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PMT14-03109 City of Menifee Permit No.: PMT14-03109 29714 HAUN RD.MENIFEE, CA 92586 Type: Residential Re-Roof ' iGCL.1 . MENIFEE Date Issued: 11/24/2014 PERMIT Site Address: 27130 PINEHURST RD, MENIFEE, CA Parcel Number: 336-112-024 92586 Construction Cost: $7,100.00 Existing Use: Proposed Use: Description of TEAR OFF 2 LAYERS COMP INSTALL 30YR COMP Work: Owner Contractor LOIS BRANOM DAN'S ROOFING INC 27130 PINEHURST RD 19011 MERMACK AVENUE MENIFEE, CA 92586 LAKE ELSINORE, CA 92532 Applicant Phone: 9514710008 DAVID DOUGLAS License Number: 491438 DAN'S ROOFING INC 19011 MERMACKAVENUE LAKE ELSINORE, CA 92532 Fee Description Qtv Amount f$1 Inspections not specified 98 98.00 $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 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 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 C'3 License No. _YYu who builds or improves thereon, and who contracts for the projects with a Expires_[(,_30.__!'5 Signature Q� licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ lam 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. 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 ly 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 I/www.leginfo.ca.clovlcalaw.htmi. permit is issued.My workers'compensation insurance carrier and policy number are: Carrier W f;^e-5 S �S. CO- Property Owner or Authorized Agent Date �T r t Expires �� �— 1 5 Policy# .�330005(v7 5 7//Y/ ,{ ❑ By my Signature below, I certify to each of the following: I am the property Name of Agent v Phone# Z 7 11�pj " �ftJO-' 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 stale 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 p rposes. 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 i subject to the workers'compensation provisions of Section 3700 of the Labor Property Owner or Authorized Ag t Date Code,I shall forthwith comply with those provisions. 7 � City Business License# Date; //— Zy_/� Applicant; WARNING: FAILURE TO SECURE W RKERS' 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 HANDLE A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES p Iv0 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 Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT 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 (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 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 00 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL IkEPORVING, compensation,will do( )all of or( ) porting of the work, and the structure is PROPERTY OWNER ALIT R D 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 City of Menifee Building & Safety Dept. "` Menifee `� `L 2 DATE �/�+gq2—q,pp/� PERMIT/PLAN CHECK NUMBER PH-T(T- o;, ?t TYPE. �'M1fdIMERCI&L XRESIDENTIAL " MULTI-FAMILY > MOBILE HOME % POOL/SPA ')SIGN SUBTYPE: O ADDITION O ALTERATION " DEMOLITION - ELECTRICAL ID MECHANICAL % NEW C`% PLUMBING OS RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK L ( (' ^�2 PROJECTADDRESS 27 /30 � S21 Sun C• �I � ASSESSOR'S PARCEL NUMBER JIL,��I�;L -0d4 LOT TRACT OWNER NAME LC)/S 1 J On `T2✓6-d•-OVV. ADDRESS a 7 / 0 25 7- PHONE 30/- rj -7 / EMAIL APPLICANT NAME bo-v ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? C:: YES XNO BUSINESS NAME ADDRESS /ybil ze-ke 'U's "..O/C 7L ��jL PHONE y7/-OOr7 Fl EMAIL cr CONTRACTOR'S STATE LIC NUMBER yq/ y3S LICENSE CLASSIFICATION L may✓ 1 VALUATION $ )/0 o SO FT 000 00 L SO FT APPLICANT'S SIGNATURE / DATE //1 L Y by CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE DUUISIWSS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP O-3�✓'-'�, INVOICE r -co PAID AMOUNT AMOUNT 1 C> CASH 'CHECK# 0CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT CASH %CHECK.# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED "' YES v NO DL NUMBER NOTARIZED LETTER :' YES0 NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 City of Menifee csafety Dept. Prescriptive Certificate of Com fiance: Residential Reroof CF-IR-ALT-Re Roof Project Address: Cr /N�V 2 4 2 Ifmatg Zone I Per It �7y3o P;,e�rr.�sr Svc Iu V3 Received ROOFING PRODUCTS (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)iHi, 152(b)1Hfl, 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-sloced roofs(greater pitch than 2:12)and product weightless than 5/Ib/ftz. Alternatives to §152(b)iHi and §152(b)Hif, Steep-slope roof (pitch>2:12) ❑ Insulation with a thermal resistance of at least 0.85 hrftz- F/Btu or at least a 314 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(f)10;or IA In climate zones 10, 12 and 13,with 1 ft2of free ventilation area of attic ventilation for every 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 ❑ 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 O In climate zones 10, 11, 13 and 14, R-3 or greater roof deck insulation abode vented attic. Exception to §152(b)l Hill. Low-slope roof(pitch_<2:12) ❑ 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 25lb/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 I6(i)are not applicable. Do not fill table below. Roof Slope Product Weight.. Product Aged Solar) Thermal CRRC Product ID Number s 2:12 >2:12 < 51b/@ a5lb/ft- Type' Reflectance Emittance SRI5 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑a Note:If no CRRC-I label is available, this compliance method cannot be used, use the Performance Approach to show compliance, 1.The CRRC Product ID Plumber can be obtained from the Cool Roof Rating Councils Rated Product Directory at w:nv.coolroo(s.ore/oroducts/search oho 2.Indicate_the type of product is being used for the roof too,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 ditactory 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 i(the Aged Reflectance is a calculated value using the equation above. - 5. Calculate the SRI value by using the SRI-Worksheet at htto.div A-1.enerpv-ca.gov/title2d/and enter the resulting value in the SRI Column above and attach acopy of the SRI-4'/orksheet to the CF-I R. To 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 §118(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 cortir/under penally of perjury,under the laws of the Slate of California,the information provided or.this form is accurate and complete_ • I cedi;y that the energy features and performance specifications ide_ntifieeed or.this Cznticaa of Compliance conform to the requirements of TiIL 24,Parts f and 6 of the California Code of Regulations. Name: 1Jc it i �' �✓O v S �� Signature: n - Company: ®4 p pate; Address: License) 79of/ m�rma�l� iZD. Y9/ Y3c� Cityls!ale/Zip: Phone. Sas 3Z -/7/ --fit o For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.