PMT15-03518 City of Menifee Permit No.: PMT15-03518
29714 HAUN RD.
�J►CCEL-A� MENIFEE,CA 92586 Type: Residential Addition
ltw ""`"""`''° MENIFEE Date Issued: 11110/2015
PERMIT
Site Address: 31727 ROUGE LN, MENIFEE, CA 92584 Parcel Number: 372-492-001
Construction Cost: $3,000.00
Existing Use: 1 &2 Family Residence Proposed use:
Description of INSTALL 12'x 12 AND 6'x 8'SOLID,AND 6'x 13.5'LATTICE ALUMAWOOD PATIO COVER WITH 1
Work: FAN,2 LIGHTS
Owner Contractor
RONALD PREVOST SOCAL HOME IMPROVEMENT
31727 ROUGE LANE 16331 LAKESHORE DR#G161
MENIFEE,CA 92584 LAKE ELSINORE,CA 92530
Applicant Phone:9512364282
TROY CRISWELL License Number: 930540
SOCAL HOME IMPROVEMENT
16331 LAKESHORE DR#G161
LAKE ELSINORE,CA 92530
Fee Description 4yt Amount ISI
Receptacle, Switch, Outlet&Fixture 3 126.00
Building Permit Issuance 1 27.00
Deck/Patio,standard 1 83.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 1.00
General Plan Maintenance Fee-Building 1 4.15
$242.15
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_Pernft_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ lam exempt from licensure under the Contractors'State License Law for the
I hereby affirm under penally 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 it
Professions Code and ply license is in full force and effect. which I must have resided for at least one year prior to completion o
License Class !S�License No. q?o�Va improvements covered by this permit, I cannot legally sell a structure that I have
Expires Imo/ % Signature built as an owner-building if it has not been constructed in Its entirety by licenser
contractors. I understand that a copy of the applicable law, Section 7044 of the
WORKERS'COMPENSATION DECLARA 0 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 pe' e of the following declarations: http:llwww.leciinfo.m.gov/mlaw.html.
I have and will maintain a certificateof con one
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# ❑ By my Signature below, I certify to each of the following: I am the propeitl
F 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 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 compll
permit Is issued.My w kers'compensation insuSprice cam and policy number are: with all applicable city and county ordinances and state laws relating to buildinl
1� _p construction.I authorize representatives of this city or county to enter the above
Carder �.r� �VhQ� identified property for the inspection purposes.
Policy# v/ 7z 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)
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, an agree that If I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation p s of Section 3700 of the Labor amounts s ecified on the Hazardous Materials Information Guide?
Code,I shall forthwith ply wit rovisions. DYES IX O
Appli%n� 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
WA G: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
CO PENSATION COVERAGE IS UNLAWFUL, AND SHALL for guideli es
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES aNO
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 I?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) hazardou material reporting.
OWNER BUILDER DECLARATIONS DYES N
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 P W ER A IZED 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 RE OVATION.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 firths 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:
❑ ro 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).
❑ 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 1\a h6 PERMIT/PLAN CHECK NUMBER
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 PLUMBIN,GG ORE-ROOF-NUUjMBEROFSQUAR/
DESCRIPTION OF WORK ,'�-��Z �1`� �7 �?5 I 1I� bX 13 '1 / 144eC
PROJECTADDRESS 31'7Z to u e- `•k{'�
ASSESSOR'S PARCEL NUMBER ?((►j��•L�q'a(A�-�I LOT TRACT
PROPERTY OWNER'S NAME Wit
uI ding & Safety Dept.
ADDRESS ��727 ,L. L•,v
PHONE ?fib- �"�y- K EMAIL NOV 10 2015
APPLICANT NAME t I L w/ Reeeived
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME J c b(9( 'Alliv l,;'+ b Lev.-„, r OWNER BUILDER? O YES O
BUSINESS NAME
ADDRESS (L331 "4jS� 1L1 1.._ EIS/nay
PHONE qsf- 2310- qbG, EMAIL
pJ
CONTRACTOR'S STATE LIC NUMBER (7b3q-0 LICENSE CLASSIFICATION L�
VALUATION$ 0 ob SO FT L SO FT
APPLICANT'S SIGNATURE DATE
I:. ..
DEPARTMENT DISTRIBUTION l CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING NGINEERING FIRE GREEN 1 SMIP
INVOICE G PAIDAMOUNT
AMOUNT • ,J O CASH O CHECK# O CREDrr CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO
City o`P ienifee Building&Safety Oeportmenr.29714 ;ic,un Rd. Menifee, CA 92585 951-572-5 7 77
u ww.cityofinenifee.us inspection Request Line 951-246-6213
LEDGER & TRACK
INSPECTION REQUIRED City of tvlenifee
Building & Safety Dept.
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CITY OF MENIFEE
BUILDING AND SAFETY DEPARTMENT r�,
PLAN APPROVAL l�
REVIEWED BY A,tb115
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.
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�60 - 8'S9 -62d9