PMT14-02878 City of Menifee Permit No.: PMT14-02878
29714 HAUN RD. Type: Residential Addition
4; CCEL/�k MENIFEE, CA 92586
MENIFEE Date Issued: 1 110 6/2 01 4
PERMIT
Site Address: 29161 FALL RIVER LN, MENIFEE, CA Parcel Number: 364-290-007
92584 Construction Cost: $1,440.00
Existing use: 1 &2 Family Residence Proposed use:
Description of WALL TR 30422-2
Work: 6'X 45
LOT 222
Owner Contractor
CENTEX/PULTE J GINGER MASONRY LP
27101 PUERTA REAL#300 8188 LINCOLN AVE STE 100
MISSION VIEJO, CA 92691 RIVERSIDE, CA 92504
Applicant Phone: 9516885050
RANDY ARNETT License Number: 940581
J GINGER MASONRY LP
8188 LINCOLN AVE STE 100
RIVERSIDE, CA 92504
Fee Description (Qtyt Amount is
Wall/Fence, non-standard 1 133.00
SMIP RESIDENTIAL 1 1.00
$162.00
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_Templale.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 [loans(
Chapter 9 (commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professici
Professions Code and my license is in full farce and effect. Code:The Contractor's License Law does not apply to an owner of a propel
License Class C.7 c� License No. who builds or improves thereon, and who contracts for the projects with
Expires/ / Signatures 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 t
❑ 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
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
permit is Issussued.
Section 3 of the Labor Code, for the performance of work for which this improvements covered by this permit, 1 cannot legally sell a structure that I he
Policy# built as an owner-building if it has not been constructed In its entirety by licens
contractors. I understand that a copy of the applicable law, Section 7044 of t
lti,<have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application -
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:httn://www.leginfo.ca,gov/caiaw.html.
permit is Issued.My workers'compensation Insurance carrier and policy number are:
Carrier ( 1 s n G' s /}+ Property0wnerorAuthorized Agent Date -
s.
Expires 7//�/ Policy# it/— 4/a=f .f�X'/3 T1L
Name of Agent Phone# ❑ By my Signature below, I certify to each of the following: I am the prope
owner or authorized to act on the property owner's behalf. I have read t1
(This section need not be completed if the permit Is for application and the information I have provided is correct. I agree to coml
one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to build!
construction.I auth sentatives of this city or county to enter the abo%
❑ 1 certify that in the performance of the work for which this permit is issued,I identifie e e in p tion purposes.
shall not employ 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 pro Owner or Authorized A
Code,I shall forthwith comply with those provis' p rtY gent Date
Date; Applicant,
City Business License# d 3 7 /O�l
,� � /,�
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
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 3097 Civil Code) WILL THE INTENDED USE OF THE BUILDING BY THE
APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name ❑YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address ❑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 DYES 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 (Chapter9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or ❑YES 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 III
❑ 1, 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 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 MENIFEE PLCK No: P N'lo
Am
29714 Haun Road Date: Date
Menifee, CA 92586 0
Phone: (951)672-6777 Amount: Amount
Fax:(951)679-3843 Ck#: Ck#:
Building Combination Permit b1s
il
To Be Completed By Applicant
Legal Description:, _ a Planning Case: F: L: Rt: R:
Property Address: Assessor's Parcel Number:
ProjectJTenant Name: / Unit#: Floor M.
f7L�i
Name: Phone No. Fax No.
9s9•� 06
Property Address: Unii Number Zip Code
Owner 7/2/ M•'s ,' 1/ (1'Pj olG
Email Address:
Name: Phone No. Fax No.
Applicant Address: Unit Number Zip Code
Email Address:
Name: _ Phone No. _ _ Fax No,
Contractor Address: C1 /�J State Zip Code
v S' a •`v ✓ N.(�a C frJ
Contra ctor s ity Business icense o. contractor's City Smte f California License No. Classification: C
079
Number of Squares:
Square Footage �T�J
Description of Work: / / L`�G Cost of Work:3 y/�/•
CX G �f
Applicant's Signature Date:
_ To B .ompleteo By City-Staff Only
ladicate As R-Racelved or N/A,Not Applicable
5 Completes sets of fully dimensioned,drawn to sale clans which include: I 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)
❑ Structural Calculations
❑ Foundation Plan ❑ Cross Section ❑ 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 LlNew Construction I .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
Bidg.Code Occupancy Group Indicate Indicate if Incate all Geo-tech.Haz.Zone
Construction YES or NO
At Project Sprinklered tdi
hat apply: Coastal Zone
Completion: T e s): C Of O Noise Zone
YP YES( orN O
Required? Listed on Historic Resources Inventory !,
CITY PLANNING STAFF ONLY
i
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit Offical Aporovald9
Expedite Project(s): Child Care city Project Green Building I Landmark Affordable Housing
For Staff Use Only
Building/Safety Permit Specialist City Planning CmI Engineering EPWM-Admin Transportation Mgmt. Rent Control