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PMT15-03773 City Of Menifee Permit No.: PMT15-03773 _ 29714 HAUN RD. Type: Residential Addition It �CCIELA? MENIFEE, CA 92586 MENIFEE Date Issued: 12/08/2015 PERMIT Site Address: 26956 HANFORD ST, MENIFEE, CA Parcel Number: 360-411-021 92584 Construction Cost: $6,260.00 Existing use: 1 &2 Family Residence Proposed use: Description of REPLACE EXISTING 658 SO FT WOOD LATTICE COVER W/658 SO FT ALUMAWOOD LATTICE Work: COVER Owner Contractor JERALD MEDVIN S A E BUILDERS 26956 HANFORD ST 28810 BROKEN ARROW CIRCLE MENIFEE,CA 92584 MENIFEE,CA 92584 Applicant Phone: 9516585807 SCOTT EGBERT License Number.625328 S A E BUILDERS 28810 BROKEN ARROW CIRCLE MENIFEE,CA 92584 Fee Description O_yt Amount 151 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 building 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_Pemiit_Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ lam exempt from Iicensure 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 m license is in full force and eff ct._ which I must have resided for at least one year prior to completion of License Class License N improvements covered by this permit, I cannot legally sell a structure that I have Expires .3 /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'COMPENSATI RATION 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 perjury one the following declarations: hfto://www.leginfo.m.goy/cala%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 Code, for the performance of work for which this permit is Issued. Property Owner or Authorized Agent Pol icy# ❑ By my Signature below, I certify to each of the following: I am the property ,u 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 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.Myworkem'compensation insurance carrier 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 5rw,,� identified property for the inspection purposes. Policy# 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) ❑ 1 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 became 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 a cified on the Hazardous Materials Information Guide? Code,I shall forthwi ly with those provisions. ❑YES A 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 WAR FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist 6-0—MISENSATION 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 ❑YES/El 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 R Safety Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardous aterisl-rq orting. OWNER BUILDER DECLARATIONS ❑YES 0 I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date/�C_w License Law for the reason(s)indicated below by the checkmark(s)I have placed PR P OWNER OR AUTHORIZED AGENT next to the applicable item(s)(Section 7031.5.Business and Professions Code: EPA RENOVATION.REPAIR AND PAINTING(RRP) .Any city or county that requires a permit to construct, alter, improve, demolish, 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.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- Bulkier 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 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 Stale License Law). If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. I• ' i 11 BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE 12/08/2015 PERMIT/PLAN CHECK NUMBER TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOUSPA ❑SIGN SUBTYPE: ❑✓ ADDITION [—]ALTERATION [-]DEMOLITION ❑ELECTRICAL ❑MECHANICAL ❑NEW ❑PLUMBING [I RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Replace existing 658 SF wood lattice cover with 658 SF Alumawood lattice cover PROJECTADDRESS 26956 Hanford Street,Menifee,CA 92584 ASSESSOR'S PARCEL NUMBER 360-411-021 LOT 21 TRACT T28303 OWNERNAME JeraldMedvin ADDRESS 26956 Hanford Street,Menifee,CA 92584 PHONE (951)672-7608 EMAIL jerrylive365@yahoo.com APPLICANT NAME Scott Egbert ADDRESS 28810 Broken Arrow Circle, Menifee,CA 92584 PHONE (760)567-0709 EMAIL soott@saebuilders.com CONTRACTOR'S NAME Scott Egbert dba SAE Builders OWNER BUILDER? ❑YES❑✓NO BUSINESS NAME SAE Builders ADDRESS 28810 Broken Arrow Circle,Menifee,CA 92584 PHONE (951)658-5807 EMAIL soott@saebuilders.com CONTRACTOR'S STATE LIC NUMBER 625328 LICENSE CLASSIFICATION B VALUATION$ $6,260.00 SQ FT 658 L SQ FT APPLICANT'S SIGNATURE DATE 12/08/2015 DEPARTMENT DISTRIBUTION �{1 CITY OF MENIFEE BUUSSIINESS U NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN V- SMIP O-J53 INVOICE Lb(9 RAIDAMOUNT AMOUNT { bb 0 CASH O CHECK# O CREDIT CARD VISAIMC PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# 0CREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0 YES C NO DL NUMBER NOTARIZED LETTER 0 YES 0 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 Carl Putnam P.E. 3441 Ivyllnk Place Lynchburg,VA 24503 Carl Putnam, P.E. June 4, 2015 Heath Morgan Amerimax Exterior Home Products 28921 US Hwy 74 Romoland, CA 92585 Dear Heath: My California PE registration was renewed in June 2015 and is currently valid u til 2017. All previous documentation (plans, letters, calculations,etc.)that I approved Conti ue to be valid under the conditions specified in those documents. If you require further information please contact me at(434) 384-2514 or at car!outnam5comcastnet Sincerely, Carl Putnam, P.E. Eli�/N PU7 4F1 60139 ,-(sY2o1i clVt �fOFCP��Q City of Menifee & Safety Deft Building DEC 0 8 2015 Received . . . . . . . . . . . . . . . . . . . . . . . . . . . .