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PMT16-01171 City of Menifee Permit No.: PMT16-01171 29714 HAUN RD. Type: Commercial Re-Roof �AACCELAI7. MENIFEE, CA 92586 MENIFEE Date Issued: 04/18/2016 PERMIT Site Address: 26850 SUN CITY BLVD, MENIFEE, CA Parcel Number: 337-230-004 92586 Construction Cost: $25,272.00 Existing Use: Proposed Use: Description of INSTALL NEW CLASS A ROOF SHINGLES, BLOW IN INSULATION TO R-38 Work: Owner Contractor SUN CITY CIVIC ASSOCIATION BAKER ROOFING CORPORATION 26850 SUN CITY BLVD 29515 DUNKIRK STREET MENIFEE, CA 92586 MENIFEE, CA 92586 Applicant Phone:9512557237 LARRY BAKER License Number:884731 BAKER ROOFING CORPORATION 29515 DUNKIRK STREET MENIFEE, CA 92586 Fee Description ,O�t Amount Building Permit Issuance 1 27.00 Inspections not specified 129 129.07 GREEN FEE 1 2.00 New Construction Permit Fee 1 116.25 General Plan Maintenance Fee-New 1 5.81 Construction $280.13 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 staled,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_BId�LPermit_Template.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION ❑ 1 am exempt from licensure 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(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 my license is in full force and effect.0 I which I must have resided for at least one year prior to completion of License Class. 3�I Ucense oo... . k� I� improvements covered by this permit,I cannot legally sell a structure that I have Expires 1 Signatures a F-- " -, built as an owner-building if it has not been constructed in its entirety by licensed 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 is submitted or at the following Web site: I I hereby affirm under penalty is perjury one the following declarations: http:/A w .leginfo.ca gov/mlaw.html. 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. Property Owner or Authorized Agent Policy# ❑ By my Signature below, I certify to each of the following: I am the property C' I have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owners behalf. I have read this rsection 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'corn ensation insurance canter and policy number are: with all applicable city and county ordinances and state laws relating to building Cp construction.I authorize representatives of this city orcounty to enter the above- Cartier o�'ffil•��[°- r�,� l identified property for the Inspection purposes. Policy#t� -L�l�' Ct> Expires `�--j�� Date Property Owner or Authorized Agent (This section need not be completed if the permit is for City Business License# ©P;� one-hundred dollars($100)or less) ❑ I certify that in the performance of the work for which this permit is issued,I 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 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 amount specified on the Hazardous Materials Information Guide? Code,I shall forthwith comply with those provisions. ❑YES NO Applicant'�J'v`� Date; 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 guidelines -- SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND [I YES (u,yv0 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 of a school? LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑YES�NO 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 understand my requirements under the State of agency for the performance of the work which this permit is Issued (Section California Health&Safety Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardous watenal reporting. OWNER BUILDER DECLARATIONS ❑YES O I hereby affirm 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 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 rile 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 Slate 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(S500).) employees.For more information about EPA's Renovation Program visit: El I, as owner of the roe �.epa.gov/lead or contact the National Lead Information Center at p p rty, 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 is 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 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 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 Menyee, CA ydJoNb 9J1-612-0/// www.cityolmenyee.us Inspection Request Line 951-246-6213 BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION City of menlTeu r,:ullding & Safety Dept. f�lenifee APR 18 2016 PERMIT/PLAN CHECK nl� DATE y1ig111p NUMBER C � 1� ���W\/Qf TYPE: l COMMERCIAL O RESIDENTIAL o MULTI-FAMILY o MOBILE HOME o POOL/SPA o / SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION o ELECTRICAL O MECHANICAL o NEW O PLUMBING }i5 RE-ROOF APPLICATION I NAME 0.4J✓2 TLC PC/' /— DESCRIPTION OF p�Dul t(^ (�i15U(Q+f do �' 38 P� bvr`�d WORK J yR-cx>F5k ` ,, Les . PROJECT �� �� S �31 v d �a �•Q ADDRESS ASSESSOW S PARCEL NUMBER 33/��p- �'dcps—DfOL1 LOT TRACT OWNER NAME /y /C_ � / 'leA/ ADDRESS or t( d PHONE /-�t� �r�-1p7 EMAIL �t� � �� ca �$�[/�CITy G� ����C • APPLICANT L CXv frehCe_ g64er NAME ADDRESS aR 6-! J QJt r{c PHONE LC'l�t� �S � "�37 EMAIL Cc3 -'-. CONTRACTOR'S ( / NAME OWNERBUILDER? OYES NO BUSINESS NAME p3o � i 9 ADDRESS 2c{�[S�DJr. i✓�64 ' ^ IPA reer Ce :�Ta58� PHONE CQ -7 P3 EMAIL CONTRACTOR'S STATE LIC LICENSE cy NUMBER gSL(73) CLASSIFICATION C 3 w VALUATIONS,, -5! 