PMT14-02780 City of Menifee Permit No.: PMT14-02780
29714 HAUN RD.' Type: Residential Addition
�CCGGE�./�k.` MENIFEE, CA 92586
MENIFEE Date Issued: 10/20/2014
PERMIT
Site Address: 25685 BETH DR, MENIFEE, CA 92584 Parcel Number: 358-232-008
Construction Cost: $6,656.00
Existing use: 1 &2 Family Residence Proposed Use:
Description of INSTALL SOLID ALUMAWOOD PATIO COVER WITH 3 FANS
Work:
Owner Contractor
DAVE HOFFMAN DAVIS BROTHERS PATIO COVERS
25685 BETH DRIVE 41309 THORNTON AVE
MENIFEE, CA 92584 HEMET, CA 92544
Applicant Phone: 9515268191
JERRY DAVIS License Number: 977816
DAVIS BROTHERS PATIO COVERS
41309 THORNTON AVE
HEMET, CA 92544
Fee Description City Amount 1$1
Building Permit Issuance 1 27.00
De a, r
GREEN FEE 1 1.00
$288.00
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
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 a d 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. 0 License No. a Z2 g/ who builds or improves thereon, and who contracts for the projects with a
Expires/0-3(-16 Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DE LARATION
I am exempt from licensure under the Contractors'State License law for the
❑ 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' 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
❑ 1 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 subm d or at the following Web site:htip'dwww leoinfo ca.gov/calaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are: )� 1 ,;�
Carrier Pro R rty 0wnerq Aut onze Agen Date
Expires Policy
# (///
❑ 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 I have provided is correct. I agree to comply
one-h honed 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-
certify that in the performance of the work for which this permit is issued, I identified property for the inspection purposes.
s all not emelov 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 Property Owner or Authorized Agent Date
Code,I shall forthwith comply with those provisions.
n ,� City Business License#
Date; L�"d-.V '- /� Applicant; v o
WARNING: FAILURE O S CURE 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, ❑YES OCCUPANT HANDLE A HAZARDOUS MATERIAL ORA
- DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑NO 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 OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address ❑NO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
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 OYES 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, ❑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 OYES 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL i
compensation, will do( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale. (Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MEN1F4P.),01ty of Menifee
ding & Safety Dept. PLCK No: Permit No:
LA
29714 Haun Road Date, —
Date: Da Oa
Menifee, CA92586 OCT 2 0 2014 col
Phone: (951)672-6777 Amount Amount:
Fax:(951)679-3843 Received Ck#: Ck#:
Building Combination Permit
To Be Completed By Applicant
Legal Description:so
1 , 1 �{�y r Planning Case: F: L: Rt: R
Property Address: / r Assessor's Parcel Number:
ProjectfTenant Name: (� Unit Floor#:
Name: c F Phonet 1 6 -S"7 IA- Fax No.
Prope0.V
Owner Address:Address: i3 e Unit Number Zip Code
Y/i
Email Ad
dress:
Name: Phone No. Fax No.
Applicant Address: Unit Number Zip Code
Email Address: pa / e �O
Name: 'F hone tyc.
-��O {'f r�Sf ( _ Fax No.
1q
Contractor Address: ( 0,--,7/C>h City;,, Stet Zip�ode
ontra ors ty Mal ass License o. Contractor' City State of California License No. Classification: t
Number of Squeres:
Square Footage F
Description of Work. . / Cost of Work:$ l,65b I
r ! tie do4z don CG'Ei :c /
Applicant's Signature Date:
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 ❑ Gen Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Tdle 24 Energy(on B%x 11)
❑ Foundation Plan ❑ Cross Section ❑ Structural Calculations
❑ Plumbing Plan ❑ Single Line diagram for also.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Sharing Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration Addition' Means/Method9
Work Type: Repair' Retrofit' Revision to Ezisfing 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 Goo-tech.Haz.Zone
Indicate YES or NO Indicate all
At Project Construction Sprinklered that apply: Coastal Zone
Completion: Type(s): Coto 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 Retrofit pec1e Case. g.
OelclalA roval
Expedite Projecl(s): Child Care City Project Green Building I Landmark I Affordable Housing
For Staff Use Only
Building/Safe Building/Safety I Permit Specialist I City Planning I Civil Engineering I EPWM-Adman I Transportation mgmt I Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
25685 BETH DRIVE City of Menifee HUFFMAN RESIDENCE
MENIFEE Building & Safety Dept.
ROUGH ELECTRICAL
3#CEILING FANS OCT 2 0 2014
SOLID ALUMAWOOD Q
Received U I
I LEDGER & TRACK U I
I
INSPECTION REQUIREM N LL
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House Frtont
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00
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33'
18'
♦ P/L♦ + 14' I
I 50 ♦50'
P/L I
CITY OF MENIFEE
BUILDING AND SAFETY DEPARTMENT
PLAN APPROVAL
I I
- - -REVtEVtE"y - - -01 - - - - - - - - J
ATE
'Approval of these plans shall not be construed to be a permit for,or an
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.