PMT16-01361 City of Menifee Permit No.: PMT16-01361
29714 HAUN RD. Type: Residential Addition
�CCELA? MENIFEE, CA 92586
`"1-11s"`"'"' MENIFEE Date Issued: 0 412 912 01 6
PERMIT
Site Address: 29487 CORTE VISTA LN,MENIFEE, CA Parcel Number: 340-571-016
92584 Construction Cost: $4,445.00
Existing Use: 1 &2 Family Residence Proposed use:
Description of INSTALL 480 SQ FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 2 FANS,3 POSTLIGHTS
Work:
Owner Contractor
JEFF CARRICO SOUTHERN CALIFORNIA PATIOS
29487 CORTE VISTA LN 1787 PAMONA DR#B
MENIFEE, CA 92584 CORONA,CA 92880
Applicant Phone: 9098161288
SOPHIA KING License Number:948536
SOUTHERN CALIFORNIA PATIOS
1787 PAMONA DR#B
CORONA, CA 92880
Fee Description 01t y Amount(SI
Receptacle, Switch, Outlet&Fixture 5 136.00
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 6.80
$311.45
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 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_81dg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I herebyaffirm under with a licensed contractor(s)pursuant to the Contractors State License Law).
penalty of perjury that I am under provisions of
Chapmr9(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 Li se No. By my signature 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 J have built as an owner-builder if it has not been constructed in its entirety by
NQ hereby affirm under penalty of perjury one of the following dedarations: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 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
this permit is issued. ,,y,Nyv.leeinfo.ca.eov/calaw.html.
l � —Policy# q ' /_ �j
1� Date
PROPERTY OWNER OR AUTHORIZED AGENT
❑I have and will maintain workers compensation insurance,as required by
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 workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number are:
y,�1 O /` ��/t `/ `,t n�/� /' application and the information I have provided is correct.I agree to comply
Carrier 1 V1K l Y f Ill IJL�i 1 l I1 1 I y 1 0. with all applicable city and county ordinances and state laws relating to
^ r��R building construction.l authorize representatives of this city or county to
Policy# 1 Ll 119 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
certify that in the performance of the work for which this permit is issued,
all not emolov any persons in any manner so as to became subject to the CITY BUSINESS LICENSE#
workers compensation laws of Califo 'a,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject tot workers compens;tin pr visionsof5ection 3700ofthe Labor
Code,I shall hwith comply wit rovisions. Will the applicant orfuture building occupant handle hazardous material or a
��Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:F URE TO SECURE W RKER'S MPENSATION COVERAGE IS ❑Yes (yqo
UNLAWFUL,AND SHALL SUBJECT AN EMP YER 70 CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UPTO ONE HUNDRED THOUSAND DOLLARS($300,000),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(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes Ir0
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 boundary of a school?
(Section 3097 Civil Code) ❑Yes tkQo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that 1 am exemptfrom the permitting checklist.I unders[ nd my requirements underthe State of
Contractors License Law for the reason(s)Indicated below by the California Health&Safe de,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable items)(Section 7031.5 ha rdous material repo ng.
Business and Professions Code).Any city or county that requiresa permitto DNo ,
Date
construct,alter,improve,demolish or repair any structure,signets its PRO Tf NER OR THORIZED GENT
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 R NOVATION.REP IR AND PAINTING IRRPj
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.eoa.aov/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. ❑No 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 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.
SAFETYBUILDING & . • APPLICATION
`3`Menifee
DATE 1 2� ��1 V PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL * 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 O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK U 00CAGAIDC
PROJECTADDRESS 2�1 p ClX'�L V�v\V\ �Y� "r eCA
ASSESSOR'S PARCEL NUMBER
/�r'+/ r� LOT TRACT
OWNER NAME Q, l U �I CID ADDRESS 2 q q I D( vbkv Ln
�p ^
'v`
PHONE n2 - 2,92 • gj '-
� �r'L� EMAIL
APPLICANTNAME
ADDRESS
PHONE( 'g:�j I K - 315 EMAIL 0b
CONTRACTOR'S NAME `C /' q� �/�� /� OWNER BUILDER? OYES ONO
BUSINESS NAME I l C(A � 1 \) VL VM/ +Q �/� /��
ADDRESS/� 'E W VI U b 1 I CA � ��r-�
PHONE ("10q) Y� -, L]S D rrEMAIL l 11 V o-
CONTRACTOR'S STATE LIC NUMBER �� ')lIl'' LICENSE CLASSIFICATION
VALUATION$ S S �[ LSQ FT
I.APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP
INVOICE � /�5 PAID AMOUNT
AMOUNT �•J I I I OCASH O CHECK# OCREOIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED DYES O NO DLNUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-6 72-6777
www.cityofinenifee.us Inspection Request Line 951-245-6213
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2,'7i Li q)-1 Cow E Vts �N
M-EN ,
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City of Menifee
Doilding & Safety Dept.
LEDGER & TRACK APR 2 9 2016
CITY OF MENIFEE " PFCTION REOUIRED Received
BUILDING AND SAFETY DEPARTMENT
PLAN APP
REVIEWE BY '�
F-DATE
'Approval of thes plans shall not be construed to be a permit for,Oran
approval of,any vi lation of any provisions of the federal,state or city
regulations and or linarces. This set of approved plans must be kept on the
jobsite until comp)!tion,
3U F'T
Sam
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