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PMT16-01068 City of Menifee Permit No.: PMT16-01068 29714 HAUN RD. Type: Residential Addition <A_CCELA_3' MENIFEE, CA92586 MENIFEE Date Issued: 0410712016 PERMIT Site Address: 29419 HARLEQUIN CT, MENIFEE, CA Parcel Number: 364-310-069 92584 Construction Cost: $15.789.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 2 SOLID ALUMAWOOD PATIO COVERS, 1-437 SO FT W/2FANS, 1-306 SQ.FT W/1 FAN, 1 Work: OUTLET Owner Contractor RAY&SANDRA MOLINA TRADER DAN'S INC 29419 HARLEQUIN CT 840 S ROCHESTER AVE STE C MENIFEE, CA 92584 ONTARIO, CA 91761 Applicant Phone:9093900555 CHANTAL CAGLE License Number:517575 TRADER DAN'S INC 840 S ROCHESTER AVE STE C ONTARIO, CA 91761 Fee Description r3yt Amount i$1 Receptacle,Switch, Outlet&Fixture 4 131.00 Building Permit Issuance 1 27.00 Deck/Pabo, non-standard 1 133.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 3.00 General Plan Maintenance Fee-Building 1 6.65 General Plan Maintenance Fee-Electrical 1 6.55 $308.20 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 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_Permil_Template.rpt Page 1 of 1 m CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contmctor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and O I am exempt from licensure under the Contractor's State License Law for Professions Code and my�jt:nse is in full force and effect. the following reason: I License Class License/yypp..S 5 �SBy my signature below I acknowledge that,except for my personal residence Expires ignature T�cf�'tn which I must have resided for at least one year prior to completion of i/JI 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 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 ,,ww.Ieeinfo.ca.aov/calaw.htmL this permit is issued. Policy# Date Dyltave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT on 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I 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 Carrier �ITJ-11y with all applicable city and county ordinances and state laws relating to uIldN ` 2 enter the above identified l edauthorizero for inspection opu this city or county to Poli # / it s enter the above identified roe for ins ection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($SOD)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑I cert' that in the performance of the work for which this permit is issued, O wall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# ✓ J orker's 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 fort ' h Rly with th a/(rrovisions. Will the applicant or future building occupant handle hazardous material or a Applicant O Date mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WOR E 'S COMPENSATION COVERAGE IS ❑Yes s--a UNLAWFUL,AND SHALL SUBJECT AN E PLOYERTO 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(SCAOMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes §jV0 1 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 bou"ry of a school? (Section 3097 Civil Code) ❑Yes o`4 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 req under the State of Contractors License Law for the reason(s)indicated below by the California 5 ode,Secti 25505 and 25534 concerning hazardo smateria eportir) chec m kmark(s)I have placed next to the applicable Item(s)(Section 7031.5 U Business and Professions Code).Any city or county that requires a permit to �es � � 7 construct,alter,improve,demolish or repair any structure,prior to its PROPE WNER AUTHORIZED AGEt issuance,also requires the applicant for the permit to file a signed statement % that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION REPAIR AND PA T G RRP 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 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($500). managers who do the paint-disturbing work themselves or through their ❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.epv/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. �Y4o EPA Lead-Safe Certified Firm is required for this project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 70,K Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. Menifee DATE PERMIT/PLAN CHECK NUMBER FO-Tito ' p TYPE: O COMMERCIAL . IDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES- DESCRIPTION DESCRIPTION OF WORK i6 y U /o a nvt,6 ;f 3 PROJECTADDRESS 2R 4 1 , I qa4g$L6,() cj- ASSESSOR'S PARCEL NUMBER �I01144 LOT TRACT OWNER NAME ADDRESS Z-q fj}vC C/° PHONE ('I�Z5) 443-(D2-7L� EMAI APPLICANT NAME -- ADDRESS * ` 0R ( l(���y PHONE �� 3-L� �_ EMAIL f nCUll'C1 CONTRACTOR'S NAME OWNER BUILDER? O YES GPPQ BUSINESS NAME ADDRESS �' PHONE `�A &l ?,C( p �SS`1 EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION `t,J VALUATION$ /,)7(� , . SOFT 43 L SQ FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP p35133 INVOICE . am[, "�Q PAIDAMOUNT y0 AMOUNT ; 9A 1 0CASH 0 CHECK 4 OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK R O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department29714 Houn Rd. Menifee, CA 92586951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 OWNER ADDRESS 2� CITY g28g -. PHONE Q2, )443—p2 '-V LOT NO. TRACT APN City of fvienifee CONTRACTOR Building 8 S' tety Dept. ROOMS N' COVERS PROPOSED ADDITION(S) r7 2016 840 S ROCHESTER AVE#C 437 41 _ 'l rq' e ONTARIO, CA 91761 X. (p LIC. B-517575 909-390-0555 SDI i U , l rvi i � y WORK COMP SI f ICW GROUP WSA5000386-07 EXP6/14/2016 �CL�iV 1�1 � p �pcd Clow aves £%G'3CT LLC T,DJ -reps t / -'lt` OF Nitta"FE iik4GAN PART EN "d AFFGVAL 06 : I7lr � g p � J VIE E r, r rovai ;i these plar II not be Construed to be a permit foi or an .9 ,v.i of,any violation o any provisions of the federal,state o citytiomAndgrdina nce This set of approved plans must be pt on the jobsite until completion. S� STREET ^ fie'+"