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PMT16-01288 City of Menifee Permit No.: PMT16-01288 29714 HAUN RD. Type: Residential Addition <A_CCELA_ MENIFEE, CA 92586 MENIFEE Date Issued: 04/25/2016 PERMIT Site Address: 25310 WATER WHEEL CT, MENIFEE, CA Parcel Number: 358-421-013 92584 Construction Cost: $3,900.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL SOLID 450 SQ FT ALUMAWOOD PATIO COVER W/ELECTRICAL 2 LIGHTS, 1 FAN Work: Owner Contractor BO&TRINA CHAMBERS T F MEADOR CONSTRUCTION 25310 WATER WHEEL CT PO BOX 713 MENIFEE, CA 92584 WILDOMAR, CA 92595 Applicant Phone:9518376180 TOM MEADOR License Number: 639087 T F MEADOR CONSTRUCTION PO BOX 713 WILDOMAR, CA 92595 Fee Description Oft Amount($1 Receptacle, Switch,Outlet&Fixture 3 126.00 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 6.30 $300.96 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_Permit 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 I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from Iicensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. gg the following reason: License Class License No CP3 c O 7 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 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 70"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 tabor Code,for the performance of work for which wvnv.leeinfo.ca.aov/calaw.html. this permit is issued. Policy It Date ❑I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 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 owners behalf.I have read this number are: 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 construction.I authorize representatives of this city or county to Policy# Expires 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 I gfI certify that in the performance of the work for which this permit is issued, O Ashall 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 compensation provisio f Section 3700 of the Labor Code,I shalfforth It'com with those vra'isions. LL Will the applicant orfuture building occupant handle hazardous material or Applicant Date 1-/ mixture containing a hazardous material equal to or greater that the amounts�s}ecified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes WNo UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER 70 CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,0W),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 forgutd es 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 boyyfdary of a school? (Section 3097 Civil Code) ❑Yes o OWNER BUILDER DECLARATIONS 1 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 hazardous mate' I repar'n checkmark(s)I have placed next to the applicable items)(Section 7031.5 es ❑No„ij Business and Professions Code).Anycityorcounry that requiresa permitto I 7: Date 1% construct,alter,Improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING(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 Iicensure 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.eov/lead or contact the National Lead Information Center at not intended or offered forsale.(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. ❑No EPA Lead-Safe Certified Finn Is required for this project because: 01,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 70",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 ` 2 S (o PERMIT/PLAN CHECK NUMBER �y' olaps TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: X ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK C7 X 1-1 I UVT""✓I.J r'\, c VQ .0 Uvifk I in ht5 PROJECTADDRESS Z 5310 A-k(- G ASSESSOR'S PARCEL NUMBER �•. 8- �k` �3 LOT TRACT OWNER NAME SO Tn'S G(nc,VM ADDRESS .S�VIA-e- (/ L PHONE 310 - 7Z�—� D� J EMAIL APPLICANT NAME Y L r ADDRESS d U 1 L/J � y�c.,� (� I2-511S PHONE 1 S 1 - OR/37-- & 1 9-0 EMAIL CONTRACTOR'S NAME OWNER BUILDER? OYES NO BUSINESS NAME ADDRESS -5 PHONE S q/v-� Zq G EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION 3 o� 5b VALUATION $ 320 v- 54 FT LSQFT/�J G APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIF.EE�yISINE$ ENS NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP NVOICE p AMOUNT `5 PAID AMOUNT OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT I O CASH O CHECK# O CREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO City of Menifee Building &Safety Department 29714 HDun Rd. Menifee, CA 92586 951-672-5777 www.cityofinenifee.us Inspection Request Line 9S1-246-6213 Ii R�� Pro,p«ey Lt nt City of Menifee 3uilding & Safety Dept. APR 2 5 2016 Received GER & TRACK CTION REQUIRED Q y w V4 1 I OAP 17 0110 r J �o J1 ci fy OF AENIFEE BUILDINI i AND SAFETY DEPARTMENT PLAN AP ROVAL ..Ir 0 EVIEWE D B3��I� DATE 9 * pproval ofthempimshall not be construed to bea panit tor,or an a proval of,anytdinances. lation of any provisions of the federal,state of city re ulations and' This set of approved plans must be kept on the jo ite until camtion.