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PMT15-01209 1 City of Menifee Permit No.: PMT16-01209 29714 HAUN RD.MENIFEE, CA 92586 Type: Residential Addition s t`"1M8M MENIFEE Date Issued: 05/08/2015 i PERMIT ' +I Site Address: 31895 SEWALT CT, MENIFEE, CA 92584 Parcel Number: 360-581-027 Construction Cost: $500.00 'a Existing Use: 1 &2 Family Residence Proposed Use: Description of 55 L FT 1 1/4" GAS LINE& 1"ELECTRICAL CONDUIT FOR FUTURE POOL EQUIPMENT Work: Owner Contractor DELAINE&DANIEL GONZALES K RAINEY CONSTRUCTION 31895 SEWALT CT 31914 SEWALT CT MENIFEE, CA 92584 MENIFEE, CA 92584 Applicant Phone: 9512052363 KYLE RAINEY License Number: 975365 K RAINEY CONSTRUCTION 31914 SEWALT CT MENIFEE, CA 92584 Fee Description rCty Amount Inspections not specified 116 116.00 0 .n ec 0 GREEN FEE 1 1.00 $260.00 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_Templatexpt 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— CS License No. `)�_�5VS who builds or improves thereon, and who contracts for the projects with a Expires X� Signature - _ 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 ❑ 1 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'f/www.leqinfo.ca.Qovlcalaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: Property Owner or Authorized Agent Date Carrier Expires Policy# r 'Bey 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- 7+1 certify that in the performance of the work for which this permit is issued, I Identified property for the inspection purposes. sh`aff 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 subject to the workers'compensation provisions of Section 3700 of the Labor property O "rAuthorIzeS,&gaatl Date Code, I shall forthwith comply with those provisions. ' City Business License# Date; �""`�—I S Applicant; WARNING: FAILURE TO SECUR- W S, 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 OR A DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES tEalO 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) APPLICANTOR 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 2J0 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, ZPO 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 egXFS INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from Iicensure 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($500).) CODE, SECTION 25505 25533 A D 25534 CONCERNING El 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL t EPO d compensation,will do ( )all of or( ) porting of the work, and the structure is PR ERTY WNER ORA 0 DAGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If,however, " the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). i APPLICATION& SAFETY PERM IT/PLAN CHECK City of Menifee o,,iiding & Safety Dept. Menifee DATE PERMIT/PLAN CHECK NUMBER ^�,j M IS- DI TYPE: �_:1,',CO Q�VE)dESIDENTIAL % MULTI-FAMILY " MOBILE HOME Ci POOL/SPA O SIGN SUBTYPE: ')ADDITION I,ALTERATION 'O DEMOLITION 1 ELECTRICAL " MECHANICAL C NEW 'O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 1/ I. 07 S LING PROJECTADDRESS -31bJS SeL%jbL---T CT. ASSESSOR'S PARCEL NUMBER 3(Q0 -�J�' 0 70T _�� TRACT 31-70 OWNER NAME C_-jav-,%ALE I - ADDRESS 3ib0l'5 L. z- , PHONE �a1�-Il Q1Z-<O`I3`1 EMAIL APPLICANTNAME Vcc IME ADDRESS G , PHONE gS1.2c,s. 23(a:i EMAIL 11-9-q, 6 JLHaz. CONTRACTOR'S NAME OWNER BUILDER? OYES *NO BUSINESS NAME cG ADDRESS I•( ^wy.,-{ PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER 9-153(,,4t; LICENSE CLASSIFICATION VALUATION$ 15;,00 SQ FT L SO FT APPLICANT'S SIGNATURE DATE 1T7STAiVrUSE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN �� SMIP INVOICE n� PAID AMOUNT AMOUNT V :,i CASH %CHECKH L)CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT Ci CASH O CHECK H 0 cREDIT CARD VISA/MC OWNER BUILDER VERIFIED YES �% NO DL NUMBER NOTARIZED LETTER YES C NO City of Menifee Building & Safety Department 29714 Houn Rd. Menifee, CA 92585 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 PLOT/SITE PLAN City of Menlfee REAR PROPERTY LINE Building & Safety Dept. MAY 0 8 2015 Received Q/ I II w jl w l 011 OF MENIFE H (I BUILDING AND FETE DEPARTMENT LU I PLAN APPROVA o �I w v"�,�. REVIEWED B6 f,,I6 �. D #//It 'Approval of these plans shal not be construed to be a permit for,or a 0 appr val of,any violation o any provisions of the federal,state or city I regu ations and ordinances. This set of approved plans must be kept o the---------------- jobsite until completion. CeviALi CT, — FRONT PROPERTY LINE r Property Owners Name 7AN,et_ Uav 2f>LES T Property Address 31`a9S 5o,. Acr e-T.