PMT14-02824 City of Menifee Permit No.: PMT14-02824
29714 HAUN RD. Type: Residential Addition
J. MENIFEE, CA92586
pwm�me30`mmx MENIFEE Date Issued: 1 012 3/2 01 4
PERMIT
Site Address: 29900 BAY VIEW WAY, MENIFEE, CA Parcel Number: 340-500-042
92584 Construction Cost: $3,300.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 14'X 26'SOLID ALUMAWOOD PATIO COVER WITH ELECTRICAL 2 FANS
Work:
Owner Contractor
KATHY KULENICH WEST COAST SIDING&TRIM
29900 BAY VIEW WAY 675 LACEY OAK DIRVE
MENIFEE, CA 92584 CORONA, CA 92881
Applicant Phone: 9517353379
DANIEL SULLIVAN License Number: 615917
675 LACEY OAK DIRVE
CORONA, CA 92881
Fee Description
F
gty AmountItc ,>U Issuance 1 27.00
1 100T,rt1_ 1 0D
$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 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 Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions Co and my licens in full force l and effect. Code:The Contractor's License Law does not apply to an owner of a property
License�Cl�ass� L' ens o. who builds or improves thereon, and who contracts for the projects with a
Expires y 311_)_y_ Signature licensed oontractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure 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 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
action 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http,//www.leainfo.m.gov/calaw.htmi.
permit is issued.My workers'compensation insurance carrier and policy number are:
/��/h� Property Owner or Authorized gent Date
r Carrie �— GG //
Expires�/05 Policy# �W�SJ Z b
By m Signature below, I certify to each of the following: I am the property
Name of Agent Phone# owner or thorized to act on the property owner's behalf. I have read this
application rid
the information I have provided is correct. agree to comply
(This section need not be completed if the permit is for 'one-hundred dollars($100)or less) with all app able cit nd county ordinances and state laws relating to building
constructs I author a 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 ,party foci he inspection purposes.
hall not employ any persons in any manner so as to become subject to the r � l
workers' compensation laws of California, and agree that if I should become --
subject to the workers'compensation provisio of Se n 3700 of the Labor Property Owner or uthorized Agent D e
Code,I shall forthwith comply with those r
7 City Business License#
Date; 7- l 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, ❑YES 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 VI O EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
INFORMATION GUIDE?
I hereby affirm that under the penalty of perjury there is a construction lending
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
1�, FROM THE SOUTH COAST AIR.QUALITY MANAGEMENT
Lender's Address y�NO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
1\ GUIDE LINES
OWNER BUILDER DECLARATIONS PRINT NAME:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the reason(s)indicated below by the checkmark(s)I have placed AYES 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
�NO
Any city or county that requires a permit to construct, alter, improve, demolish, 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
Section 7000)of Division 3 of the Business and Professions Code)or that he or AYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any �N� CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to 1 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) \\ CODE, SECTION 25505 25533 AND 25534 CONCERNING
HAZARDOUS MATERIAL REPORTING.
as owner of the property, or my employees with wages as their sole
mpensation,will do( all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered or sale.(Section 7044,Business and Professions Code; X
The Contractor's State License Law does not apply to an owner of a.property
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF ME1"+rIFEE PLCK No: P i
29714 Haun Road Date: ate:
Menifee, CA 92586
Phone: (951)672-6777 Amount: Amount �2�
Fax:(951)679-3843 Ck#: Ck#:d 7J
Building Combination Permit �s
To Be Completed By Applicant
Legal Description:w.'1 LO Planning Case: F: L: Rt: R
Property Address: Assessor's Parcel Number:
70°w �q I 3 n-5oo -0q;
Projecl/Tenant Name: Unit#: Floor#:
Name: I I ?�t t N Phone No. G v Fa o.
'JO ,— �
Property Owner �(��Address:„L G Unit Number Zip Code
Email Address: JJ
Name: i(I �I�i�&✓� Pho7)No.
Applicant Address: , Unit Number Z' Code
Email Address:
Name: I ` Phone No. Fax No. /� J
I� S i,a i e �6 �'X/t
�J
Contractor Address{ / ��,� %� ( Ci Statg,� Zip Code ,M
ontractor's �> nse Sm. Contractor's City State of Calieinfornia License No. Classification:
13
Number of Squares:
Square Footage ✓
Description of Work: / I C C Cost of Work:$ yy f
Applicant's Signature i Dale: 2 j
J
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 ❑ Geo Tech/Soils Report(on cd only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8%x 11)
❑ Foundation Plan Cross Section❑ ❑ Structural Calculations
Founda ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan ` ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' Means/Methads
Work Type:El Repair' Retrofit' I 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 It YES or NO Indicate all Geo-tech.Haz.Zone
At Project Construction Sprinklered that apply: Coastal Zone
Completion: Type(s): Coro { Noise Zone
Required? YES or NO Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch,Review Board ILandmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Charger eismic Landmark S Retrofit Pecial ase.BI g.
OFdaIA royal
Expedite Project(s): Child Care City Project Green Building Landmark I Affordable Housing
For Staff Use Only
B.,lding/S.lety I Permit Specialist I Guy Planning I Civil Engineering EPWM-Admin Transportation Mgmt. I Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
2 ly' l,6` ��� �u atFiD Cn�P� z ��,�s rl I'v11�AiCti �',I-33t�s5.
I Qsoeet-W \gym
LEDGER & TRACK
INSPECTION REQUIRE
City of Menifee
Building & Safety Dept.
OCT 2 3 2014
Received
OF ,","ENIFEE
S'11LDING AND SAFETY DEPARTMENT
A.I.AN A�rpF;OVAL
REVIEWED
--1 DATE
*Approval of these plan, ;hall not be ccn,trued to be a
?pprova;of,any violation .f anyprovisio Permit for,or an
"Y' ions and ordinances. nli the federal,state or cit
osi a until completion. PFIVwCuplans must be kept on the