PMT15-01802 City of Menifee Permit No.: PMT15-01802
29714 HAUN RD. Type: Residential Addition
<—ACCELA— MENIFEE, CA 92586
MENIFEE Date Issued: 01/27/2016
PERMIT
Site Address: 32025 BYERS RD, MENIFEE, CA 92584 Parcel Number: 362-020-009
Construction Cost: $202,670.55
Existing Use: 1 &2 Family Residence Proposed Use:
Description of 1758 SO FT ADDITION INCLUDING HVAC, PLUMBING&ELECTRICAL
Work: Existing 784sf,TOTAL SF for SFR is 2,542.
Owner Contractor
BENJAMIN BOATRIGHT K P M GENERAL BUILDERS INC
32025 BYERS ROAD 663 S RANCHO SANTA FE STE 165
MENIFEE,CA 92584 SAN MARCOS,CA 92078
Applicant Phone:6193225968
MICHAEL SELLERS License Number:827310
663 S RANCHO SANTA FE STE 165
SAN MARCOS,CA 92078
Fee Description gyt Amount
Services,Switchboards, Control Centers& Panels 1 116.00
Receptacle, Switch, Outlet&Fixture 140 811.00
Plumbing Fixtures and Vents,fixtures 15 176.00
Gas System 1 116.00
Piping/Repiping Single Family Residential 1 163.00
Plan Check Fee 205 205.00
Plan Check Fee 103 102.50
Water Heater 1 83.00
Plan Check Fee 103 102.50
Sewer 1 150.00
Forced-Air or Gravity-Type Furnace or Burner 1 149.00
Air Handling/Condensing Units SFR 1 133.00
Building Permit Issuance 1 27.00
Additional Plan Review Building 45 45.00
Additional Plan Review Building 720 720.00
GREEN FEE 1 9.00
SMIP RESIDENTIAL 1 27.00
New Construction Permit Fee 1 932.28
$4,067.28
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as othervrise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
M� .10 �$
City Of Menifee
LICENSED DECLARATION ❑ 1 am exempt from licensure under the Contractors'State License Law for the
I hereby affirm under penalty or perjury that I am licensed under provisions of following reason:
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in
Professions Code and my license is in full force and effect. which I must have resided for at least one year prior to completion of
License Class License No. improvements covered by this permit, I cannot legally sell a structure that I have
Expires Signature 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
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is
submitted or at the following Web site:
❑ 1 hereby affirm under penalty of perjury one of the following declarations: htt ,11 .le info.ca. ov/cala html.
have and will maintain a certificate of consent of self-insurefor workers' `�
compensation,issued by the Director of Industrial Relations as provided for by Date / //i '
Y
Section 3700 of the Labor Code, for the performance of work for which
permit is issued. Property Owner or Authorized Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the property,
❑ 1 have and will maintain workers' compensation Insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comply
permit is issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to building
censtru n.I authorize representatives of this city or county to enter the above-
Carrier ide/nti property for the inspection purposes.
Policy# Expires C _L___� Date
Property Owner or Authorized Agent
(This section need not be completed if the permit is for City Business License#
one-hundred dollars($100)or less)
❑ 1 certify that in the performance of the work for which this permit is issued,1 HAZARDOUS MATERIAL DECLARATION
shall not employ any persons In any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers'compensation laws of California, and agree that if I should became mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide?
Code,I shall forthwith comply with those provisions. DYES ❑NO
Applicant; Date; Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES ❑NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑YES ❑NO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penally of perjury there is a construction lending permitting checklist.I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous material reporting.
OWNER BUILDER DECLARATIONS DYES ❑NO
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date
License Law for the reason(s)Indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable item(s)(Section 7031.5. Business and Professions Code: EPA RENOVATION.REPAIR AND PAINTING(RRP)
Any city or county that requires a permit to construct, alter, Improve,demolish,
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 The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law(Chapter 9 (commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is exempt from Wensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees.For more information about EPKs Renovation Program visit:
www.epa.govAead or contact the National Lead Information Center at
❑ I, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the work,and the structure is
not intended or offered for sale.(Section 7044,Business and Professions Cade;
The Contractor's State License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however, Certified Finn Name:
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 Firm Certification No.:
purpose of sale).
