PMT15-03582 City of Menifee Permit No.: PMT15-03582
29714 HAUN RD. Type: Residential Re-Roof
�ACCEL/? MENIFEE,CA 92586
MENIFEE Date Issued:
11N612015
PERMIT
Site Address: 29064 THORNHILL DR, MENIFEE, CA Parcel Number: 338-043-012
92586 Construction Cost: $8,000.00
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING LAYERS, INSTALL NEW COOL ROOF SHINGLES
Work: •'CRRC#0890-0009'"
Owner Contractor
LARRY WEBSTER HOUSETOP ROOFING
29054 THORNHILL DRIVE 31760 BRIGGS ROAD
MENIFEE, CA 92586 MENIFEE, CA 92584
Applicant Phone:9516798369
RICH CARROLL License Number.371783
HOUSETOP ROOFING
31760 BRIGGS ROAD
MENIFEE, CA 92584
Fee Description Qtv Amount($
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
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_Pemiil Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ lam exempt from Iicensure 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 i
Professions Code nd m license Is In full force and effect. which I must have resided for at least one year prior to completion
License Class Ucennsse No. improvements covered by this permit, I cannot legally sell a structure that I hay
Expires / / Signature built as an owner-building if it has not been constructed in its entirety by license
— 7 contractors. I understand that a copy of the applicable law,Section 7044 of th
WORKERS'COMPENSATION DEC RATION Business and Professions Cade,is available upon request when this application
submitted or at the fallowing Web site:
,AV-hereby affirm under penalty of perjury one of the following declarations: hHo:Nwww.leginfo.ca.aov/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 issuedd.t-�L
. / Property Owner or Authorized Agent
Policy# �my Signature below, I certify to each of the following: I am the proper
have and will maintain workers compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read th
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 comp
permit is issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to buildin
ST�� �� consW ve construction.I authorize representatives of this city or county to enter the abo
Cartier identified property for the inspection purposes.
Policy# �ll 2 Expires I LA/// � � Date /� G
T"— Pm"Owner or Authorized Agent(This section need not be completed If the permit is for City Business License# 3 /�� �
one-hundred dollars($100)or less)
HAZARDOUS 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 Will the applicant or future building occupant handle hazardous material or:
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
lfforthwith comply
�with those provisions. DYES L"I.NO
ApplicantY Tate; r Z/3//15 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 checklis
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guideltine�
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES 00
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 cute
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑YES 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 conceming
3097 Civil Code) hhazz dous material reporting.
OWNER BUILDER DECLARATIONS y{>ES ❑NO
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date �l G
License Law for the reasons)indicated below by the checkmark(s)I have placed PROP OWNER ORAUTHORIZED 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 Iicensure 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($500).) employees.For more information about EPNs Renovation Program visit:
❑ www.epa.gov/lead or contact the National Lead Information Center at
I, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the work, and the structure is
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's Stale License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort, builds or Improves the property,
provided that the Improvements are not intended or offered for sale.If,however, Certified Finn Name:
the building or improvement Is sold within one year of completion,the Owner-
Builder will have the burden of proving that It was not built or improved for the Firm Certification No.:
purpose of sale).
❑ 1, as owner of the property an exclusively contracting with licensed No EPA Lead-Safe Certified Finn is required for this project because:
contractors to construct the project(Section 7044, Business and Professions
Code:The Contractors License Law does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement
-
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE / / PERMIT/PLAN CHECK NUMBER Cj -
TYPE: O COMMERCIAL WRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
ONEW OPLUMBING W-ROOF-NUMBEROFSQUARES/J
DESCRIPTION OF WORK /vf(/!/ �i�'/S%�� 2(9 -.2C3t7.� mil/
PROJECTADDRESS
ASSESSOR'S PARCEL NU/MBER�/?j?j$-[' •Q '� LOT TRACT
OWNER NAME i�c-s7/�- City Of Menifee
ADDRESS -2 �V y/CY /`-�iL,/!/�L� U
PHONE 4 /%' EMAIL
APPLICANT NAME ived
ADDRESS
PHONE ,� /7 EMAIL 1400//J/L. C147
CONTRACTOR'S NAME ze4z e k 01— OWNER BUILDER? O YES YmNO
BUSINESS NAME Zo /
ADDRESS ' _. %`�/L/�j4'S /C.0 .
