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PMT15-01140 City of Menifee Permit No.: PMT16-01140 _ MENIFEE, EE, C 92 Type: Commercial Re-Roof t"�" MENIFEE, CA 92586 o swv> P MENIFEE Date Issued: 0 4/3 012 01 6 PERMIT Site Address: 27824 HILLPOINTE DR, MENIFEE, CA Parcel Number: 333-243-033 92585 Construction Cost: $10,500.00 Existing Use: Proposed Use: Description of REMOVE TILE, REPLACE FELT& REINSTALL TILE Work: Owner Contractor HILLPOINTE HOME OWNERS ASSOC BERRY ROOFING INC 27824 HILLPOINTE DRIVE 3226 KLUK LANE MENIFEE, CA 92585 RIVERSIDE, CA 92501 Applicant Phone: 9519055116 KEN ALVARADO License Number: 691947 BERRY ROOFING INC 3226 KLUK LANE RIVERSIDE, CA 92501 Fee Description Qtv Amount f$1 TBLIi In` Grip'({ssl'!a�ce'r *' H E�>a- �'„>� '-�3"•4" 4�a �..;,*'„-., � T, ;„S�" -.� * m .t�7 -'°tlfjn 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 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 Permil_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, License No..by 7S_Z who builds or improves thereon, and who contracts for the projects with a Expires // tl Signature_ ' licensed contractors)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. 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 I,d' 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'//www.leqinfo.ca.Qov/caIaw.htmI. permit is issued.My workers'compensation insurance carrier and policy number are: Carrier PJ070�);:ir a,_� Property Owner or Aut orized Agent Date Expires Policy# �,;6p6S y 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 ample v 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; m// — 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, []YES 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 Z 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 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 DYES 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, O'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 []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 2TNO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE SECTION C I OTE 505ffE 5533'�WG AND 25534 CONCERNING El I, as owner of the property, or my employees with wages as their sole compensation,will do( )all of or( ) porting of the work, and the structure is PROPERTY OWNER THORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; 9' The Contractor's State License Law does not apply to an owner of a property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY O MENIFEE PLCK No: Permit No:City Ills Me 29714 Haun Road Building &t afety Dept. Date: Date: Menifee, CA 92586 Phone: (951 )672-6777 APR 3 0 2015 Amount: Amount — Fax:(951)679-3843 Ck#: Ck#: Received Building Combination Permit To Be Completed By Applicant Legal Description: Planning Case: F: L: Rt: R Property Address: Assessor's Parcel Number: Z 7f3O %f o;Y� �. 3 - Project/Tenant Name: . �es / ;„ Unit#: Floor#: Name: Phon Fax No. 4 \ I-G y y749 Property Address: Unit Number Zip Cod��-gr Owner Email Address:r Name: / Phon o. Fax No, Applicant Address: J�, Unit Number Zip Code Email Address: Name: Phone o`/7t�^,5- - Fax No. contractor Address: ZZ� [-!'Y City i2� Stara Zip C. e ontractor s City business License NO. Contractor's City Sta f I fornia License No. Classification:Cyg Number of Squares: �7 Square Footage JJD Description of Work: Cost of Work:$ -ifs/� "/`�G/n/ .�� !� /OS Applicant's Signature Date: fl z Be-Completed.By,City Staff Only - - 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 1A x 11) ❑ Structural Calculations ❑ Foundation Plan ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP ❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential Class Code: Indicate New Construction Alteration' Addition' Means/Methods Work Type:H Repair' Retroff 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 if Indicate all Geo-tech. Haz Zone Indicate YES or NO At Project Sprinklered that apply: Coastal Zone ConsCompletion: Type(Is)ction C0 D Noise Zone Required? YES or NO Listed on Historic Resources Inventory CITY PLANNING STAFF ONLY APPROVALS: Costal Commiss Arch. Review Board Landmark Comm. Planning Comm.Zoning Administrator Fee Exempt: City Project Elec.Vehicle Charger Landmark Seismic Retrofit special case:slag p y I g Official Approval Expedite.Project(s): Child Care City Project Green Building Landmark Affomable Housing For Staff Use Only 5 ld g/5 I ty Permit Specialist City Planning Civd Engineering EPWM-Admin Transportation Mgmt I Rent Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY