The URL can be used to link to this page

PMT15-02719 I City of Menifee Permit No.: PMT15-02719 29714 HAUN RD. 4 CCEl.f�k MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 09/02/2015 PERMIT Site Address: 28272 W WORCESTER RD, MENIFEE, Parcel Number: 339-101-012 _ CA 92586 Construction Cost: $1,212.80 Existing Use: 1 &2 Family Residence Proposed use: Description of ADD 8 X 18'WALL TO WEST SIDE OF CARPORT Work: FOR CASE CE-15-0960 Owner Contractor ST IVES INVESTMENT, LLC-ROSALIND LUTON 1862 TUSCAN GROVE PL CAMARILLO, CA93012 Applicant License Number: ST IVES INVESTMENT, LLC-ROSALIND LUTON 1862 TUSCAN GROVE PL CAMARILLO, CA 93012 Phone: 8056309642 Fee Description Qtv Amount l$1 Inspections not specified 387 387.21 E SMIP RESIDENTIAL 1 1.00 e n e B I i $436,57 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. A,A_31dg Permit Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ I 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: ❑ I hereby affirm under penalty of perjury one of the following declarations: htt ://www.le info.ca. 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 Y �� Date 2 S 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 ❑ I 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 carrier and policy number are: 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- Carrier ident" d property for the i speectiioon purposes. Policy# Expires � �� rv�( �� ` Date Z 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) HAZARDOUS MATERIAL DECLARATION ❑ 1 certify that in the performance of the work for which this permit is issued, I 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 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. 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 El YES ❑ 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 ❑YES ❑ 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: Any city or county that requires a permit to construct, alter, improve, demolish, EPA RENOVATION REPAIR AND PAINTING(RRP) 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: ❑ I, as owner of the property, or m employees with w�a es as their sole www.epa.gov/lead or contact the National Lead Information Center at P p 1 y9 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 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 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 Firm 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 Acknowledgement. APPLICATION& SAFETY PERMIT/PLAN CHECK y;�1l-ML enifee DATE q - 15 / PERMIT/PLAN CHECK NUMBER a M TYPE: :) COMMERCIAL is RESIDENTIAL "') MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: 0 ADDITION VALTERATION ^DEMOLITION ELECTRICAL Ci MECHANICAL G NEW OPLUMBING :' RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK S Rp F-:- WALL It S Gt�RFbRT PROJECTADDRESS c�.� 702. �(V• WO CESTEI� �D Sao C1T C ASSESSOR'S PARCEL NUMBER 339- i0I- oIa LOT L4 TRACT c71GGa. OWNERNAME ZT, TvP-S XNV�STM�NT 1-I-�- ADDRESS 186a TuscRo 6-4zovl_- PLR«- c4mpkq-jt- A ciE 03013_ PHONE 505-630-a(0LFo1 EMAIL SQ IU SIIC.jj APPLICANTNAME Rp ALI1 01-UTON ADDRESS �. l ,Y.1. (Z��.'S'jcf� RP SUQ ck-cy C41 PHONE 805- 630 -q( L4- EMAIL5oLjj,\+I,1jeSjVjj6Lqaa AA CONTRACTOR'S NAME OWNER BUILDER? (/YES ONO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBERR�� LICENSE CLASSIFICATION VALUATION$ 0 1 , SO FT L SO FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN IGO SMIP INVOICE PAIDAMOUNT AMOUNT Lk�.� <% CASH :CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH 0 CHECK# `)CREDIT CARD VISA/MC OWNER BUILDER VERIFIED DYES % NO DLNUMBER NOTARIZED LETTER '`% YES - NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-5777 www.cityofinenifee.us Inspection Request Line 951-245-6213 s `�4P��cx�aTJck�ev►� IZOSAUT13D LLt-M" �°J�- O"rTTbLI ..> City of Menife Building & Safety Dept. SEP 0 2 2015 .:-._------_--- .-Ree ed poof� S�C�tcco r�� f S" U CIT41. OF MENIFEE —C-) o BUILDING ANDXAqffkDEPARTMENT 2 a_ c�7 I PLAN APPROVAL 0 REVIEWED B f ' DAT „ *Approval of these plans shall not be construed to be a permit for,or an approval of,any violation of any provisions of the federal,state or city regulations and ordinances. This set of approved plans must be kept on the jobsite until completion. n LDC'WTt oN F09, Atyo SeDIN(,- � Ip � L_ pouGt-, s 'Fig, sTuog Ib" nrJ Cv-tNT'R� �y-4 00U&L%_ ka F+R TOP 9L' ATE- 2�Y.u 7l1b `ZTURb1 PRN�L SI1Jr�4s bo N\ir.uTe. r-PR--r Pn9p-9,