PMT14-02959 City of Menifee Permit No.: PMT14-02959
29714 HAUN RD.
Type: Residential Re-Roof
OW&Cr=L.a�? MENIFEE, CA 92586
epX�As0k.. MENIFEE Date Issued: 11/07/2014
PERMIT
Site Address: 28840 AMERSFOOT WAY, MENIFEE, CA Parcel Number: 337-133-011
92586 Construction Cost: $5,000.00
Existing Use: Proposed Use:
Description of REPLACE ROOF
Work:
Owner Contractor
HAZEL HEAPS
28840AMERSFOOT WAY
MENIFEE, CA 92586
Applicant License Number:
HAZEL HEAPS
28840AMERSFOOT WAY
MENIFEE, CA 92586
Phone: 9516794646
Fee Description oyt Amount is
Inspections not specified 98 98.00
G. pp
$126.00
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_eldg_Permil Templatespt 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. who builds or improves thereon, and who contracts for the projects with a
Expires Signature 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
❑ 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.
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
❑ 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.leainfo.ca.gov/calaw.htmi.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier Property Owner or Authorized Agent 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-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-
0 1 certify that in the performance of the work for which this permit is issued,I identified property for the inspection 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 PropertylSd ner or Aut orized Ag nt Date
Code, I shall forthwith comply with those provisions. ri
City Business License#
Date; 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, DYES OCCUPANT HANDLEA HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES Li 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 ❑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 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, ❑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($500).) CODE, SECTION
E 3 MATERIAL 505{fE 5533 AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole
compensation,will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENIFEE PLCK No:
29714 Haun Road Date: Date: 11 I /
Menifee, CA 92586
Phone: (951)672-6777 Amount: Amo u
Fax:(951)679-3843
Building Combination Permit
S To Be Completed By Applicant
Legal Descri 'on: Planning Case: F: L: Rt: R:
Pr p d rgss: mar cA A/ Assessort � (eLJJuntbT-S O[
Project/Tenant Name: 7 UnR#[: Floor A!
Name: S hppe G Fax No.
Property Address: Oj cI 9 Unit/Number Zip Code
Owner 0 d (/ ! O r2
Email Address �n e)'1Q,�'
Name: Phone No. Fax No.
Applicant Address: Unit Number Zip Code
Email Address:
Name: Phone No.
Fax No.
Contractor Address: City State I Zip Code
Contractors City Business License No. Contractor's City State of California License No. Classification:
Number of Squares:
Square Footage
Description of Work: (1 Cost of Work:$ S f as d
Applicant's Signature�i Date: / 1 j
To Be'CojnpletedBy City Staff Only l
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)
❑ Structural Calculations
❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration' Addition' Means/MeNods
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 that a
Completion: Conswction apply: Coastal Zone
Type(s): C Of O YES or NO LEI Noise Zone
Required? Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. Planning Comm.Zoning Atlminisfrater
Fee Exempt: City Project I Elec.Vehicle Charger I Landmark Seismic Retrofit Pedalcase:Bldg,
OmdalA royal
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Building/Safety Permit Specialist City Planning I Civil Engineering EI'Mi-Admen Transportation Mgml. Rent Control
Prescriptive Certificate of Compliance: Residential Reroof CF-1 R-ALT-ReRoof
Pro�(�ectad ess' ) I Climat one
nwfk
ROOFIOONGUPRODUCTS (COOL ROOFS) §151(f)12
When the area of exterior roof surface to be replaced exceeds 50%of the existing roof area, or 1,000 f , whichever is less, the new
roofing area must meet the roofing product"Cool Roof"requirements of§152(b)1Hf, 152(b)iHii,or 152(b)iHiii.
Check applicable alternative or exception below if the roof alteration is exempt from the roofing product"Cool Roof"requirements::
❑ Cool roofs not required in Climates Zones 1-12, 14,and 16 with a low sloped roof pitch(less or 2:12 pitch).
❑ Cool roofs not required in Climates Zones 1-9, and 16 with a steep-sloped roofs(greater pitch than 2:12)and product weight less than 5/lb/fie.
Alternatives to §152(b)1Hi and §152(b)Hif,Steep-slope roof(pitch>2.12)
❑ Insulation with a thermal resistance of at least 0.85 hrf 2- F/Btu or at least a 3/4 inch air-space is added to the roof deck over an attic;or
❑ Existing ducts in the attic are insulated and sealed according to§151(010;or
In climate zones 10,12 and 13,with 1 ft2oi free ventilation area of attic ventilation for ever/ 150 If of attic floor area, and
where at least-30-percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or
Ig Building has at least R-30 ceiling insulation;or
❑ Building has radiant barrier in the attic meeting the requirements of§151(02;or
❑ Building has no ducts in the attic;or
❑ In climate zones 10, 11, 13 and 14,R-3 or greater roof deck insulation above vented attic.
Exception to §152(b)1Hiii, Low-slope roof (pitch 52:12)
❑ Building has no ducts in the attic..
Other Exceptions
❑ Roofing area is covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the Cool Roof criteria.
❑ Roof constructions that have thermal mass over the roof membrane with at least 25 Ib/ft2 are exempt from the Cool Roof criteria.
NOTE:If any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofing
products in§1 18(i)are not applicable. Do not fill table below.
Roof Slope Product Weight Product Aged Solar Thermal
CRRC Product ID Number' <_ 2:12 >2:12 < 51b/fig >- Slb/ft' Type Z Reflectance'° Emittance SKIS
❑- ❑ ❑ ❑ ❑4
❑ ❑ ❑ ❑ ❑4
Note:If no CRRC-1 label is available, this Compliance method cannot be used, use the Performance Approach to show compliance,
1.The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at trmw.coolrooIs.orayomducis/search oho
2.Indicate the type of product is being used for the roof top,i.e.single-ply roof,asphalt roof,metal roof, etc.
. If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same
directory and use the equation (0.2+0.7(p,,,;,,-0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance.
4. Check box it the Aged Reflectance is a calculated value using the equation above.
5. Calculate the SRI value by using the SRI- Worksheet at htto:/1-,r,nv.enerov.ca.00v.4itle24/and enter the resulting value in the SRI Column above and attach
acopy of the SRI-Worksheet to the CF-I R.
o apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in§I 18(i)4. Select the applicable coating:
❑ Aluminum-Pigmented Asphalt Roof Coating ❑ Cement-Based Roof Coating ❑ Other
NOTE: When a Cool Roof is required, the installing contractor shall complete and submit the CF-6R-ENV-01 for final inspection.
Declaration Statement
• I certify under penalty of perjury,under the tans of the State of California, the information provided on this tom is accurate and temple_(=__
• I certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24, Parts
1 and 6 of the California Code of Regulations.
Nam Si
axe f a- s -
Company: U Date: 61
Address' D License:
o g N
City/stele/Zip: � ` Phone: r f F
O- Ljv, rU /
For assistance or questions reg rding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.