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PMT16-01627 City of Menifee Permit No. PMT16-01627 29714 HAUN RD. Type: Residential Addition '�1C:CELA-> MENIFEE, CA 92586 MENIFEE Date Issued: 05/25/2016 PERMIT Site Address: 26573 REED CT, MENIFEE, CA 92584 Parcel Number: 360-720-012 Construction Cost: $1,500.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 200 SQ FT SOLID ALUMAWOOD PATIO COVER NO ELECTRICAL Work: Owner Contractor LEA&MATT SUMMERS - BOBBY BURGESS 26573 REED CT 25772 CASA FANTASTICO MENIFEE, CA 92584 MORENO VALLEY, CA 92551 Applicant Phone:9512149988 ROBERT BURGESS License Number.974368 BOBBY BURGESS 25772 CASA FANTASTICO MORENO VALLEY, CA 92551 Fee Description Oty Amount fEl 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 $168.65 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 I hereby affirm under penalty of perjurythat 1 am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o 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 �,�3 Licen By my signature below i acknowledge that,except for my personal residence Expires 30 L� Signature Z in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I have built as an owner-builder If it has not been constructed in its entirety by o 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 workers 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.Iuinfo.ca.gov/caIaw.htmI.permit is issued. Policy# Date o I have and will maintain workers 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 workers 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 with all applicable city and county ordinances and state laws relating to Carrier 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 dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT certify that In the performance of the work for which this permit is issued, �f✓1_/.�` I D I shall not emolov any persons In any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation law of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers oiensation provisions of Section 3700 of the Labor Code,I shall forthwit I plywith those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date V� `, -ILe mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO WCURE WORKER'S COMPENSATION COVERAGE IS o Yes ANo 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 IN SECTION N TO OF COST LABOR CODE,INTERTION,DAMADATTOGES AS REYSFEOVIDED 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 oyes -(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 boundary of a school? (Section 3097 Civil Code) ❑Yes ANo OWNER BUILDER DECLARATIONS 1 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 understand my requirements underthe State of 4 Contractors License Law for the reason(s)indicated below by the California Heaterial r o lg. lth&Safe CA/ e, ecteon 25505 and 25534 concerning checkmark(s)I have placed nett to the applicable item hazardous mas)(Section 7031.5 oyes r}eNo )))Business and Professions Code).Any city or county that requires a permit to Date -J td construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OWNER OR IZED AGENT issuance,also requires the applicant for the permit to file a signed statement that he orshe is licensed pursuant to the provisions of the Contractors 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 apre-1978 and the basis for the alleged exemption.Any violation of Section 70315 by receiving compenor sation facility to beork that firms poi and in with than Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their o I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( I all of or( I portion of the work,and the structure is www.eoa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will he responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that It was not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP role please fill out the RRP Acknowledgement APPLICATION& SAFETY PERM IT/PLAN CHECK - -,Menifee DATE n •Z�J '10LL PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL kkESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL ONEW OPLUMBING ORE-ROUuO''F-NUMBER OFFSQUTARES r�� DESCRIPTION OF WORK A$ 0„ $elI t'I�I"m14uM (aTI D SOU PROJECTADDRESS "�-I�b�3 R-e,,-17�cli 2c� ASSESSOR'S PARCEL NUMBER E)`a- LOT _ TRACT OWNER NAME R 2.q t y SDM S ADDRESS Uo51.3 A PHONE g51 -103 218 6*2i 1 EMAIL APPLICANT NAME o �6 W 5S ADDRESS Z 11t FD..vTes 'o U " wLM VR PHONE a! t--bN.jq 6 EMAIL CONTRACTOR'S NAME 4LUfC/Sa yr SS OWNER BUILDER? O YES r NO BUSINESS NAME oa o ADDRESS 15112, GSo, r.•,l�sr,ep J 7 �q PHONE �5 2/y•ggB EMAIL wJ+v� Ss y5 r3T A'VL/. h.>7 CONTRACTOR'S STATE LIC NUMBER a 1 3�B LICENSE CLASSIFICATION Clo VALUATION$ L � a 0 SO FT Zz) O L SO FT APPLICANT'S SIGNATURE DATE 1) 'Zh «° DEPARTMENT DISTRIBUTION r CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I p SMIP I� 3 0 INVOICE AMOUNT PAID AMOUNT IVg'� 0CASH 0 CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building& Safety Department29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 City of Menlfee Building & Safety Dept. MAY 2 5 2016 SITE PLJG%ER UTRACK SIT ADDRESS uo5q-3 t F eccivl r ASSESSORS PARCE; -;NWMBEA Leo t �� S�rtm2r5 iL ir,EG AND SAFETY DEPARTMENT Provide MO1t Arrow pp : VD ��PoAvC t ,7 DATE So1� Co'jcr construed 'Apr,roval of these plans shall to be a permit for,cr an approval of,any violation of any pronsions of the federal,state or city S rer.L,+ions and ordinances. This set of approved plans must be Pt on the S icbs to until comp!et!on. f; P P R P 4 o Xx ?P-}iot Ito Tt L 25 � 3$ E 1-MOKI a PIRIGPE 71% LIFE 284-199 (Rev. 06/2009) . City of Menifee Building & Safety Dept. MAY 2 5 2016 Received 1-M PLAH 'DGER & TRAM REQUIRED saY> nat�R ss 2�5q 3 R 'N�WECTION R BI_i+,Lp1n;G AND SAF PL A,M APPF:'OVAL A�� h Provide North Arrow oowg Bf r- f eA N o 11 C4 J u permit for,or an S o`r a plans shall "-he construed to a php,,val of these p n visions of the le.deral,state or cit on the app;uvai oi,any violation of any p ' roved plans must be kept regulations and ordinances. This set of app S lobsite until Completion. E 01 P P E Gin x ' L �5 x Gil 3B .. �,Aag FRONT PROPERTY LKNE 284-199 (Rev. 06/2009) .