PMT15-03694 City of Menifee Permit No.: PMT15-03694
_ 29714 HAUN RD.
�CCIELA? MENIFEE,CA 92586 Type: Residential Addition
MENIFEE Date Issued:
11/30/2015
PERMIT
Site Address: 29940 COTTONWOOD CV, MENIFEE, CA Parcel Number: 340-510-062
92584 Construction Cost: $4,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 407 SQ FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 3 FANS&5 LIGHTS
Work:
Owner Contractor
THOMAS WALKER PSLQ INC
29940 COTTONWOOD CV 28910 RANCHO CALIFORNIA RD
MENIFEE, CA 92584 #206
Applicant Phone: 9517954260
LOIS MONTINI License Number:919885
PSLQ INC
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description ,rQty Amount ISI
Receptacle, Switch, Outlet&Fixture 8 151.00
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
$319.65
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_Permit_Templalesiot 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 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 'tense is in full force and effe 4 which I must have resided for at least one year prior to completion of
License Class License No. / W4 improvements covered by this permit, I cannot legally sell a structure that I have
Expires - [7 ' 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 autinngg 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 the following declarations: hdo://www.leainfo.ca.cov/calaw.html.
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 Cade, 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
❑ 1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owners 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 stale laws relating to building
,p construction.I authorize representatives of this city or county to enter the above-
Carrier 0� ,/��'/ identified property for the inspection purposes.
Policy# Lr7//D/JD7Ja skicpires Date
Property Owner orAuthorized Agent
(This section need not be completed if the permit is for City Business License#
one-hundred dollars($100)or less)
❑ 1 certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
shall not emploX 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'corn nation laws of California, and agree that if I should become mixture containing a hipardous material equal to or greater that the
subject to wo ers'compensation provisions of Section 3700 of the tabor amounts specified fhe Hazardous Materials Information Guide?
Code,I sh ort empl�w hose provisions. DYES
Ap Ii t; ate; e W Will the intended us94 the building by the applicant or future building
occupant requireApermit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Qu9t9 Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for gut 2 s
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES ❑NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed but tfig"or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary,of sc I?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES
CONSTRUCTION LENDING AGENCY I have read the Hazardo aterial Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist erstand my requirements under the State of
agency for the performance of the work which this permit Is Issued (Section California a fe ,Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous t
OWNER BUILDER DECLARATIONS DYES 0
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHOR'1Z&DA6ENT
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 1RRP1
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 EPA's Renovation Program visit:
www.epa.govAead 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 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 El 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 contractorfs)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
DATE PERMIT/PLAN CHECK NUMBER 5-O
TYPE oft
❑COMMERCIAL RESIDENTIAL n MULTI-FAMILY MOBILE HOME POOL/SPA SIGN
SUBTYPE: ADDITION ALTERATION ODEMOLITION
❑NEWPLUMBING []ELECTRICAL []MECHANICAL
RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 7
PROJECT ADDRESS
ASSESSOR'S PARCEL NUMBER O a LOT _� TRACT
^,
PROPERTY OWNER'S NAME d vt s+ /��'
ADDRESS �J
PHONE g� ' -6� EMAIL
APPLICANT
ADDRESS CJ I'a O
PHONE
951- �0-7 EMAIL rTem l �Aq� U
CONTRACTOR'S NAME `
OWNERBUILDER7 [:IYESQNO
BUSINESS NAME
ADDRESS O On I y '^�{n a �A
11
PHONE Iyl� �rf1 EMAILr
CONTRACTOR'S STATE LIC NUMBER yw ��
LICENSE CLASSIFICATION
VALUATION$ 0 0 FT
LSQFf
APPLICANT'S SIGNATURE _d
= _ DATE
e _
DEPARTMENT DISTRIBUTION K
BUILDING PLANNING ENGINEERING FIRE GREEN �" w do CITY OF MEN E BUSINESS LICENSE NUMBER
INVOICE ((�,, SMIP S ''jv^
AMOUNT !Aj.(0 PAIDAMOUNT
C CASH QCHECK71 IT
PLAN CHECK FEES PAID AMOUNT 0CRED CARD VISA/MC
D CASH O CHECK q D CREDR CARD VISA/M
OWNER BUILDER VERIFIED D YES C NO DL NUMBER C
NOTARIZED LETTER C YES D NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
Thomas Walker
Plot plan 29940 Cottonwood Cove
Not to Scale Menifee, Ca. 92584
951-378-0744
407 total sq. ft. of Alumawood Solid Patio Cover. Attached to the house and
concrete slab. with (3) ceiling fans and (5) post lights , Patio set at 9' high
Of Menifee
g Safety Dept.
.OGER & TRAIK 3 0 2015
31' =pFi7'TIDN REQUIRED ; ,ceived
$�
+ + + 11'
CITY OF ME FEE
r" 'It DING At 1D SAFE1Y DEPARTMENT
REVIEWED E
DATE
*Approval of these pl ns s a not a construed to be a permit for,or an
Driveway approval of,any viol ion of any provisions of the federal,state or city
regu ations an noes, This set of approved plans must be kept on the
jobsite until completion.
Sidewalk
Cottonwood Cove