PMT14-02611 City of Menifee Permit No.: PMT14-02611
29714 HAUN RD,
9, MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE Date Issued: 09/26/2014
PERMIT
Site Address: 29165 ALICANTE DR, MENIFEE, CA Parcel Number: 327-250-074
92585 Construction Cost: $2,500.00
Existing Use: Proposed Use:
Description of RELOCATE REFRIDGERATOR, RELOCATE STOVE AND ADD NEW GAS LINE TO STOVE
Work:
Owner Contractor
JOANN BALDWIN A A A RESTORATION INC
29165 ALICANTE DRIVE 29850 2ND STREET
MENIFEE, CA 92585 LAKE ELSINORE, CA 92532-2420
Applicant Phone: 9514715828
KIRK MUNIO License Number: 834839
AAA RESTORATION INC
29850 2ND STREET
LAKE ELSINORE, CA
Fee Description (3ty Amount f$)
& �" `".m w,�y-...>„s�,.ea-mr-a-=.sc vra'�!�^'ae;..'7 s+t �,� ca rr•
Building Permit Issuance 1 27.00
$144.00
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 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 t5'ivision 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions Codeagd my license is In full cB•a &�( Code:The Contractor's License Law does not apply to an owner of a property
License Class_('s�License No. 4Vz'• C' 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'COMPEN ION DECLARAT IN
❑ I am exempt from licensure under the Contractors'State License Law for the
Syr 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 b this permit, I cannot legally sell a structure that have
permit is issu P - y p 9 Y
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
I have and will maintain workers' compensation Insurance, as required by Business and Professions Code,is available upon request when this application is
`ction 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:httm//www leginfo ca gov/calaw html.
permit is Issued.My workers'compensation insurance carrier and policy number are:
Carrier Property Owner or Authorized Agent Date
Expires / Policy#65 1
/ c: K C" ❑ By my Signature below, certify to each of the following:l am the property
Name of Agent hone t °7,_ / � � owner or authorized to act on the property owner's behalf. I have read this
(This section ne 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 certify that in the performance of the work for which this permit is issued, I identified propert Of the 1 spection purposes.
shall not emolov any persons in any manner so as to become subject to the
workers' compensation laws of California, and agree that I should become " �.� `"'�,,,_, a"...-�-^• /C„/^
subject to the workers'compensation provisions of Section 3700 of the Labor e Owner or Authorized ant —�
Code,I shall forthwith comply with those provisions. LL ' Date.
�q ✓ City Business License#
Date; /'- '"'/ Applicant -� y
WARNING: FAIL U ET 0
TO SECU WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAW L, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINA 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, OYES OCCUPANT HANDLEA HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE. CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ONO 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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
❑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 OYES 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, ❑NO 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 DYES 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($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING.
compensation, will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER ORAUTHORIZED AGENT
not Intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property, t
provided that the improvements are not intended or offered for sale.If,however, I'
the building or improvement is sold within one year of completion, the Owner.
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFEE PLCK No: Permit No:
amity of Menifee
29714 Haun Road ;3 iding & safety Dept. Date: Date: I�
Menifee, CA 92586
Phone: (951)672-6777 SEP 2 6 2014 Amount: Amount:
Fax:(951)679-3843 lyyc-0
Ck#: Ck#:
eCel�e
Building Combination Permit
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: IF:
Property Address: ,
Wktje
Assessor's Parcel Number:
Project/Tenant Name: Unit#: Floor#:
Name: yt Ph0!g!1 , F„y 2-7 Fax No.
Party Add '—
Pro , I / Unit Number ZipCode
Owner
Email Address:
Name:
Pit
rye o. e, V Z Fax N . ' -
Applicant Address: c �( I f Unit Number Zip Core
Email Address: �+
Name: .I. A Phone No. Fax No.
1 1'� i✓v w 19 v _
Contractor Address. r�SQ � I� City State Zip Cotle
C� An o f✓x-�
-Contractor s ry usmess tense o. Con to' MCalifornia License No. Classifiicalio .
Number of Squares:
Square Footage
Description of Work: (1 _ r+ I :. M..,,. `, ost of Work:$ 2✓7v''�
Applicant's Signature
Date:
To Be:Completed.6yCity.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 ❑ Gen Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8'/x 11)
❑ Foundation Plan El Cross Section ❑ Structural Calculations
❑ 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 New Construction Alteration' Addition* Means/Methods
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?
Bldg.Code Occupancy Group Y of N
P Y P Indicate iF Geo-tech.Haz.Zone
Indicate YES or NO Indicate all
At Project Construction Sprinklered that apply: Coastal Zone
Completion: Type(s): Colo 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 E ec.Vehicle Charger Landmark Seismic Retrofit p?coal Case:Bldg
OamialA roval
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Buildingfsafety Permit Specialist City Planning I Civil Engineering I EPWM-Admen I Transportation Mgmt. Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
City of Menifee
Building & Safety Dept.
SEP 2 6 2014
Received ?-
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CITY OF MENIFEE o - �aM -e
BUILDING AND SAFETY DEPARTMENT 04tt)
PLAN APPROVAL0"'
REVIEWED BY a( �a�e ( Iu I--ar 4-,
DAl
*Approval of these plans shall not be construed to be a permit for,or an p '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 &'nv rw t'tZ T�'Vk
jobsite until completion,