PMT15-02693 City of Menifee Permit No.: PMT15-02693
29714 HAUN RD. Type: Residential Addition
�CCEL/� MENIFEE,CA 92586
MENIFEE Date Issued:
10/13I2015
PERMIT
Site Address: 31183 PLEASANT VALLEY RD, Parcel Number: 360-210-022
MENIFEE,CA 92584 Construction Cost: $103.992.00
Existing use: 1 &2 Family Residence Proposed use:
Description of CONSTRUCT NEW 2400 SO FT DETACHED GARAGE W/ELECTRICAL
Work:
Owner Contractor
RICK&JILL SWANSON ,
31183 PLEASANT VALLEY RD
MENIFEE, CA 92584
Applicant License Number:
RICK&JILL SWANSON
31183 PLEASANT VALLEY RD
MENIFEE, CA 92584
Phone:3104907377
Fee Description OQt Amount(S)
Services, switchboards, Control Cent ers_&_Panels 1 116.00
Receptacle, Switch, Outlet&Fixture 28 251.00
Plan Chedc Fee- _� - 103 1.0250
Building Permit Issuance 1 27.00
Inspections not specified 129 129.07
Additional Plan Review Building 225 225.00
_Additional Plan Review Building 45 45.o0
GREEN FEE 1 5.00
}SMIP RESIDENTIAL 1 14.00
New Construction Permit Fee 1 478.36
GeneraL.Plah Maintenance Fee-Electrical 1 18.3.5
General Plan Maintenance Fee-New 1 23.92
Construction
$1,435.20
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_Pemnit_Template.rpt Page 1 of 1
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 t a folio ing Web site:
❑ I hereby affirm under penalty of perjury one of the following declarations: h :f n 6 c ov/calaw.html.
I have and will maintain a certificate of consent of self-insure for workers'
compensation,issued by the Director of Industrial Relations as provided for by
Date !a •��- /�
Section 3700 of the Labor Code, for the performance of work for which this
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 morAuthodzed
information I have provided is cored. I agree to comply
permit is issued.My workers'compensation insurance carrier and policy number are: c' county ordinances and state laws relating to building
z representatives of this city or county to enter the above-
Carrier r e inspection purposes.
Policy# Expires
Date �d��/��
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,I HAZARDOUS MATERIAL DECLARATION
shall not emolov 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 become 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. ❑YES ❑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 DYES ❑NO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty 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 Cade:
Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION,REPAIR AND PAINTING(RRP1
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 licensure 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 EPA's Renovation Program visit:
❑ www.epa.gov/lead 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 Code;
The Contractor's Slate 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 Firm 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 Finn Certification No.:
purpose of sale).
❑ 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 Contractor's 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
kld'..'�wen
Ifee
DATE S 128 115 PERMIT/PLAN CHECK NUMBER I S' Dz -1
TYPE: 0 COMMERCIAL • RESIDENTIAL 0 MULTI-FAMILY 'O MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: :%ADDITION OALTERATION CDEMOLITION ELECTRICAL OMECHANICAL
• NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK De4dc�e4 Gava3e 2400care Feef
PROJECTADDRESS 31193 pleasdrit V411e 4J - Men*&ec , CAZ
ASSESSOR'S PARCEL NUMBER 3IeD' ZIO- DZZ LOT _ TRACT
OWNER NAME Ricy OnA Jill Swanson
ADDRESS 81193 Pfe4s4nV V411eV Rn4j Menike j CA q158L4
PHONE 31D- 4qD- '7371 EMAIL riek @0bSe55j6nraC*".C&M
APPLICANT NAME Rio< Swanson
ADDRESS a aM4 Micil RoaJ ' Memfcc CA q 2SRLI
PHONE 310 - 4qD- 7377 EMAIL rick C oyn
CONTRACTOR'S NAME OWNER BUILDER? 'YES O NO
BUSINE
ADDRESS I Z 7 rtt I 2-112
PHONE EMAIL (O/ •1,
CO TRACTOR'S STATE LIC NUMBER L42.1162 LICENSE CLASSIFICATION
VALUATION$ _S'O 000.`o SQ FT aLJa4 L SQ FT
APPLICANT'S SIGNATURE DATE gI ZS 15
DEPARTMENT DISTRIBUTION _r� CITY OF MENIFEE BUSINESS LICENSE NUMBER
lIL BUILDING PLANNING ENGINEERING FIRE GREEN SMIP L
INVOICE �`'� '�j(p PAID AMOUNT
AMOUN �% CASH C CHECK# 0.CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED C)YES 0 NO DL NUMBER NOTARIZED LETTER :i YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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Menifee PMT15-02693
09/08/2015
[DO NOT PAY- THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Menifee PLAN CHECK NO.: PMT15-02693
PREPARED BY: Dwight Ashman DATE: 09/08/2015
BUILDING ADDRESS: 31183 Pleasant Valley Rd.
BUILDING OCCUPANCY:
BUILDING AREA Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
Det Garage 2400
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code IManual Input
Bldg.Permit Fee by Ordinance W
Plan Check Fee by Ordinance $225.00
Type of Review: ❑ Complete Review ❑ Structural Only
❑Repetitive Fee ❑ Other
Repeats _Hourly 2 Hrs. @
EsGil Fee $90.00 $180.00
Based on houdy rate
Comments: In addition to the above fee, an additional fee of$45 is due (0.5 hour @
$90/hr.) for the CalGreen review.
Sheet 1 of 1
macvalue.doc+