PMT16-01442 City of Menifee Permit No.: PMT16-01442
29714 HAUN RD.
�ACCELA> MENIFEE,CA 92586 Type: Residential Addition
MENIFEE Date Issued: 06/09/2016
PERMIT
Site Address: 30454 WIDE PLAINS CT, MENIFEE, CA Parcel Number: 358-49D-.045
92584 Construction Cost: $4,625.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 12'x 4Y SOLID ALUMAWOOD PATIO COVER WITH 3 FANS,2 GFI OUTLETS
Work:
Owner Contractor
ANDY TAVAREZ PSLQ INC
30454 WIDE PLAINS COURT 28910 RANCHO CALIFORNIA RD
MENIFEE,CA 92584 #206
Applicant Phone: 9517954260
LOIS MONTINI License Number: 919885
PSLQ INC DBA GREENBEE
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description PA Amount IS)
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
$311A5
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_B1dg Permit_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 700D)of Division 3 of the Business and By my signature below I acknowledge that,except for my personal residence in
Professions Code and ry license is in full force and eff n (1. which I must have resided for at least one year prior to completion of
License Class Lice s o. �1 jj Improvements covered by this permit. I cannot legally sell a structure that I have
Expires _ _ ignature built as an owner-building if it has not been constructed in its entirety by licensed
r 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:
❑ 1 hereby affirm under penalty of perjury one of the following declarations: htto!/www.leainfo.ca.aov/calawhtml.
i have and will maintain a certificate of consent 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 cerlify to each of the following: I am the property
❑ 1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
section 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'compensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
Carrier ' fm�Y identified property for the inspection purposes.
Policy# (.U('i�o�D�' 1/J� Expires / (p 'L.t�'D Date
"7 3� Property Owner orAulhorized Agent
(This section need not be completed rf the permit is for City Business License# C��+o3
one-hundred dollars($100)or less)
HAZARDOUS MATERIAL DECLARATION
❑ 1 certify that in the performance of the work for which this permit is Issued,I
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 Oazardous material equal to or greater that the
subject to the wo �rs'compensation provisions of Section 3700 of the Labor amounts speec ration the Hazardous Materials Information Guide?
Code,I shall o .. h comply tth those Provisionsss... / •!�7 DYES GYRO
Applic t; ate; C-J�-�4 / 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 Quali anagement District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guideli
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES ❑NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed it id g r modified facility be within 100D feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of ool?
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES bNO
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 checklislt undo land my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health €€CCyy Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous die nal reporting.
OWNER BUILDER DECLARATIONS ❑Y
1 hereby affirm under penally of perjury that I am exempt from the Contractor's - Date 6;�/7
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR ALI bRIZED AGENT
next to the applicable item(s)(Section 7031.5. Business and Professions Code: EPA RENOVATION.REPAIR AND PAINTING fRRPI
Any city or county that requires a permit to construct, alter, improve,demolish,
or repair any structure,prior to its issuance, also requires the applicant for the
permit to file 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 State 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 Iicensure 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($500).) employees.For more information about EPA's Renovation Program visit:
www.spa.gowlead or contact the National Lead Information Center at
❑ I, as owner of the property, or my employees with wages as their sale 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; G(, -
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).
❑ 1, 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
W
_-
_ K{Y y
I
DATE 5 i PERMIT/PLAN CHECK NUMBER y
TYPE: ❑COMMERCIAL []RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑NEW ❑P<<LUMMBIN,,G__-❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
rPROJECTADDRESS OR'S PARCEL NUMBERLOT � TRACRTY OWNER'S NAME Z Building $ $atety Dept.
ADDRESS EMAIL MAY O J 20
PHONE
APPLICANT NAME
ADDRESS
PHONE -)V�J �J I EMAIL W S CO? 1O fv0
O OWNERBUILDER? ❑YES❑NO
CONTRACTOR'S NAME -f—n
BUSINESS NAME
ADDRESS G O u
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER L 7 LICENSE CLASSIFICATION
SQ FT �-- _ L SQ FT
VALUATION$ R r
DATE
APPLICANT'S SIGNATURE
a - CITY OF MEN[It FEE BUSINESS LICENSE NUMBER
DEPART MENTDISTRIBUTION _ 1�
BUILDING PLANNING ENGINEERING FIRE GREEN
SMIP
INVOICE PAID AMOUNT ` � G CASH 0 CHECK# 0 CREDIT CARD VISA/MC
AMOUNT
C CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK#
OWNER BUILDER VERIFIED OYES O NO DLNUMBER
NOTARIZED LETTER O YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. fVenifee, CA 92586 951 672 6777
www.cityojmenifee.us Inspection Request Line 951-246-6213
Andy Tavarez
Plot plan 30454 Wide Plains Ct.
Not to Scale Menifee, Ca. 92584
951-833-5106
480 sq. ft. Solid Top Alufnawood Patio Cover }
set at 9' high . Attached to the house and to the existing concrete slab. p.
(3) ceiling fans (2) outlets O
U
City of Menifee
Building & safety Dept.
LEDGER & TRACK MAY 0 9 2016
20' INSPECTION REQUIREPeceived
18' � El0 0 � 22
1 �
CITY OF MENIFEE
W fl UILDING AND SAFETY D PARTMENT
LAN APPROVAL
REVIEWED BY 101111
DATE
'Approval of these plans shall not be constru d to be a permR for,or an
Driveway approval of,any violation of any provisions of the federal,state or city
regulations and ordinances, This set of approved plans must be kept on the
jobsite until completion.
Sidewalk
Wide Plains Ct.