3D SQ FT L SQ FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF NUNIFEE BUSINESS LICENSE BUQ,DING PLOWDVG ENGINE& VG NUMBER F Q SMIP x GREEN a INVOICEAMOUNT 4a go . . 15 PAID AMOUNT4d; f� 1 '� CVISASH O CHFCK V O CREDIT CARD IMC PLAN CHECK FEES PAID AMOUNT �v�+ O CASH O CFBiCK N o CREDIT CARD VISAIMC OWNER BUILDER VERIFIED O YES O NO LICENSE NUMBER NOTARIZED LETTER 0 YES 0 NO 0 O O w E N y E E z m m E E A 0 V n m O .. ` U m s c y — ^ C o 0 0 m z o� Um O C _c W W C Q ov LL ii Z O W y m •- _ K C .2O C G N O O y N C W O a c U r " y ¢ p U U cai E °u U D z ¢ ¢ z = = u ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ m y a y c N ¢ LL N cc LL N a ^ v � � T W O v y 13 o a o a ,?❑ W LL « c v a w t N u a V Q Q U1 1j U Uo,¢ a _C O C V Q ¢ F 4 IT O O d a Y o p ip n m m m a n m m CA > N v U a U - u m 0 o M o o m (y� d U p > � a _ _w LL n U o m NCY o j p u N J m o m o m v n a¢ � «m E!0 t O C. `J p m O T Z IL u s a ` a N ❑ ❑ E�° LL Q c a W s W LL m Z aZ 2 Z ¢` a a O m m D o Q G o LL > Z > > IL d a J_ N L J N L W Q O K V CO O N Yl L Q O W F O W W w in 1 IL o .� 'p' `o ~oa a a c Q UQ QJ z U E u U u W m Hs V` m O Wa w >0 WW > > u F ` C � ZU o aWC U W W C Q ei N RI V 10 I- F m o W U n Q O O O O O m U U W O O E C G N Z a E ZU W N 0 lJ � ❑ O C N U a ti O ah i u (0 W ti C 7 Z 15 w N h o N E v iw U c EO w _ c � N J W LL 3 0 O v j E u ti t v n a U N w o '3 o ua ti z o a c w u a y E uvi a° a ° v E c c o 'G o a c = y o w c c m u E G ,°� y `t• Y°, S o z w > C w y m o u s E w m u y o o a E F W o E 0 a v in w nu G 3 h w a we y a W W hap E u .m v = c o m m z « 0 > a aoa w E o n w m G a 10 E w v O w v a d: m rl ti a c t W a c E E 15 a N c e c o a o z o c O « m V! 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N 01 U a E N yl V E « y u w y° ;n m u O a 0 a O m E N a U O N O w N N v O d W 1O a0. w av o 00 v 0 m m a Q Ix v W ~ a y r W m c u L m o m c > v 80 o J v V o o w yOC -° 15 kR O v a a 0 Jc = R U 0 3 Z ^ c o a E t c c c p c E ° v c v W u a s u Z m u 1O 'v w « v ° N c wv W m ❑ V ❑ H m m O i Z `O Z o IL a 3 a' �I N c S v w m w a w ° w >, > o Q _ J � a ° u m a s gym, a a y v a u Q 'm N J N H 7 = - ry E m c y u C c a K O c F p in D O w ` c a c E o m v V w u_ °a, G � � °a v « a v m � 'LL-' E m a 0 a v � m pWwo O E p z `m 'Ga ' .5 a Ev 'a ° w i ° W li> �++ O a l7 E m a y m w '5 v E `m C yv c c LY J U U n W ❑ W O �' m c U p, O U N J p C o `W � t= w Z o m O o H = v ❑ ❑ ❑ c ma mmz « a °' u'^it '° " F / Z a. ) G W F N N (7 Q. _ 2 �-+ H m « .2 F U > v~iLuWi U w a G ui 2 `� `o ❑ ❑ z ❑ w ❑ mFa ❑ °z � �i Arm = j \ | \ 2 | G 0 Li \ * ] \ 0 / E } \ m ) ) ) \ f ) - 0 ( ) \ B k ® k } w 0 u { § I . y ( ` / k / / k - o ; § @ | { \ \ k ■ \ § ) ; § B \ / z B { j z ! � ) � \ } \ \ ` k � § ) � \ 99 , , � ` ! o ; & _ ! lL) U c � � § ; a \ \ ) 9L - 2 ! § § \ § Q -j0u E 2 w \ z z : ui8 � � , c - �kz > � G § / t e « ❑ _ Ewwu - - STATE OF CALIFORNIA ENVELOPE COMPONENT APPROACH CEC-NRCC-ENV-01-E Revised MMIYY CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-ENV-01-E Envelope Component Approach (Page 4 of 4) Pmject Name: Date Prepared; DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: t_ Documentation Author Sign ure: // L d-2c11P QY'P .1%L Company: Signature Date: Address:, C, CEA/HERS Certification Identification(if applicable): gyp' / r� ^7 �7 City/State/ZIP m e m -�'e�J CL�- C CT� O ib Phone: TCT i of s^5 - ( 3 / RESPONSIBLE PERSON'S DECLARATION STATEMENT l I certify the following under penalty of perjury,under the laws of the State of California: 1. The Information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance(responsible designer). 3. The energy features and performance specifications,materials,components,and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections.I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: L Responsible Designer Signature:l� Company: - ` Date Signed: L)_lq Y k�� i1 / Address: 5 �r �� 1 r ` license: Lr -7 3 ) City/state/Zip: r Phone: -7 3 CA Building Energy Efficiency Standards-2016 Nonresidential Compliance January 2016