65. GREEN FEE 1 1.00 $785.74 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 building 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 Sd 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 rL) License No. 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'COMPENSATION DECLARATION ❑ I 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. 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 Yy ' 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.leginfo.ca.aov/calaw.html. permit is issued.My workers'compensation insurance carrier and policy number- c7 are: Carrier t\Y��-5' c� - � _ }, Property Owner or Authorized Agent Date � �s�m;� "� Expires 71 1 f Policy# �,C nr7 ❑ By my Signature below, I certify to each of the following: I am the property Name of Agent Phone# �'1Jr"�-I r'��7 y j 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 I certify that in the performance of the work for which this permit is issued,I ide &dfi l � spe 'o uses. 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 operty Owner or Authorized Agent D to Code,I shall forthwith comply with those provisions. )��, City Business License# Date; —1 LdJJJ Appli 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, AYES 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 r­640 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) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address , �I0 FROM THE SOUTH COAST AIR QUALITY MANAGEMENT {" DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR OWNER BUILDER DECLARATIONS GUIDE LINES 1 hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME: License Law for the reasons)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, >1110 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 Stale 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 Eg NFORMATION 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 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than ($500).) CODE SECTION 25505 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL IAEPOOING. compensation,will do ( )all of or( ) porting of the work, and the structure is PROPER 0 OR l)T)jRIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X - who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY OF li"1ENI Eli PLCK No: i 29714 Haun Road Date Date: Menifee, CA 92586 3 Phone: (951)672-6777 Amount: 4-7Amu Fax:(951)679-3843 Ck#: vo Ck 9.1 Building Ct, QI S3 It To Be Completed By Applicant Legal Description: b1 G 2 Planning Case: F: L: Rt: R Property Address; J J7 Assessor's Parcel Number: 2Q —.;X2_ Project/Tenant Name: Unit#: Floor#: Name: '\ J` fly`\ P N�. y ax No. Proper!)' Address: �, Tf \ Unit Number •T� Zip Code Owner Email Address: Name: Phone No. Fax No. Applicant Address: Unit Number Zip Code Email Add a s: Name: Ph a No. Fax No. Contractor Address: \ JS �� City - S�(e Zip ode tJ `E- ontractor s ty us ness License No. Contractor's City State of California License No. Classification: Number of Squares: Square Footage Description of Work: CN` Cost of Work:$ ` Applicant's Signature J l ' Date: � jai 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 cd only) ❑ Plot/SHe 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 8 Details ❑ Shoring Plan ❑ Sound Report-Residential Class Code: Indicate LJNewconstruction Alteration' Addition' Means/Methods Work Type: Repair• Retrofit Revision to Existing Permir'IRequired? 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 IND Indicate all Geo-tech.Haz.Zone At Project Construction Sprinklered that apply: Coastal Zone Completion: Type(s): Colo Noise Zone Required? YES or 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 JElec.Vehicle Charger Landmark Seismic Retrofit I Speclatass:drug. Official Approval Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing For Staff Use Only Building/Safe Building/Safety I Permit Specialist I City Planning I Civil Engineering EPWM-Admen I i ransportagon Mgmt. I Rent Control THANK OU FOR HELPING US CREATE ABETTER COMMUNITY