PMT15-03732 City of Menifee Permit No.: PMT15-03732
29714 HAUN RD. Type: Residential Addition
<ACCEL/_> MENIFEE, CA 92586
MENIFEE Date Issued: 1 2/0 212 01 5
PERMIT
Site Address: 30417 WARM LODGE CT, MENIFEE,CA Parcel Number: 358-441-063
92584 Construction Cost: $3,800.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 480 SQ FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 3 LIGHTS,2 FANS
Work:
Owner Contractor
TIMOTHY MAUS KYLE KELLY
30417 WARM LODGE CT 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 O.t Amount 1$1
Receptacle,Switch,Outlet&Fixture 5 136.00
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
$304.65
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 an 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_Perrrit 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 penalty or perjury that 1 am licensed under provisions of following reason:
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below 1 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 /S License No. improvements covered by this permit, I cannot legally sell a structure that I have
Expires 6/ Signat0 "-7 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 Cade,is available upon request when this application is
submitted or at the following Web site:
❑ 1 hereby affirm under penalty of perjury one of the following declarations: htt .le fo.ca. ov/oala
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
Section 3700 of the Labor Cade, for the performance of work for which this T
permit is issued. Prope er arAu dz en
Policy# ❑ By my Signature below, I certify to each of the following: I am the properly
❑ 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 carder and policy number are: with all applicable city and county ordinances and state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
Carrier identified p!pperlq-F e m pe poses.
Policy# Expires Date
roperty Owner orAuthoriz t r�
(This section need not be completed ff the permit is for City Business ucense# n, �.T.7 ` 5
one-hundred dollars($100)or less)
HAZARDOUS MATERIAL DECLARATION
❑ 1 certify that in the performance of the work for which this permit is issued,1
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. DYES ❑NO
Applicant; _ Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WART NG": 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 DYES ❑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 100D 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.I understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safety Cade,Section 25505 and 25534 concerning
3097 Civil Code) hazardous material reporting.
OWNER BUILDER DECLARATIONS ❑YES—EMO —Rafe � �,
I hereby affirm under penalty of perjury that I am exempt from the Contractor's _ r
License Law for the reason(s)indicated below by the checkmark(s)I have placed PR9P NER O'AUTHORIZED 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 Stale 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 anyApplicent 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 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 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 Finn Certification No.:
purpose of sale).
❑ I, 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
& SAFETY PERMIT/PLAN CHECK APPLICATION
4•'(
NF
Menifee
DATE 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 PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS �917 Llar,,+ 6o C-�-
ASSESSOR'S PARCEL NUMBER �� LOT �� TRACT
OWNER NAME / A,�
ADDRESS s• OV C C '/-
PHONE 95If- 61) 2 -o380' EMAIL
APPLICANT NAME n !/ 1611-1
ADDRESS yr Iyed
ZL•/p'�/ i I' 4 /'11 �C
PHONE ! '(— /L7'(�/. EMAIL
CONTRACTOR'S NAME 1 ' n OWNER BUILDER? O YES ONO
BUSINESS NAME Q I e ( L� f nG,'
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER y�(Jj' cj 7 (� LICENSE CLASSIFICATION
VALUATION$ 4f-' 3 906 SQ FT �(,Q� L SQ FTT 51W
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION to �^ CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP
INVOICE 1m PAID AMOUNT
AMOUNT 0 - 0CASH OCHECKp OCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0 CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES 0 NO DL NUMBER NOTARIZED LETTER O YES O 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
PLOT/SITE PLAN
City of Menifee
REAR PROPERLY LIN�oldinq & Safety De t.
\ DEC 0 2 2015
Received
yG l LEDGER & TRACK
INSPECTION REQUIRED
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MENIFEE
NG AND SAFETY DEPARTMENT
'APPROVAL
bui f-J7 '
i JIlED B et
DA rE
al of these plans shall not bo construed to be a permit for,or an
;i of,any violation of any provisions of the federal,state or city
ons and ordinances. This set of approved plans must be kept on the Q
FRONY0ROPd l ion' `1
Property Owners Name U '
Property Address