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PMT16-00498 City of Menifee Permit No.: PMT16-00498 29714 HAUN RD. Type: Residential Re-Roof �CCEL/_> MENIFEE,CA 92586 MENIFEE Date Issued: 02/29/2016 PERMIT Site Address: 28640 SNEAD ST, MENIFEE, CA 92586 Parcel Number: 337374-009 Construction Cost: $8,000.00 Existing Use: Proposed Use: Description of TEAR OFF EXISTING ROOF, REROOF W/OWENS CORNING COOL ROOF ANTIQUE SILVER Work: Owner Contractor JACKIE RICHARDS VILLAREAL ROOFING CO 28640 SNEAD ST P 0 BOX 1581 MENIFEE,CA 92586 COLTON,CA 92324 Applicant Phone:9093701000 GILBERT VILLAREAL License Number:802689 VILLAREAL ROOFING CO P 0 BOX 1581 COLTON,CA 92324 - Fee Description Qtv Amount f91 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 carded 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_Pennil Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that 1 am under provisions of O I am exempt from licensure under the Contractors State License Law for Chapter9(commencing with section 7000)of Division 3 of the Business and Professions Code and my license is in full force and effect. rp b the following reason: License(lass C— 3 Licei se No. Gg 91 By my signature below I acknowledge that,except for my personal residence Expires /-3/- It Signature in which I must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by ❑I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which www.Iegmfo.ca.aov/calaw.htmi. this permit is issued. Dale Policy# PROPERTY OWNER OR AUTHORIZED AGENT md'have and will maintain worker's compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below certify to each of the following:I am the property this permit is issued.My worker's compensation Insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: / application and the information I have provided is correct.I agree to comply S r��� �/�yrJ with all applicable city and county ordinances and state laws relating to Cartier pf building construction.I authorize representatives of this city or county to Policy#1-9_�71' Expires /D Z,� enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑Icertify that in the performance of the work for which this permit is issued, O Jq O dl�;p I I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers comppensation provisions of Section 3700 of the Labor Will the applicant or future building occupant handle hazardous material or code,I shall thwi c bly j h rhos rovisions. mixture containing a hazardous material equal to or greater thatthe Applicant amounts 'filed on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS OYes �", UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes cko I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer boun of a school? (Section 3097 Civil Code) ❑Yes o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the ha3pdous material reporting.checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ONgs,f o N'� a�/}7✓ IC and Professions Code).Any city or county that requires a permit to 7 f .b/r Z&111� Date construct,alter,improve,demolish or repair any structure,prior to its PROP TY OWN R OR AUTHORIZED AGENT issuance,also requires the applicant for the permit to file a signed statement EPA RENOVATION REPAIR AND PAINTING IRRPI that he or she is licensed pursuant to the provisions of the Contractors State License Law(Chapter 9(commencing with Section 7900)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their ❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoamov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.if,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was ❑No EPA Lead-Safe Certified Finn is required for this project because: not built or improved for the purpose of sale. ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contactors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK Menifee DATE �—a — I PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL u'RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL ONEW OPLUMBING (2,-fE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK ,—"r off i14/ % / L.12 PROJECTADDRESS 0 5;velho S ASSESSOR'S PARCEL NUMBER ;5'5 (' 1?14-OD I LOT (O J TRACT OWNER NAME ^ ` ADDRESS 9-�C ter-' wv C f CA PHONE 95/-3pl ` 0la-1 EMAIL APPLICANT NAME Y-/- I` / r{ l ADDRESS PHONE EMAIL CONTRACTOR'S NAME Y/' ` / /'.Ziq OWNER BUILDER? O YES O NO BUSINESS NAME 4 i rJ ADDRESS 11210 97 6i*,t'd Vie,% C-c- /3 PHONE Gfp�- 370'-1D(N EMAIL 2- O d�rGO CONTRACTOR'S STATE LIC NUMBER 7 Odb D 9 LICENSE CLASSIFICATION C- 3 VALUATION$ cJ SQ FT !� �Q(J L SQ FT APPLICANT'SSIGNATUR DATE a'C;L -� DEPARTMENT DISTRIBUTION I CITY OF MENPE B SIN'S LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP .• ���� INVOICE I�}1 PAID AMOUNT V, n AMOUNT ✓VV CASH OCHECKp CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES O 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.cityofineniiee.Lis Inspection Request Line 951-246-6213 N o m :E . . . Z y, n ci m n N D S S A r S O � C ^f w N N " 01 m m m 0 H o - o A 3 a ^� p ITl -Di 3 J o J 0 c o m 3 O d d N A O m 3 .m. N m n 0 t, w N wJ a n Z t -_I O a m c p 0, \ v a u o. m o a n N A n m 3 -p., < Dr d o m p r9- m m m D m D .a Z 9 o. 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