PMT16-01428 City of Menifee Permit No.: PMT16-01428
_ 29714 HAUN RD. Type: Residential Re-Roof
9ACCEL A? MENIFEE, CA 92586
MENIFEE Date Issued: 0 510 512 01 6
PERMIT
Site Address: 26145 ALLENTOWN DR, MENIFEE, CA Parcel Number: 335-274-020
92586 Construction Cost: $8,000.00
Existing Use: Proposed Use:
Description of REMOVE EXISTING SHINGLES, REPLACE W/OWENS CORNING ANTIQUE WHITE COMPOSITION
Work: COOL ROOF
Owner Contractor
JOSEPH BADALAMANTE TRIANGLE ROOFING
26145 ALLENTOWN DR 1392 ENCHANTED TRAILS
MENIFEE, CA 92586 SAN JACINTO, CA 92582
Applicant Phone: 8003606771
MAYNOR ALV AREZ License Number:790599
TRIANGLE ROOFING
1392 ENCHANTED TRAILS
SAN JACINTO, CA 92582
Fee Description Dty, Amount($1
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
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.
f
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 a I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class C-3 0\ license f fe
No. /`'es-1 '-% By my signature below I acknowledge that,except for my personal residence
Expires to 13 A i-I Signature +mil -mot 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
o l 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 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 www.le¢info.ca.eov/calaw.html.
this permit is issued.
Policy# 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 o By my signature below I certify to each of the follosing:I am the property
this permit is Issued.My worker's compensation insurance carrier and policy owner or authorized to act an the property owners behalf.I have read this
number are: application and the Information I have provided is correct.I agree to comply
Carriers r'fl 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 I o t L L fe enter the above Identified property for inspection purposes.
(This section need not to be win plated is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued, �t"/ �
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# O 9
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 pl�ywitt hose provisions. Will the applicantor future building occupant handle hazardous material or a
Applica / r� �— Date S S ��P mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS DYes 1t7Ql0
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(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ci Yes "'o
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) o Yes "4o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I understand my requirements underthe State of
Contractors license Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material rep rtin
ptks DN
Business and Professions Code).Any city or county that requires a permit to
Date
construct,alter,improve,demolish or repair any structure,prior to Its
issuance,also requires the applicant for the permit to file a signed statement PROPERTY O TIER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRP)
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
a 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 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 a An EPA Lead-Safe Certified Renovator will be responsible forthis 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:
u 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.
BUILDING ♦ SAFETY PERMIT/PLAN APPLICATION
Menifee
DATE S S 7I PERMIT/PLAN CHECK NUMBER 1 IV, t)1 0(b
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 &RE-ROOF-NUMBER OFF SQUARES 25 (0
DESCRIPTION
rOFWORK "1`P.wla �, 4EXfQ 9eY-NOD (�C^�
�c �. s,H c +as�•� s(t- rI��L �6
PROJECT ADDRESS 2(f
ASSESSOR'S PARCEL NUMBER
(( �� LOT �� TRACT
OWNER NAME Se?� -
ADDRESS r �¢_
PHONE Cis l / -7 2.3 I'S EMAIL
APPLICANTNAME VeL-C.4p
ADDRESS
PHONE .T� EMAIL ,'
CONTRACTOR'S NAME �'�a 'f-���1^'� OWNER BUILDER? O YES AD
BUSINESS NAME rw - `
ADDRESS t-- 1 Z �N�"�"'��' �hl S " +cL^ CA
PHONE (?66)3(C6— �� EMAIL q
CONTRACTOR'S STATE LIC NUMBER '7�6-S qq LICENSE CLASSIFICATION
VALUATION$ Ot�� 'n U SO FT 2S� L SO FT
APPLICANT'S SIGNATURE C ° --� DATE 5
CITYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION CITY OF MEj�IFE1U51NE55 LIlSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN ( SMIP �,fJ�
INVOICE 3�♦ PAIDAMOUNT
AMOUNT 5 O CASH O CHECK# C CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER C YES O 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
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