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PMT16-00815 City of Menifee Permit No.: PMT16-00815 29714 HAUN RD. Type: Residential Addition <—ACCELA7. MENIFEE, CA 92586 MENIFEE Date Issued: 03/21/2016 PERMIT Site Address: 31879 BRENTWORTH ST, MENIFEE, CA Parcel Number: 372-432-002 92584 Construction Cost: $6,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL542 SQ FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 2 FANS Work: Owner Contractor JACK BAKER PSLQ INC 31879 BRENTWORTH ST 28910 RANCHO CALIFORNIA RD MENIFEE, CA 92584 #206 Applicant Phone: 9517954260 LOIS MONTINI License Number:919885 PSLQ INC 28910 RANCHO CALIFORNIA RD #206 TEMECUTA,CA 92590 Fee Description Oft t Amount($) Receptacle, Switch,.Outlet&Fixture 2 121.00 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 General Plan Maintenance Fee-Electrical 1 6.05 $295.70 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_Permk_Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ 1 am exempt from licensure under the Contractors'Stale 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 py license is in full force and eff, n (J, which I must have resided for at least one year prior to completion of License Class Lice se/No. Y jj improvements covered by this permit, I cannot legally sell a structure that I have Expires — — ignature ' built as an owner-building if it has not been constructed in its entirety by licensed i 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: ❑ I hereby affirm under penalty of perjury one the following declarations: httoJ/www.lecinfo.ca.aov/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 Code, for the performance of work for which this permit is issued. Properly Owner crAuthorized 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 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.My workers'compensation insurance carder and policy numberare: 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 Tz, 1�4�y?t' // rr identified property for the inspection purposes. Policy# well 00641 Expires / (p 'L.f� Date y37 Property Owner orAuthodzed Agent (This section need not be completed rf the permit is for City Business License# G -�f—lfO3 one-hundred dollars($100)or less) ❑ 1 certify that in the performance of the work for which this permit is issued,1 HAZARDOUS MATERIAL DECLARATION shall not employ 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 Califomia, and agree that if I should become mixture containing a azardous material equal to or greater that the subject to the we '�rs'compensation provisions of Section 3700 of the Labor amounts specified on the Hazardous Materials Information Guide? Code,I shall o h comply ith those provisions. / •��7 DYES 1-N0 Appli t; ete:--C-��-IF / /� 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' CoastAir Quali anagement District(SCAQMD)?See permitting checklist COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guide], 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 it id g r modified facility be within 1000 feet of the outer DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of pot? LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES tfNO 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 undgcstand my requirements under the State of agency for the performance of the work which this permit is issued (Section California Health&9af6ty Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardous pall reporting. OWNER BUILDER DECLARATIONS DY I NQ=I- I hereby afire under penalty of perjury that I am exempt from the Contractor's Date License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR ALI bRIZED 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 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 licensure 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.gowlead or contact the National Lead Information Center at ❑ I, n owner of the property, or my employees with wages the their sole 1-800-424-LEAD(5323). compensation,will re ( )all . or( )parting of the work,and the structure is &r�s_„ 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- Builder will have the burden of proving that it was not built or improved for the Firm 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 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 Stale License Law). If your project does not complv with EPA RRP rule please fill out the RRP i N,n{ �_ ie DATE - - PERMIT/PLAN CHECK NUMBER I(o• 008 S . TYPE: ❑COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA []-SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL ❑NEW ❑PLUMBING'-ElRE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK PROJECTADDRESS ^ C71-� Lkr2 (XI't 2 ASSESSOR'S PARCEL NUMBER � l pt - L-, 'Q OT 61 TRACT I;b J PROPERTY OWNER'S NAME ADDRESS ��jj qq 4f1J^^��' PHONE II�Y 2cfo - 9 EMAIL APPLICANT NAMME` ,pyy� ADDRESS I`S� O c 8- �1II ltG�' ��/A�q` U PHONE 1� �t I E�MAAI�IL CONTRACTOR'S NAME OWNER BUILDER? DYES[-]NO BUSINESS NAME P (% I ADDRESS U t ✓`-�' ` ed PHONE -I v J �EEMAIL CONTRACTOR'S STATE LIIC//N]]U��MBER 15q (�� �� LICENSE CLASSIFICATION VALUATION$ ( Pap SOFT yJ`f�l LSO.FT APPLICANT'S SIGNATURE DATE r DEPARTMENT DISTRIBUTION Up CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP I INVOICE ;)RC �0 PAIDAMOUNT UCASH OCHECK# OCREDITCARD VISA/MC AMOUNT DC PLAN CHECK FEES PAID AMOUNT OCA5H OCHECK#. OCREDITCARD VISA/MC OWNER BUILDER VERIFIED U YES U NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92596 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-5213 Jack Baker City of Marilee Plot plan 31879 Brentworth St. rj ding & safety Dept. Not to Scale Menifee, Ca. 92584 MAR 2 1 2016 714-293-4059 542 sq.ft. Solid Alumawood Patio Cover. (2) Fans. Attached' o t e house and to the existing Concrete. set at 9' high .LEDGER & TRACK T INSPECTION REQUIRED 10, �125 ❑ ❑ 4 9' 19' ❑ ❑ ❑ 11, 71 12' Solid Patio Cover V C!T`i OF rVIENIFEE ,!1!s.DING AND SAFETY DEPARTMENT N ,: APPROVAL Utt';4EWEDBY _ DATE r thoco nipm shpll not hW -nnstrued to be a permit for or an Dr w1Aayf,any violation of any r1,ov, r s of the federa�kept regulations and ordinances. This set jobsite until completion. Sidewalk Brentworth St.