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PMT14-02966 { i City of Menifee Permit No.: PMT14-02966 29714 HAUN RD. 1w MENIFEE, CA 92586 Type: Residential Alteration cmm:nmx sm` .o MENIFEE Date Issued: 11/1 012 01 4 PERMIT Site Address: 26361 SOSA CT, MENIFEE, CA 92585 Parcel Number: 331-500-005 Construction Cost: $1,500.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 3 NEW UNDER CABINET LIGHTS, 1 NEW OUTLET FOR ELECTRIC STOVE Work: Owner Contractor MAGGIE PRICE AAA RESTORATION INC 26361 SOSA COURT 29850 2ND STREET MENIFEE, CA 92585 LAKE ELSINORE, CA 92532-2420 Applicant Phone: 9514715828 KIRK MUNIO License Number: 834839 AAARESTORATION INC 29850 2ND STREET LAKE ELSINORE, CA Fee Description Oft Amount R c -d tc Building Permit Issuance 1 27.00 0: $159.00 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_Bidg_Permit Template.mt 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 Codyynd my license is in ful rce a d 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 r licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DEC N ❑ 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 /Y 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:htto'L/www.Ieglnfo.0.gov/cPIaw html. permit is issued.My workers'compensation insurance carrier and policy number are: {; Carrier ''A114G�j YF-- Property Owner or Authorized Agent Date Expires '�1' _ �1/,5 1 Policy# �,+�� Name of A ent YAM Z Phone# Z/.JS 2�(� ��-! By my Signature below, I certify to each of the following: I am the property 9 owner or authorized to act on the property owner's behalf. I have read this t be completed if the permit is for application and the information I have provided is correct. I agree to comply (This section need no one-hundred dollars be 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 J/ workers' compensation laws of California, and agree that if I should become ��"�� �7 Y subject to the workers'compensation provisions of Section 3700 of the Labor P Owner or Authorize Ag Date Code,I shall forthwith comply with those provisions. � City Business License# Date; 10-40-1 c r Applicant; WARNING: FAILURE TO SECUR WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERAGE IS UNLAWFU , 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 HANDLEA 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) 1/ APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Lender's Name A DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address ONO DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDE LINES OWNER BUILDER DECLARATIONS I hereby affirm under penally 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 (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 DYES 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($500).) CODE DOSECTION S ON 25505ATERIAL�tE5533�MGD 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole compensation,will do( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement Is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY OF MENIIFEE City of Menifee PLCK No: Permit e: Building & Safety Dep — �i 29714 Haun Road Date: Date: Menifee, CA 92586 NOV 10 2014 )\ ( o Phone: (951)672-6777 Amount Amount: Fax:(951)679-3843 �/T l Received Ck#: Ck#: Building Combination Permit 171� To Be Completed By Applicant Legal Description: Planning Case: F: L: Rt: R: Property Address: ,rC - Assessor's Parcel Number. Cn ' r Project/Tenant Nam Unit#: Floor#: rh MCI C r'I G Name: Ph _ Fax No. PropeOwner rty Address: Unit Number�G Zip Code C z J Email Address: �G 7 Name: / n 7 Address t�lI � owo � ..C� Ph e N /,,J_s Favo./ Applicant ![<./j s Unit N, utnlyes`� Zip Code QY� Email Address: Name g64, Phone V;, Contractor AddreCityContractors ity Business icense o. Contractor's City j,Gal' 'a 'tense No. laSSification: •l Number of Squares: y Square Footage Description of Work: . %de " Cost of Work:$ I Applicant's Signature Yi[7 Data To Be Completed By City Staff Only Indicate As R-Received or N/A-Not Applicable 5 Completes sets of fully dimensioned,drawn to sal plans which include: 1 set or documents which include ❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Gen TechlSoils Report(on cd only) ❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 Yr x 11) ❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Structural Calculations ❑ 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/Methods Work Type: Repair' Retroffi' Revision to Existing Fermi? 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 Spdnklered YES or NO Completion: Construction that apply: Coastal Zone Type($): C of O YES or NO Noise Zone Required? Listed on Historic Resources Inventory CITY PLANNING STAFF ONLY APPROVALS: Costal Control Arch.Review Board Landmark Comm. Planning Comm.Zoning Administrator Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic ReiroOt $petal Case:Bltlg. ORciA royal Expedite Project(s): Child Care City Project Green Building I Landmark Affordable Housing For Staff Use Only Building/Safety Permit Specialist City Planning Civil Engineering EPWM-Admin TransportationMgml. Rent Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY @ulldYn ty pew ' r L i - edi it - -- - - x - _ All -gy IT B - - - U CI1�SAFE Ft � i . PL' PPROVAL I _-- - 1 +, -.'� '- -- RVIWD3Y _ I I 4 -_- prov. eseprnsshalFnot�cor�trueAtabea.permd�ro an: '�_���j� ', ' all ofYfi V`tl a—Wovato apyviolation o£any pwvuwhs of.the federal statA or _ s " antes This sot of approved ons must 6e on dre -- .— - - .o%intil pmpietwn, r' L L- K"T i ti