PMT14-02801 City of Menifee Permit No.: PMT14-02801
29714 HAUN RD.
' '�titiC;C—L.,Y MENIFEE, CA92586 Type: Residential Addition
MENIFEE Date Issued: 1 0/2 212 01 4
PERMIT
Site Address: 30336 CAROB TREE CIR, MENIFEE, CA Parcel Number: 360-621-037
92584 Construction Cost: $4,200.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL SOLID ALUMAWOOD PATIO COVER WITH 3 FANS&5 POST LIGHTS
Work:
Owner Contractor
ROBERT GARCIA PRO INSTALLATION
30336 CAROB TREE 43043 CAMINO CARUNA
TEMECULA, CA 92592
Applicant Phone: 7142348652
TOM MOOKE License Number: 895950
PRO INSTALLATION
43043 CAMINO CARUNA
TEMECULA, CA 92592
Fee Description
Q�t Amount
t :
Building Permit Issuance 1 {27.00
xe. : _ a•da ' 0
GREEN FEE 1 1.00
$313.00
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 ❑ 1, 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 Cycle-a license is in f r a d effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class License who builds or improves thereon, and who contracts for the projects with a
-Expire 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
❑ 1 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. built as an owner-building if It has not been constructed in its entirety by licensed
Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the
\�(, 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:httc'//www.lecinfo.ca.gov/calaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
nn pp�� 11 ('� _ l ` n ,� Property caner or Authorized Agent pate
Carrier NQ& a�tw— °\�
Expires-- 1 Q.. ( Policy#. }"f Q / ,/
my Signature below, certify to each of the following: I am the property
Name of Agent Phone# wner 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-
El I certify that in the performance of the work for which this permit is issued, I identified p ity for the ins ection purposes.
shall not emolov any persons in any manner so as to become subject to the //�V^`------
workers' compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labo -P�roipertyowner or Authorized Agent Date
Code, I shall orthwit com*with those provisions. ((11
City Business License
Date; Applica
WARNING: FAILUR T 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 CUPANT 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 O 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) APP CANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name D�- D
ERMIT FOR THE CONSTRUCTION OR MODIFICATION
OM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address TRICT(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 reason(s)indicated below by the checkmark(s)I have placed DYES 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, 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 I HAVE READ THE HAZARDOUS MATERIAL
provisions of the Contractor's State License Law(Chapter 9 (commencing with INFORMATION GUIDE AND THE SCAQMD PERMITTING
Section 7000)of Division 3 of the Business and Professions Code)or that he or ES
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,
SEHAZARDOUS ION 25505RIAL ftE5533, G AND 25534 CONCERNING
El 1, as owner of the property, or my employees with wages as their sole
compensation,will do( ) all of or ( ) porting of the work, and the structure is PR RTY 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 A
who, through employees' or personal effort, builds or improves the property, —w
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 MLL'ii'g1LFEEClty Of Menifee PLCK No: Permit No:
Building & Safety Dept, 1#-k-0 T10111
29714 Haun Road Date: Date:
Menifee, CA 92586 OCT 2 2 2014 1L0-Z-c-%4
Phone: (951)672-6777 Amoa'nb .• Amount:
Fax:(951)679-3843 Received Ck#: Ck#:
Building Combination Permit GA ` S�
To Be Completed By Applicant
Legal Description: ,1 Planning Case: F: L: Rt: R:
Prope ddees V Assessor's Parcel N tuber.
ProjecVienant�JrtC,pdff ' CIA Unit#: Floor III:
\
Name: phone No.
GAe-cJAFax No.
Property Addr -- , Unit Number
Owner b G+� 0
Email dress:"me "
4Add
P one o. J Fax No.
Applicanttea)e Unit NumberlUL /� 7 O23 q_Q�G Fax No.
Contractor �/I ` J`/ U^ ✓Sta Z' gge�Q
ConVactor s rty Business Ucensue No. Contracto ' ifomia License No.H Classifications Cs I
4
Number of Squares:
Square Footage
GbY� � •�
Description of Work: 1 ,. CostBf Work:sz
Applicant's Signature i1
Date:
To Be'Cornpleted By Gtty'.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(ore 8%x 11)
❑ Structural Calculations
❑ Foundation Plan ElCross Section ❑ Plumbing Plan ❑ 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 Existing Permit' Required? 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 Indicate all Geo-tech.Haz.Zone
At Project Sprinklered YES or NO
Completion: Construction that apply: Coastal Zone
Type(s): C Of O YES or NO Noise Zone
Required? ( 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 Elea.Vehicle Charger Landmark Seismic Retrofit spacial case:aldg.
OrnaalA royal
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safety Permit Specialist I City Planning I Civil Engineering I EPWM-Admin I Transporshon Mgmt. I Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY