PMT14-02658 City of Menifee Permit No.: PMT14-02658
29714 HAUN RD.
CF—h.,1�.' MENIFEE, CA 92586 Type: Residential Addition
Wk'.° MENIFEE Date Issued: 1 010 2/2 01 4
PERMIT
Site Address: 27936 RIVER SHORE CT, MENIFEE, CA Parcel Number: 333-370-022
92585 Construction Cost: $4,700.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 13.5'x 20'SOLID& 10.5'x 18' LATTICE ALUMAWOOD PATIO COVER WITH 2 FANS, 3
Work: LIGHTS, 1 GFCI OUTLET
Owner Contractor
KAREN LOVELL PSLQ INC
27936 RIVER SHORE COURT 28910 RANCHO CALIFORNIA RD
MENIFEE, CA 92585 #206
Applicant Phone: 9517954260
LUIS BENTIVENGO License Number: 919885
PSLQ INC
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description Oily Amount
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
REND NT '°
$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 underwhich no work is commenced within six
months after issuance,orwhere 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 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. 1vg s%f— who builds or improves thereon, and who contracts for the projects with a
Expires 1`LI. Signature licensed contractors)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from Ilcensure 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 permit is issued. improvements covered by this permit, I cannot legally sell a structure that I have
PoI # 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
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http�//www.leciinfo.ca.ciovlcalaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier��j>11\2 Property Owner or Authorized Agent Date
Expires 7, ISM Policy# 9
ptV� Phone# (av0 °vo'a ❑ By my Signature below, I certify to each of the following: I am the property
Name of Agent
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-
sei I certify that in the performance of the work for which this permit is issued, I !dentifi d p erty for the inspection purposes.
shall not emolov 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 properly wn r or Authorized Agent Date
Code,I shall forthwith comply with those pro ' ions. 7
10 City Business License# ®� �yJ
Date; _ Z Applicant;
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, OYES 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 LrNO 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
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 reasons)indicated below by the checkmark(s)I have placed ❑YES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable items) (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, Y"O 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 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 HAZARDODUSAWTERIA REPORYING.
compensation, will do ( )all of or ( ) porting of the work, and the structure is PROP RTY OWN OR RI ZED 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 MENIFEE PLCK No: Permit No:
'CQ
29714 HaUn Road City of Menifee Date: Dale:
Menifee, CA 92586 BUilding & Safety Dept- I LA
Phone: (951)672-6777 Amount Amount:
Fax:(951)679-3843 OCT 0 2 2014 Ck#: Ck#:
Building Combination FP&ffftived
To Be Completed By Applicant
Legal Description: Planning Case: F: L: Rt: R
Property Address: -7 -y.3� Assessor's Parcel Number:
L �-1 IUef�loP�e � 333-37a- oZZ
Project/Tenant Name: Unit#: Floor#:
Name: L Phone No., � , Fax No,
Property Address: Unit Number Zip Code
Owner 2l7`�34 Jel`�'lor--C �-T-
Email Address:
Name: L Phone f .C�� O Fax No.
Applicant Address: Unit Number Zip Code
Email Address;�uly
Name: Phone Fax No.
Contractor Address: o q � ^ t r City, Slate Zip Code
Contractor's C
$
us es LLicy o. Contractor's Ci Slate of Califo�rnia License No. Classificatio9n:
3 t
Number of Squares:
Square Footage I Oc7
1 u(sue
Description of Work: Cost of Work:$
Applicant's Signature L.,. I 31\ , 1 C'�C1 Date:
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 ❑ Goo Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8%x 11)
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Structural Calculations
❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan I ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' Means/Methods
Work Type: Repair' Retrofit' Revision to FxisWlg Permir Required? YES NO
Proposed Building Use(s): Existing Building Use(sI El ):
#Buildings: #Units: i#Stories: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate Indicate if YES or NO Indicate all Geo-tech.Hoz.Zone
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 Elec.Vehicle Charger Landmark Seismic Relnefit peetal ase: g.
ORctalA mval
Expedite Project(s): Child Care City Project Green Building ILandmark Affordable Housing
For Staff Use Only
Sutldin /Safel PerNt Specialist City Planning ICivil Engineering EPWM-Admen I Transportation Mgml. I Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
Karen Lovell
-Plot plan 27936 Rivershore Ct.
Not to Scale Menifee, Ca. 92585
925-324-9256
10.5'x18' Lattice top, 13.5'x20' solid Alumawood Patio Covers Attached to
the house and to the concrete slab. color to be ( Adobe with Molave Tan )
Z
City of Menifee O
9 Building & Safety Dept,
LEDGER & I BACK OCT 0 2 2014
w
7� INSPECTION R§@ IRED - Received U
3' w
10 5' w
Lattice Top �
10.5'xl8' _(3- Solid Top
13.5'x20'
0 .( OF MENIFEE 9
JWING AND SAFETY DEPARTMENT
t AN APPROVAL O
REVIEWED BY L to kal ILA
��((�p�nn((���� DATE
'Approval of these plans shall not be constrdpd`tb`6l�d�rmit for,or an doom
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.
Driveway
Sidewalk
Rivershore Ct.