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PMT16-00816 City of Menifee Permit No.: PMT16-00816 29714 HAUN RD. Type: Residential Addition {ACCEL.j? MENIFEE, CA 92586 MENIFEE Date Issued: 0 3/2112 01 6 PERMIT Site Address: 26015 RIDGEMOOR RD, MENIFEE, CA Parcel Number: 338-301-001 92586 Construction Cost: $3,000.00 Existing Use: 1 &2 Family Residence Proposed use: Description of INSTALL 420 SQ FT SOLID ALUMAWOOD PATIO W/ELECTRICAL 2 FANS,2 POSTLIGHTS Work: Owner Contractor LUIS M DIAZ , 26015 RIDGEMOOR RD MENIFEE, CA 92586 Applicant License Number: LUIS M DIAZ 26015 RIDGEMOOR RD MENIFEE, CA 92586 Phone: 9519928203 Fee Description OQt Amount ISl Receptacle,Switch, Outlet&Fixture 4 131.00 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 6.55 $306.20 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 eldg_Permt_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: License Class License No. By mysignature below I acknowledge that,except for my personal residence Expires Signature in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that 1 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 forworkers 7044 of the Business and Professions Code,is available upon request when compensation,issued bythe Director of Industrial Relations as provided far this application is submitted or at the following website: by Section 3700 of the tabor Code,for the performance of work for which this permit is issued. www.leginfo.ca.Rov/calaw.Mml. Policy If Date ❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which J_By my signature below l certify to each of the following:I am the property this permit is issued.My workers compensation insurance carrier and polity fawner or authorized to act on the property owners behalf.I have read this numberare: application and the information I have provided is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relating to building can'tructio thorize representatives of this city or county to Policy# Expires /ROPERTY above i ntifi property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less OW AU ED AGENT ❑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 CITY BUSINESS LICEN # workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of section 3700 of the Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date mixture containing a hazardous material equal to or greaterthat the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS O Yes ❑No 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 See SCAQMD)? IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES ( permitting checklist farguidelines CONSTRUCTION LENDING AGENCY ❑Yes ❑No 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 boundary of a school? (Section 3097 Civil Code) ❑Yes o No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist I understand my requirements under the State of Contractors License Law far the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning material reporting. checkmark(s)I have placed next to the applicable items)(Section 7031.5 hazardous Dyes ❑No Business and Professions Code).Any city or county that requires a permit to construct,alter,improve,demolish or repair any structure,prior to its Date PROPERTY OWNER OR AUTHORIZED AGENT issuance,also requires the applicant for the permitto file a signed statement that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Cade)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.eoa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800424-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 noot built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: 4 as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors 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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE C) I I Rzz PERMIT/PLAN CHECK NUMBER I10- E�0181 (Q TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: 'ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK -E.I-CK- d S 2 os+ PROJECTADDRESS ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME / - ADDRESS � �QN V F(� � 2SSL PHONE "( )1 QZ tiS2U � EMAIL IWAAC) Warflo� l?�(?LC/ti1Do •CO APPLICANT NAME Luk& ADDRESS Q5yy--,, �. GMOO� l=t II"C�L 7 CQ IS PHONE�9J1,)�y�_ ?J EMAIL jUjdlO,- ' . '!Ibi I� �l. ' Fl6 II--k CONTRACTOR'S NAME ��J�(� �d� `Z�_ OWNER BUILDER? O YES k'-N0 BUSINESS NAME tirr S /�-t U M A V000br��nj JLS ^^6, ADDRESS •2>'l�JU 'ppQ(j A laC ,.c ' ,& ke _+GVA` C PHONE (gis �p-I`I 0��.7 EMAIL CLPISS Cbti1 CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ ti SQ 2© L SO FT APPLICANT'S SIGNATURE DATE 03& IPOW DEPARTMENT DISTRIBUTION ao CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE I I55� PAIDAMOUNT AMOUNT ��P• I OCA5H OCHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT OCASH C'CHECK# 0CREDIT CARD VISA/MC OWNER BUILDERVERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES 0 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 D c iJ iV c`1Z Cow 7 R 4 LTG g- LuIS bIAZ 12L4-SS« 44OMILtrAoYJ C'ovc'VS Z(Oo (s R4yerjoo2 3 (�q.SSD (3WAf ,ei. wdY M e,v . fee f'cZ F2-t-gy m u N'r^ e�k C'.ti ? 2,56,3 SSJ - F9Z - 8zo3 g.ri - 67V SS33 LEDGER & TRACK C17Y l ' ENIFEE ;\€4,A PECTION REQUIRED BWLC-11`1; AND SAFETY DEPARTMENT PLAN A .,, ,ROi.`.0 REVIEWED BY ■� City of Menitee ATE Gailding & Safety DeptMAR 21 *Apprwi these plans shall no:be construed to be a permit for,or an approval of,any v olation of any prnvisions of the federal,state or city Received regulations ind of linances. This se!of approved plans must be kept on the jobsite until completion. � LEc7�.j cd t. Z F,aw s y a o s g r T ['ft V i 3S � 12 10 2�{ a o R 9 t