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PMT15-03385 City of Menifee Permit No.: PMT15-03385 29714 HAUN RD. �ACCELA. MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 1 1/0 212 0 1 5 PERMIT Site Address: 28678 RUSTIC GLEN ST, MENIFEE, CA Parcel Number: 333-500-022 92584 Construction Cost: $5,255.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 579 SO FT SOLID ALUMAWOOD PATIO COVER NO ELECTRIC Work: Owner Contractor ALAN DUNCAN KYLE KELLY 28678 RUSTIC GLEN ST 35406 REDBERRY PALMS COURT MENIFEE,CA 92584 LAKE ELSINORE,CA 92532 Applicant Phone:9512960908 KYLE KELLY License Number:948536 KYLE KELLY 35406 REDBERRY PALMS COURT LAKE ELSINORE,CA 92532 Fee Description QQrt Amount(81 Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 1.00 General Plan Maintenance Fee-Building 1 6.65 $168.65 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be forfeited. AA Bldg_Penit Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ [am exempt from licensure under the Contractors'State License Law forth, I hereby affirm under penalty or perjury that I am licensed under provisions of following reason: Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence ii Professions Code and m cerise is in full force and effect. which I must have resided for at least one year prior to completion c License Class License No. "'$'8-Sj( Improvements covered by this permit, I cannot legally sell a structure that I haw Expires -/C—!f Signature built as an owner-building if it has not been constructed in its entirety by licensee contractors. I understand that a copy of the applicable law, Section 7044 of thi WORKERS'COMPENSATION DECL ON Business and Professions Cade,is available upon request when this application is submitted or at the following Web site: ElI hereby affirm under penalty of perjury one the following declarations: htt ://www.le info.ra. ov/ I have and will maintain a certificate of consentt 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 ner 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 thi: 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 compl, permit is issued.My workers'compensation Insurance carrier and policy number are: with all applicable city and county ordinances and state laws relating to buildini .�(� n construction.I authorize representatives of this city or county to enter the above Carrier /if�� -,/� identified prgparty-for-4he2nspoeffan-porposes: Policy# c Expires �— --- 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) ❑ I 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 OYES ❑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.1 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 El 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 chedrmark(s)I have placed PROPE@.'f9 R OR9LLTklO GENT 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 I 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 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. SAFETYBUILDING & PERMIT/PLAN CHECK A• • A • Menifee DATE PERMIT/PLAN CHECK NUMBER T'�� 0�✓D TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK ] Id lh+✓/J ail a �k PROJECTADDRESS 8 72 lf ,c- 61,9 /1k1,1I)ceK ASSESSOR'S PARCEL NUMBER "7^� �0 D LOT _ �L2 TRACT PROPERTY OWNER'S NAME ADDRESS 'f PHONE EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAMErr /� p',/ OWNER BUILDER? 0 YES4k > BUSINESS NAME 0 eln C'A////� T/q/'�I ADDRESS 35 .K nl/IJ r PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER 9 YE53IL LICENSE CLASSIFICATION VALUATION$ S.,) S S SQ FT S 7� L SQ FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION � CITY OF MENIFEEEE ULENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN Igo Y_p SMIP INVOICE {'^ PAID AMOUNT AMOUNT 1 YJ 0 CASH O CHECK p 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES O NO City of;blenifee Building &Safety Department 29714 Houn Rd. Menifee, CA 92556 951-572-6777 www,cit yofinenifee.us Inspection Request Line 951-246-5213 LEDGER & TRACK ity of Menifee INSPECTION REQUIRED Buil„ir,g & Safety Dep , NOV 0 2 2015 Received �V 's r �7 , �s CITY OF MENIFEE BUILDING AND SAFETY DEPARTMENT PLAN APPROVAL REVIEW�Y � DATE *Approval of these plans shall not be crnstr_ed to be a permit for,or an approval of,any violation of any prcaisi:ms of the federal,state or city regulations and ordinances. This set of approved plans must be kept on the r e jobsite until completion. pro (I Ct 19 t n rp or; ,9014 41urn&ooG� pa�10 COder Co f c� Ke ('Olo K S�on15�i 4,rdaA �LZA Sou��tetn Ca li�a�Ne os ens ups - 4853