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PMT15-00830 1 City of Menifee Permit No.: PMTIS-00830 `'� 29714 HAUN RD. '5 iCCIEL-P MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 05/13/2016 PERMIT Site Address: 29668 TIERRA SHORES LN, MENIFEE, Parcel Number: 340-470-012 CA 92584 Construction Cost: $14,000.00 Existing Use: 1 &2 Family Residence Proposed use: Description of CONSTRUCT NEW DECK 51'X 11' Work: NO ELECTRIC Owner Contractor JAMES MARKLE , 29668 TIERRA SHORES LN MENIFEE, CA 92584 Applicant License Number: JAMES MARKLE 29668 TIERRA SHORES LN MENIFEE, CA 92584 Phone: 8582205312 Fee Description QtV Amount Building Permit Issuance 1 27.00 Additional Plan Review Building 148 148.37 SMIP RESIDENTIAL m� 1 2.00 $618.87 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 1 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 frort�licensure under the Contractors' fate License Law for the ❑ 1 hereby affirm under penalty of perjury one of the following declarations: Ilowing reason: ,y � l�'V`L 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 ❑ 1 have and will maintain workers' compensation insurance, as req uired 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 a e o log jng We site:htt ://www.4, info.ca. ov/calaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: s 5 /3 /,< Carrier Pro prty wneror Authorized Agent D e 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 c struction.I authorize representatives of this city or county to enter the above- 0 I certify that in the performance of the work for which this permit is issued, id til�propertfopection purposes. shall not emO_yloylov any persons in any manner so as to become subject to the (3 �� workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor roe ty Owner or Authorized Agent ate Code,I shall forthwith comply with those provisions. 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., AYES 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 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 KNO DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR OWNER BUILDER 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, kLNO 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 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($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL,REPORTING. compensation, will do ( )all of or( ) porting of the work, and the structure is PR ERTY OI) .ftL(yJJ//��CLAUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). i BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION I Jul] Y`:t +'Menifee DATE PERMIT/PLAN CHECK NUMBER TYPE: - COMMERCIAL %RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA a SIGN SUBTYPE: '0 ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL 0 NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK �U{�d W GI �U (e&Jr6. VWilSt. PROJECTADDRESS 2_g41&d j4'M SYWfeS hAJ\1h&4jjP iA q2-9 ASSESSOR'S PARCEL NUMBER 7O OI p LOT 6LI— TRACT OWNER NAME ADDRESS Z %/`UTA Mores M 92-S,sV PHONE brn 22o --5N2- ( EMAIL im yY1a rKie ,7000 6 o$W.6b>;j APPLICANT IN1A/�ME JAB.^''eS `� (� / yy� /I �// ADDRESS 2q(p W I 1 C* b i1� t-v /L LGA/j4.ee G1,Y -Y2-9,( PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? OYES ONO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ lqI d60 SO FT L SQ FT APPLICANT'SSIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER �BUILDING PLANNING ENGINEERING FIRE GREEN Y4 SMIP INVOICE �'O PAID AMOUNT AMOUNT '�� (.%CASH '.`%CHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT OCASH OCHECK# C CREDITCARD VISA/MC OWNER BUILDER VERIFIED C%YES NO DL NUMBER NOTARIZED LETTER 0 YES ':' 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 I Menifee I PLANNING DATE ROUTED j I PERMIT NUMBER PROJECT NAME I ADDRESS APN TRACT LOT(S) APPLICANT NAME PHONE EMAIL COMMENTS APPROVED BY DATE 19 ENGINEERING DATE ROUTED 5/4/2015 � 6 •I I •115 PERMIT NUMBER PMT15-00830 PROJECT NAME DECK-MARKLE RESIDENCE ADDRESS 29668 TIERRA SHORES LN APN 340-470-012 TRACT 29837 LOTS 97 APPLICANT NAME JAMES MARKLE PHONE 858-220-5312 EMAIL JIMMARKLE2006@YAHOO.COM COMMENTS 2ND SUBMITTAL-PLEASE RETURN PLANS APPROVED BY ®I ' I u DATE ! City of Menifee Building& Safety Department 29714 Houn Rd, Menifee, CA 92586 951-672-6777 www.cityofrnemfee.us Inspection Request Line Gltr oe iiAENIFQ ` V---1 .. , CITY OF MENIFEE MEMO DATE: May 8, 2015 TO: Building Department FROM: Carlos Geronimo, Engineering SUBJECT: PMT 15-00830 — 29668 Tierra Shores PC2 The City Engineering Department has reviewed the plans provided for this project and has no additional comments: Carlos E. Geronimo, PE Associate Engineer City of Menifee