B'I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044. Business and Professions
Code:The Contractors License Law does not apply to an owner of a property
who builds or Improves thereon, and who contracts for the projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY
PERMIT/PLAN
• APPLICATION
Y S
Menifee
DATE /� PERMIT/PLAN CHECK NUMBER - I e6
TYPE: C COMMERCIAL rG RESIDENTIAL 0 MULTI-FAMILY C MOBILE HOME :% POOL/SPA C SIGN
SUBTYPE: ADDITION O ALTERATION - DEMOLITION 0 ELECTRICAL C MECHANICAL
O NEW O PLUMBING C RE-ROOF-NUMBER OF SQUARES �y
DESCRIPTION OF WORK (p Q A s v1
al
PROJECT ADDRESS 3*20 S /� IC D
ASSESSOR'S PARCEL NUMBER ?,)'( -�Q��� LOT TRACT
OWNER NAME 6erl, pq� L
ADDRESS 320 Q /'S
PHONE k-21 y- 7-/ -G9 '26 EMAIL
APPLICANT NAME % 51�i �r C/`S
ADDRESS n PHONE 9SI"/S�- �� /� EMAIL SG 1 s jn �- 4 U •O•Co
CONTRACTOR'S NAME OWNER BUILDER? DYES NO
BUSINESS NAME/ /4.eo-A f
ADDRESS // //6 S q,A G .S IA L *%4 pFe 0
PHONE Cal -3. -59�}� / EMAIL f / "[�1 P •� �./' O N•la i
CONTRACTOR'S STATE LIC NUMBER 06.2 '/3 t D LICENSE CLASSIFICATION
VALUATION$ �per? 1• L SQ FT TE G-; fib/s APPLICANT'S SIGNATUR DA
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN q SMIP
INVO AMOUNICET log?).-6PAID AMOUNT
CASH CHECK W :%CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH 0 CHECK 9 OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED C YES C NO DL NUMBER NOTARIZED LETTER v YES C NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.cis Inspection Request Line 951-246-6213
5/25/2015
I give Michael A. Sellers authorization to submit the plans for approval &any
communication needed with the Menifee Building Department for 32025 Byers
Rd, Menifee, CA 92584•
8u0diny of Menifee
g & Safety Dept.
JUN 2 9 2015
Benja Boatright_
Michael A. Sellers
O
t
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of
On before me,G]�
(in ert name and title oft)Ile officer)
personally appeared ) C-M;0) g ' ,
who proved to me on th6 basis of satisfactory evidence to a th erson(,§)whose name,(s) is/afe
subscribed to the within instrument and acknowledged to me that he/the/tkiey executed the same in
his/glar/tKeir authorized capacity(igls), and that by his/hpr/kheir signature(t) on the instrument the
person($), or the entity upon behalf of which the person(u) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
DIPTI 06MY
WITNESS my hand and official seal. _ Commission#2016150
;± Notary Public•California z
_ Orange County
M Comm. Ez fires r 7,2017 J
Sig (Seal)
Manifee PMT15-1802
07/10/15
[DO NOT PAY— THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Menifee PLAN CHECK NO.: PMT15-1802
PREPARED BY: Ray Fuller DATE: 07/10/15
BUILDING ADDRESS: 32025 Byers Rd.
BUILDING OCCUPANCY: R3 U TOC
BUILDING AREA Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code mnf iManual Input
Type of Review: ❑ Complete Review ❑ Structural only
❑Repetitive Fee ❑ Other
_ Repeats —!i_ 8 Hrs. @
EsGil Fee $90.00 $720.00
Based on hourly rate
Comments: In addition to the above fee, an additional fee of $45 is due (.5 hour @
$90/hr.) for the CalGreen review.
Sheet 1 of 1
macvalue.doc+