PMT15-03867 City of Menifee Permit No.: PMT16-03867
_ 29714 HAUN RD.
�A\CCEO MENIFEE,CA 92586 Type: Residential Addition
MENIFEE Date Issued: 1 2/1 712 01 5
PERMIT
Site Address: 28690 MAHOGANY TRAIL WAY, Parcel Number: 333-690-030
MENIFEE,CA 92584 Construction Cost: $5,425.00
Existing use: 1 &2 Family Residence Proposed use:
Description of INSTALL SOLID ALUMAWOOD PATIO COVER WITH 2 FANS,3 POST LIGHTS, I OUTLET
Work:
Owner Contractor
SUZANNE VONS PSLQ INC
28690 MAHOGANY TRAIL WAY 28910 RANCHO CALIFORNIA RD
MENIFEE,CA 92584 #206
Applicant Phone:9517954260
LUIS BENTIVENGO License Number.919885
PSLQ INC DBA GREENBEE
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description Oft Amount I51
Receptacle, Switch, Outlet&Fixture 6 141.00
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
$309.65
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_Permit_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ I am 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(commencin 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 an license is In full force and effect.^/��- which I must have resided for at least one year prior to completion o
License Class License No. "J improvements covered by this permit, I cannot legally sell a structure that I have
Expires Signature built as an owner-building if it has not been constructed in its entirety by licensec
contractors. I understand that a copy of the applicable law,Section 7044 of the
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application ie
submitted or at the following Web site:
❑ 1 hereby affirm under penalty of perjury one of the following declarations: htto•//www.leainfo.ca.aov/calaw.html.
I have and will maintain a certificate of consent of seff-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
F
i 'sued. Property Owner ar Authorized Agent
❑ BymySignaturebelow, I certify to each of the following: I am the propetyb
have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read thin
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 comph
permit is issued.My workers'compensation insurance carrier and policy number are: with all applicable c nd-county ordinances and state lam relating to building
construction. thorize mOese tatives of this city or county to enter the above
Carder identified car on purposes.
Policy# j y, Expires ?--((o Date /2
Property Owner or Authorized Agent
(This section need not be completed if the permit is for Cj j 5 a 3
one-hundred dollars($100)or less) City Business License#
HAZARDOUS MATERIAL DECLARATION
I certify that in the performance of the work for which this permit Is issued,I
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 a ified on the Hazardous Materials Information Guide?
Cade,I shall I�wi ply with those provisions. DYES 0 NO
Applicant; Date; ( 2 — ( 7 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 checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guideline
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES NNO
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 school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES O
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
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 8,Safe r Code,Section 25505 and 25534 concerning
3097 Civil Code) ha/yg_rdous mate• reportin .
OWNER BUILDER DECLARATIONS K� E'S ❑NO
Date 1 Z— 1-71 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 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-certifled 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 1s
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 Finn 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
AA,nnwlodnomnnt
DATE PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: P§ADDITION []ALTERATION ❑DEMOLITION ❑ELECTRICAL El MECHANICAL
❑NEW ❑PLUMBING [—IRE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORKPt
OIJI �{ I Ocl
PROJECTADDRESS D O Tr i
ASSESSOR'S PARCEL NUMBER , LOT TRACT
PROPERTY OWNER'S NAME S L,,ji ling if Safety Dc t.
ADDRESS G 1 DEC 17 2015
PHONE �SI-�3�{. I I { EMAIL
A
APPLICANT NAME t � I r
Reiceived
ADDRESS IO ()
QakyrutuO q 0
PHONE ( l- 4 � 3j EMAIL re-e fVO CONTRACTOR'S NAME OWNER BUILDER? ❑YES,nNO
BUSINESS NAME
ADDRESS -'( F/ r I I 1 I,A.G�. 1 '057V
PHONE qSI 1 ' 54 / �EMAIL
CONTRACTOR'S STATE LIC NUMBER q[ ( LICENSE CLASSIFICATION
VALUATION$ 49 SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE {-� •�
FF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP (—
INVOICE PAID AMOUNT
AMOUNT • I,QS O CASH OCHECK# OCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDITCARD VISA/MC
I
OWNER BUILDER VERIFIED O YES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
Suzanne Vohs
Plot plan 28690 Mahogany Trail Way
Not to Scale Menifee, Ca. 92584 __
951-334-1711
612 sq.ft. Solid Patio Cover and Alumawood. Attached to the house and to
the concrete slab. (2) fans (3) lights. (1) outlet
Value $ 5,425
LEDGER & TRACK BuildingCity of Menifee
& Safety Dept.
INSPECTION REQUIRED
DEC 17 2015
Received
1'
El 0
121
CITY OF MENIFEE
BUILDING AND SAFETY DEPARTMENT
PLAN APPROVAL 1
00 �2 \-I �1S
REVIEWED BY DATE
*Approval of tay,�s all not ro construed a ed a permit far,city
an
'I7jI�1� ° any provisions of the federal,state or city
approval of,an roved plans must be kept on the
regulations and ordinances. This set of app
iobsite until completion.
Driveway
Sidewalk
Mahogany Trail Way