PMT16-01681 City of Menifee Permit No.: PMT16-01681
29714 HAUN RD. Type: Residential Addition
�ACCEL/? MENIFEE,CA 92586
MENIFEE Date Issued:
06I01/2016
PERMIT
Site Address: 31781 LIVINGSTON ST, MENIFEE, CA Parcel Number: 360-710-012
92584 Construction Cost: $6,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 12'x 35'SOLID/LATTICE ALUMAWOOD PATIO COVER WITH 2 FANS, 5 LIGHTS
Work:
Owner Contractor
JAMES RUSSELL PSLQ INC
31781 LIVINGSTON STREET 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 Oyt Amount IEI
Receptacle, Switch, Outlet&Fixture 7 146.00
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 7.30
$321.95
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
I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed
Chapter 9(commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044,Business and Professions
Professions Code arjo my license is in full fog a4d If t7 Code:The Contractor's License Law does not apply to an owner of a property
License Class License No. '� J who builds or improves thereon, and who contracts for the projects with a
Expires(J)ignature - licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors State License Law for the
❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that,except for my personal residence in
compensation,Issued by the Director of Industrial Relations as provided for by which I must have resided for at least one year prior to completion of
Section 3700 of the Labor Code, for the performance of work for which this improvements covered by this permit,I cannot legally sell a structure that I have
permit is issued.
Policy# built as an owner-building if it has not been constructed in its entirety by licensed
contractors. I understand that a ropy of the applicable law, Section 7044 of the
❑ 1 have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:hlto://www.leoinfo.ca.gov/calaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier 01/ rope ty Owner or uthodzed Agent Date
Expires �� l � Policy#
Name of Agent Phone# ❑ By my Signature below, 1 certify to each of the following: I am the property
owner or authorized to act on the property owner's behalf. I have read this
(This section need not be completed if the permit is for application and the information I have provided is correct I agree to comply
one-hundred dollars($100)or less) with all applicable city and county ordinances and slate laws relating to building
construction. thorize representatives of this city or county to enter the above-
0 1 certify that in the performance of the work for which this permit is issued,I identi y f r t e inspection urposes.
shall not employ any persons in any manner so as to become subject to the
workers'compensation laws of California, and agree that If I should become
subject to the workers'compensation provisions of lion 3700 of the Labor Property Ow er or Authorized Agent Date
Code,I she[ forthwil comply with those provisions. Q �
City Business License#
Date; Applicant
WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION, ❑YES OCCUPANT HANDLEA HAZARDOUS MATERIAL ORA
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES 9N9--'DUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE?
agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name OYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION...
Lender's Address �R9M-THE SOUTH COAST AIR QUALITY MANAGEMENT
LIwt DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS I GUIDE LINES
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reason(s)indicated below by the checkmark(s)I have placed OYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, gN�M
or repair any structure, prior to its issuance, also requires the applicant for the
pennit to file a signed statement that he or she is licensed pursuant to the
provisions of the Contractor's State License Law(Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or (DYES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to ❑MO UNDER-THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than(5500).) CODE, SECTIO 25505,25533 AND 25534 CONCERNING
❑ 1, as owner of the property, or my employees with wages as their sole HAZARDOUS M RIAL REPORTING.
compensation,will do( )all of or( )porting of the work,and the structure is PROP R A GE
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
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
purpose of sale).
City Df Menifee t.
Bu I
Menifee JUN 01 2016
DATE L' \W.0 PERMIT/PLAN CHECK NUMBERn�,Q 0jUS\RQQE Ived
TYPE: ❑COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑N�E�W F]PLUMBING El RE-ROOF-NUMBER OF SQUARES p�
DESCRIPTION OF WORK c5 `r C b6 .V
n h rn
PROJECT ADDRESS S ' L'v)
ASSESSOR'S PARCEL NUMBER �� •��p• (��, LOT TRACT '50k -
PROPERTY OWNER'S NAME \ /arr}� � I
ADDRESS L I y F 11n S ` e
PHONE Sl 1 EMAIL c
APPLICANT NAME
ADDRESS 10 od
PHONE C6 34-2)C EMAIL
CONTRACTOR'S NAME� �-�--!1V OWNER BUILDER? ❑YES NO
/,I
BUSINESS NAME e —
ADDRESS QYM
PHONE �{SI - (�?j��j EMAIL R
CONTRACTOR'S STATE LIC�NUMBER lJ �Iq 2 LICENSE CLASSIFICATION
VALUATION$ ,OLJ.J SQ FT L SO.FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS UCENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN - SMIP 1-
INVOICE Q� PAID AMOUNT /M�
AMOUNT 1'- IS 4;' 0CASH 0CHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0 CASH O CHECK# O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER Q YES O NO
City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
James Russell
Plot plan 31781 Livingston St.
Not to Scale Menifee, Ca. 92584
951-567-9158
432 sq ft of Solid / Lattice Combo Top Alumawood Patio Covers. Attached to the
house and to existing concrete slab. set at 9' High (2) ceiling fans and (5) lights
total. a Value $6000
City of Moifee
Building & Safety Dept.
LEDGER & TRACK JUN 0 1 2016
INSPECTION REQUIRED Received
10 '+ CL
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W
U
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LL
O�
35
29' ❑ ❑ ❑ ❑ 251 _' V
P° 156 sq ft. 264 sq ft. Solid
Lattice 6
CITY OF
BUILDING AND SAFETY DEPARI MENT
PLAN APPROVAL
MEN 5
REVIEWED BY 1°
, E
permit for,or an
a proval ot,anyvolation of any provisions of the fede al,state or city
r gulations and ordinances. This set of approved plan must be kept on the
j bsite until completion.
Sidewalk
Livingston St.