PMT15-02914 i
City of Menifee Permit No.: PMT15-02914
29714 HAUN RD. Type: Commercial Re-Roof
,11: ^. MENIFEE, CA92586
MENIFEE Date Issued: 0911812015 j
PERMIT
Site Address: 27378 SUN CITY BLVD, MENIFEE, CA Parcel Number: 335-192-024 ul�i
92586 Construction Cost: $40,000.00
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING 1 LAYER, REROOF W/SINGLE PLY COOL ROOF TREMCO, INC BRIGHT
Work: WHITE
Owner Contractor
US BANK NATIONAL ASSN F C AND SONS ROOFING INC
2800 E LAKE ST 6508 CLARA ST
MINNEAPOLIS, MN 55406 BELL GARDENS, CA 90201
Applicant Phone: 5629272310
ANDY CABRAL License Number: 776310
F C AND SONS ROOFING INC
6508 CLARA ST
BELL GARDENS, CA 90201
Fee Description Ot2ti Amount l$1
Buflding�Permit Issuanee,�,r�. r L ��+' �''�`x. x�� 1"�r� �y��44'�27`00`
GREEN FEE 1 2.00
General Plan Maintenance Fee-New 1 9.20
Construction
$222.20
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_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
following reason:
I hereby affirm under penalty or perjury that I am licensed under provisions of
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 C- 3 License W��
improvements covered by this permit, I cannot legally sell a structure that I have
Expires 0111, 2-0 17 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:
�f I hereby affirm under penalty of perjury one of the following declarations: http,//www.leginfo.ca.gov/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
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. Property Owner or Authorized Agent
Policy# * - 887103 -o I- o -L ❑ By my Signature below, I certify to each of the following: I am the property
2 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 aut ri representa)weso his city or county to enter the above-
Carrier ll1 U��U oy (& �Saki.-VlG0- Co, I identified p.i in ��PUr(roses. c�
Policy# L/(C_8`6T IU3-01-V Z Expires 0 i l (�I (�:/ / Date
roperty Owner o Authorized Agent
(This section need not be completed if the permit is for City Business License#
one-hundred dollars($100)or less)
AZARDOUS MATERIAL DECLARATION
I 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 (boundary
l the applicant or future building occupant handle hazardous material or a
workers' compensation laws of California, and agree that if I should becometure containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Laborounts pacified on the Hazardous Materials Information Guide?
nCode,I shall forthw'h mply ith those provisions. DYES �NO
Griplicant; Date; q l the intended use of the building by the applicant or future building
!!!! ",, cupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' ast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL guidelines
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANDEl ❑NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION,: l the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE of a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES YESCONSTRUCTION LENDING AGENCY ave read the Hazardous Material Information Guideand the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lendingrmitting checklist.I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Sectionlifornia Health&Safety Code,Section 25505 and 25534 concerning
3097 Civil Code)
ous material r porting.OWNER BUILDER DECLARATIONS L1 � 69
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 items)(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:
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 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).
❑ 1, 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.
BUILDING & SAFETY • APPLICATION
Menifee
DATE C+" p S PERMIT/PLAN CHECK NUMBER
TYPE: ®COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA []SIGN
SUBTYPE: ❑ADDITION [-]ALTERATION ❑DEMOLITION ❑ELECTRICAL [-]MECHANICAL
❑NEW [:]PLUMBING RE-ROOF-NUMBEROF SQUARES
DESCRIPTION OF WORK c Jv F '- TC�GEC - d � �/IQ
la ')v (1 n1 S'>�s �. elL
PROJECTADDRESS 7 3 7 g 5uo C; ij - , 5L1v1 ` i 4, ( 25J
ASSESSOR'S PARCEL NUMBER LOT L' TRACT
PROPERTY OWNER'S NAME (U 5 q of (/e—
ADDRESS rZ-73 -7 p JLIs/l if Wild, S,t rj Az , cA Zzs I
PHONE 951 ( (0�72� �/� EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME fit V2401.0 Ll"d OWNERBUILDER? ❑YES❑NO
BUSINESS NAME /,� O R- 5Qr5
ADDRESS 7V L' (a R to
PHONE 'TbZ 19 Zl - Z 3/ ;) EMAIL
CONTRACTOR'S STATE LIC NUMBER # -T7ln 3/0 LICENSE CLASSIFICATION C 3
VALUATION$ '-��V� SO FT �,L'I L SQ FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE 1 PAID AMOUNT
AMOUNT Q� 0CASH '0 CHECKp CREDIT CARD VISA/MC.
PLAN CHECK FEES PAID AMOUNT O CASH J CHECK# '"CREDIT CARD VISA/MC
I
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER C' YES 0 NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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Manufacturer: Tremco,Inc.
*CRRC Rapid Ratings:These are Interim laboratory-aged values that simulate weathered values.These values will be replaced with the measured three-year aged
values upon completion ofthe weathering process.SRI values calculated using Rapid Ratings may change once the aged rating replaces the interim rating.
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Wen 3year Initial 3year What 3". -
o611o1313 Tremco,Inc:Tremco TPOI TPO FB Membrane:Single Ply Bright White 0.79 0.72 0.87 0.87 98 88 +
White Thennoplasticand —
Thermoset Roofing
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