PHONE &!r— `7// EMAIL
CONTRACTOR'S STATE LIC NUMBER ,3-7/7�r3 LICENSE CLASSIFICATION VALUATIONS SQ FT �.,�(JQ L SQ FT
APPLICANT'S SIGNATURE DATE 2 G-
221941071,14
F
TDISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
LANNING ENGINEERING FIRE GREEN 1 SMIP X.pglDAMOUNT q 3b.G 0 OCASH OCHECK# OCREDITCARD VISA/MC
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 O 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
a s ra0 ^ o z 3 ` 2 n Mqm>
z
pc o m O a n a 'n in M c� cnm
mm0
e -O°i. vOi c n v a d n m < O N m D m n
G O 9 -30 a N
N m O
D O m
o
mDz
O' O m n 2 3 TI In O
x 3 0 ax 0 � a < y n .Q V I , Z �' � 3 O C T m r n
� , n 3 ^ O nr
O o o- m n 0 m o w n O as m E m --I
N N »
SL
— a m o t
° s o
a s Z 3 °n A
3
o, M O
N y O N w m N IA
y m 3 0 o N a g • - 7 0
w m w 3 F ;L
p M.
Er
^. n o x fD 10 ° c m o o fD A O
0 , m g m o
O n 0 .O
N _ 3 0
O o n m a N
c 1° R 3 H N w z o
O O in A O O T n
m F o = O m ry O m F m
F 0 S °
T o .a. _ F a c O m in m p
o m 01 y n m a a x w a u
3 0 ` 3
w a 0 n a N m M a m
m N o 0 o m 3
p a m
a s 0 N o o '^ 00 0
m m ,m, 90 ti D °
ry m n p D
m 0 a^ an d jp Q d u a ° G 0 N X
0 w
m N n C C o 9 a 0 °'1 0
3 s a z m
a c m
d �
ID
s
'° N a w < O —
o m w ° a e•
0 m < _
A ;
xa n
m m
m m
o m o 0 3 3 m
O �
0 '0 � m m m m o z_ w �• z O
T n a n z 0 9 n.
3 3 ^ n s Z w ti r o `•° m m to ➢ ti A
O �
'° o S 'o o a
' � � m D
m a $ 3 3 3 - a °- °° o K c c n n
s 0 m o 3 3 3 s a a b a n o » 9 n p
2 N T
N D
w E. E' f » 3 m A n c d M N c m m p
S J 'm 'm £ « d A
N ^y O � W ry 6 6 f O m m 1 °' m n = O y 7
w
n m 0 o ° o'i m
3 A R T % n n p ^! j G ^ p O Q. 0, 0
3 '^
ppm Zy f. m b .., m f° A w W. m
< O '1 •3 b d N i d N N O b 9 .,
ry ➢ Q T C T ^
n J b. d W
m °° m S a m b T .» N d o ° d 0 u A
G m d ,u ui n d {n �.°} n �' OJ- 3 b O =
S < O
❑O c 3 ? O a A C n o n 0 m 2 ° o m 3' OR
0 M ' 7
T C 6 oP o nm m
m —
_.a„•, bm nd A y abd a
O
D _ c
O
w nwoc z ' 3
a O m w o rdtD4 m n N
/�
�`pa 3 0 0 � o d n •2 m -
Z = A O a d w
a J d 0 m a N n a m
r A 2
•, M D b
O � A a J O pq O
N n ➢ J 6 D a 6 C O ^ -O N 2
O a % m a n .d. w p' ? f
J S In � W J �•
O T �
O N d d e w CT b C y S n
u w e^s
w
mo d J »
j \ o a a ra m m
T c
a o m u = m
b J
P'. m a w a �+ .c—. o Cc
J o n e N —
•j.P
a N d m
v 0 I+
O »
c O ^ J b u A
a• v d O d D
n O r
N m O ° d O a
6
3 < f D z m
M N <
o m g m _
m
m n d m n rc O
20 •n „ w c N O
3 s m b m O ^
m Z
O N O
m