PMT14-03047 i
City of Menifee Permit No.: PMT14-03047
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 1 1/1 712 01 4
PERMIT
Site Address: 25456 WAGON TRAIL LN, MENIFEE, CA Parcel Number: 358-440-011
92584 Construction Cost: $4,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 13'x 38'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS, 5 POST LIGHTS
Work:
Owner Contractor
JOHN BIARBI QUALITY FIRST CONSTRUCTION
25456 WAGON TRAIL LANE 15910 SAGEWOOD COURT
MENIFEE, CA 92584 RIVERSIDE, CA 92504
Applicant Phone: 9516853555
MIKE RIVERS License Number: 739214
QUALITY FIRST CONSTRUCTION
15910 SAGEWOOD COURT
RIVERSIDE, CA 92504
Fee Description (City Amount f$1
R e a .-S ftcli OU e' sFktU,e' � 14q�Q'
Building Permit Issuance 1 27.00
o s
GREEN FEE 1 1.00
'SMIP R -SIDENTIAL 00
$308.00
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_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 Code and my license is in full fore and effeqt. Code:The Contractor's License Law does not apply to an owner of a property
License Class License No. T3 -.—> I who builds or improves thereon, and who contracts for the projects with a
Expires 0 D1 )'T_ Signature s'�-^ ...:I#!1 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
VVI have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
I
3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htta'//www leginfo ca aov/calaw html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier 8 roperty Owner or Authorized Agent Date
Expires �/ r / � ' Policy# "Y�'� �d �`�'
❑ 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-
El I certify that in the performance of the work for which this permit is issued,I identified property for the inspection purposes.
shall not emolov 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 Property Owner or Authorized Agent Date
Code, I shall forthwith comply with those provisions.
City Business License#
Date; Applicant; 4--V—
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, AYES 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 ❑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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
- FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address ❑NO DISTRICT(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 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
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($500).) CODE, SECTION
C M T 5505AL I�E5533 AND 25534 CONCERNING
❑ 1, as owner of the property, or my employees with wages as their sole
compensation,will do( )all of or( )porting of the work, and the structure is PROPERTY OWNER OR AUTHORIZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE )I In ( PERMIT/PLAN CHECK NUMBER
i
TYPE: 0 COMMERCIAL >cRESIDENTIAL O MULTI-FAMILY " MOBILE HOME 0 POOL/SPA C1. SIGN
SUBTYPE: `AADDITION 0 ALTERATION «DEMOLITION ELECTRICAL 0 MECHANICALCity of Meni ee
NEW PLUMBING C:+ RE-ROOF Building & Safet Dept,
APPLICATION NAME fy\1 Vie rZv NOV 17 2014
DESCRIPTION OF WORK 0
Z r_14JQ s 1A -V-
PROJECT ADDRESS 9-5- L-� 5 y V A-&01\J In-41 Il L'0�j
ASSESSOR'S PARCEL NUMBER LOT TRACT
r
OWNER NAME
ADDRESS
PHONE(q-sI ) '3CIy EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME A-I,) OWNER BUILDER? O YES <.` O
BUSINESS NAME
ADDRESS i's11to St�'(2��Y�/O� �ff''�- 'r
PHONE (41-1 ) &8� - 3S�� EMAIL UGkJF-L1
CONTRACTOR'S STATE LIC NUMBER _ � l r}f I LICENSE CLASSIFICATION
VALUATION$ N/ O 0 0 SO FT L/ R Ll L SO FT f 2
APPLICANT'S SIGNATURE ®'�—?` DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE
AMOUNT PAIDAMOUNT ) CASH 0 CHECK# QCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT - CASH 0CHECK# '"CREDITCARD VISA/MC
OWNER BUILDER VERIFIED "YES O NO LICENSE NUMBER NOTARIZED LETTER 0 YES O NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92585 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
Sot_ 10IL
LEDGER & TRACK O
INSPECTION REQUIRED U
W
U
e vv N C--P— LL
y City of Menifee 1 O
u i,A )?, 3 Building & Safety Dept.
NOV 17 .2014 1 .
VNACt -C--C— Cj a sZ �I Received 1
i doom
CITY OF MENIFEE
13
BUILDING AND SAFETY DEPARTMENT
- - —
EVIEWED BY " ' 1 �� t1 t�i
DATE
'?Approval of these plans shall not be construed to be a permit for,or an
approval of,any violation of any provisions of the federal,state or city
regulations and ordinances. This set of approved plans must be kept on the
jobsite until completion.