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PMT14-02465 i I City of Menifee Permit No.: PMT14-02466 29714 HAUN RD. Type: Residential Addition "56CEI[%fir?' MENIFEE, CA 92586 MENIFEE Date Issued: 09/12/2014 PERMIT Site Address: 29428 BREEZEWAY CT, MENIFEE, CA Parcel Number: 92585 Construction Cost: $5,900.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 480 SQ FT SOLID ALUMAWOOD PATIO COVER WITH ELECTRIC 2 FANS Work: Owner Contractor LYLE&VICKY WORSLEY TRADER DAN'S INC 29428 BREEZEWAY CT 840 S ROCHESTER AVE STE C MENIFEE, CA 92585 ONTARIO, CA 91761 Applicant Phone: 9093900555 CHANTEL CAGLE License Number: 517575 TRADER DAN'S INC 840 S ROCHESTER AVE STE C ONTARIO, CA 91761 Fee Description ,OQrt Amount($) Building Permit Issuance 1 27.00 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,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 i 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 Class License No. who builds or improves thereon, and who contracts for the projects with a Expires Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION �.1 ❑ I am exempt from licensure under the Contractors'State License Law for the `t'I hereby affirm under penalty of perjury one of the following declarations: following reason: 1 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# w 5 tO , V O O D 3 �t/p U built as an owner-building if has not been constructed in its entirety licensed contractors. I understand that a copy of the applicable law, Section 700 44 of the V 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:http,//www.leginfo.o.aovicalaw.html. permit is issued. �Mlylw�or�kers'compensation insurance carrier and policy number are: Carrier ! W Property Owner or Authorized Agent Date Expires Policy# ?Q;By my Signature below, I certify to each of the following: I am the property Name of Agent Phone# 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 1 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 certify that in the performance of the work for which this permit is Issued, I identified property 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 - —�Z subject to the workers'compensation provisions of Section 3700 of the Labor Pr a Owner or Autho ed Agent Date Code,I shall forthwith comply with those pro isions. Date; / GJ^ 12 41 Applicant; City Business License# WARNING: FAILURE TO SECURE WOR RS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS LAWFUL, 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, ES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE l—� MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES g�vu EQUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDING AGENCY C 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 DES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address NO 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 reason(s)indicated below by the checkmark(s)I have placed EYES 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, WO 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 $KVES 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL I';EPORfING. compensation,will do ( )all of or( )porting of the work, and the structure is PROP TY OWNER ORROP TY OWNER OR GENT AA not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY OF MENIFEE PLCK No: P it In; 29714 Haun Road Date: Date: riq Menifee, CA 92586 C1 ( 1 Phone: (951)672-6777 Amount Amount: Fax:(951)679-3843 ck#: ck#: Building Combination Permit 3 Ip Be Completed By Applicant Legal Description:,— anning Case: F: L Propem,,Ad rles Assessor's Parcel Number. -roi tenant Name: V U Unit#: Floor#: Name: i e N Fax No. OwPProperty Address: rj Unit Number Zip Code Email Address: 0 JAI Name:n 1„ „ ,� �1_- ^ Phona No. Fa Applicant AddressMIMI : h' lU-AfI�T c� Unit Number Zip Co 11 Email Address: l Name: Contractor Address: City (State Zip ontractor s ltye r1wg Number of Squares: ^� Contrac 's Ci State of California License No. Classification: l Square Footage Descriptiop r,¢W � / -94Cost of Work:$S�,q� App Slane Date: (�L•y ompleted By City Staff only n R-Received or N/A Not Applicable 5 Cc t .f I �r '/1/'v I y- 1 set of documents which include ❑ Electrical Plan ❑ ❑ Geo Tech/Soils Report(on cat only) ❑ I '6� I`�/ ,� ❑ Mechanical Plan ❑ Title 24 Energy(on 8'/:x 11) / 0 L (��_,,JJJ v (v ❑ Plumbing Plan ❑ Structural Calculations ❑ Single Line diagram for elec.services over 400 AMP ❑ Shoring Plan ❑ Sound Report-Residential C 1 Alteration' Addltl0n' Means/Methods Retroflf Revision to Existing PermiC Required? YES NO P Existing Building Use(s): cries: Will the Building Have a Basement? Y of N ate if Indicateall Geo-tech.Haz.Zane nklered YES or NO that apply:apply: Coastal Zone «If O YES or NO Noise Zone uired? Lisled on Historic Resources Inventory ITY PLANNING STAFF ONLY APPROVALS: I l os"'"I......" .Review Board Landmark Comm. Planning Comm.Zoning Administrator Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit Special ase:Bldg, Official Approval Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing For Staff Use Only Building/Safely Permit Specialist I City Planning I Civil Engineering I EPWM-Admin I Transportation Mgmt, Rent Control THANK YOU FOR HELPING US CREATE BETTER COMMUNITY OWNER kx ADDRESS `&61 CITY ZI PHONEgSl --514 0( R LOT NO. TRACT APN# I CONTRACTOR ROOMS N' COVERS PROPOSED ADDITION(S) 840 S. ROCHESTER AVE #C �7s5-* S ONTARIO, CA 91761 �j� �CZS 1K LIC. B-517575 909-390-0555 O-hA j26 a ) pwl�ry bw WORK COMP ICW 2— WSA5000386-04 6/14/215" A C K 25' is I C h CITY OF MENIFEE BUILDING AND SAFETY DEPA TM NT `'�� PLAN APPROVAL REVIEWED BY DATE 'Approval of these plans shall not he construed to e a permit for,or an approval of,any violation of any provisions of the f deral,state or city regulations and ordinances. This set of approved be ken't an thP- jobsite until completion. STREET T . :. MASTER ASSOCIATION Tuesday, July 28, 2014 Lyle worslew� 29428 Bree:`cway CT. 'Mnibee, Chi 92585 RE: Architectural Modification Conditionally Approved, Dear Lyle. We are pleased to inform you that%our plans were Cc minionallv Approved ore Daly 22, 2014. Please erasure that you coulpls with the conditions netted on Exhibit A (also transcribed oil the:Letter of Transmittal) of"your IIon7:e Improverneot Packet (enclosed). Also, please keep the followings ,matters in mirick (1) The Committee approves plans and specifications based on aesthetics and compliance with the community guidelines.They do not revie", for engineering design or structural integrity. Zoning and bu�itding perwitr; are the responsibility of the homeowner, (2) 'Fhe-Conunittee has the right to inspect.improvernents, constructed or being constructed,to determine that such improvements have been or are tieing built in compliance with the playas and specifications approved, (3) You will have six months to install the proposed improvernents. When the approved work has been. completed, p1case subtrtit photos of the completed work and the enclosed Notice of Completion form to our oil-site office. office. Thank you f'or your patience and cooperation. If you have any questions, please refer to your C'.orru urnity'Policies or contact me at 951-246-7678 or at nicole.defr� iiico@l.sresidential.cont. Sincerely, Nicole DeFra nco Con-imunity ,Service Representative P905-01 FirstService RV SIM".INT Ai 27606 Heritage Fake Dr, Menifee CA 92585 - (961)246-7679 Fax.(951)246-7651