PMT16-01829 City of Menifee Permit No.: PMT16-01829
29714 HAUN RD. Type: Residential Addition
�CCEL/-> MENIFEE,CA 92586
MENIFEE Date Issued:
O6/14/2016
PERMIT
Site Address: 26553TRUMBLE RD, MENIFEE, CA Parcel Number: 331-461-064
92585 Construction Cost: $7,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 16'x 42'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS, 12 LED LIGHTS
Work:
Owner Contractor
BRIAN PALMER PSLQ INC
26553 TRUMBLE ROAD 28910 RANCHO CALIFORNIA RD
MENIFEE, CA 92585 #206
Applicant Phone:9517954260
LOIS MONTINI License Number.919885
PSLQ INC DBA GREENBEE
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description Qtv Amount 1$1
Receptacle, Switch, Outlet&Fixture 14 181.00
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 9.05
$358.70
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 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 ❑ 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 license is in full force and eff n (l, which I must have resided for at least one year prior to completion of
License Class Lice s o. q improvements covered by this permit, I cannot legally sell a structure that I have
Expires - fgnature i 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:
❑ I hereby affirm under penalty of perjury one the following declarations: htto://www.leginfo.m.aov/mlaw.html.
I have and will maintain a certificate of consentt 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 certify 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 owners behalf. 1 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 carierand policy number are: with all applicable city and county ordinances and state laws relating to building
�,^ n construction.I authorize representatives of this city or county to enter the above-
Carrier / (��}-��-1py�( identified property for the inspection purposes.
Policy# W i l 01V 10161 Expires / (p "/ Date
L� Property Owner or Authorized Agent �
(This section need not be comp)3d4f the permit is for City Business License# ��-TO3
one-hundred dollars($100)or less)
❑ I certify that in the performance of the work for which this permit is issued,1 HAZARDOUS MATERIAL DECLARATION
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 a azardous material equal to or greater that the
subject to the wo rs'compensation provisions of Section 3700 of the Labor amounts spec r on the Hazardous Materials Information Guide?
Code,I sNOWh comply ith those provisionns. ❑YES C3-ROApp 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, Wi11 the proposed it id g r modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of ool?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES NO
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 checklist.I unde land my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health 4-Wgty Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous dia nt€`al reporting.
OWNER BUILDER DECLARATIONS ❑Y
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's Date //
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AU 'ORIZED AGENT
next to the applicable item(s)(Section 7031.5.Business and Professions Code:
Any city or county that requires a permit to construct, alter,improve,demolish, EPA RENOVATION,REPAIR AND PAINTING(RRP1
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 licensors 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.epa.gov/lead or contact the National Lead Information Center at
I, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the work,and the structure is �l r
not intended or offered for sale.(Section 7044,Business and Professions Code; G(,
The Contractor's Slate 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 wfll have the burden of proving that it was not built or improved for the Finn Certification No.:
purpose of sale).
❑ I, 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
licensed contractor(s)pursuant to the Contractors Stale License Law). If your project does not comply with EPA RRP rule please fill out the RRP
sz�-9 �4/.Wi ib�v g
DATE PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN
SUBTYPE: []ADDITION [-]ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
❑NF\Al noIIIMBING-❑RE-ROOF-NUMBEROFSQUARES Q
DESCRIPTION OF WORK l.J� !�' �'
2 L.eD
PROJECT ADDRESS
�ulmlde �Cee.e �
TRAM
ASSESSOR'S PARCEL NUMBER _��� fyU� nl nt n�-1 LOT ,
PROPERTY OWNER'S NAME kan
ADDRESS �y
PHONE �bq1b2� EMAIL a '
APPLICANTNACM�E (� li
ADDRESS a� 11 V D W
EMAIL
PHONE 101 �J I��
OWNER_ BUILDER? ❑YES❑NO
CONTRACTOR'S NAME
BUSINESS NAME II - `A
ADDRESS C O,rt {�-r t
PHONE �151��U/ ' " UD EMAIL 'r
LICENSE CLASSIFICATION
CONTRASTt�STATE LIC NUMBER .� E
(� L SQ FT
VALUATION$ SO FT�""�
DATE
APPLICANT'S SIGNATURE
t a CITY OF MENIFEE BUSINESS LICENSE NUMBER
DEPARTMENT DISTRIBUTION l� SMIP
BUILDING PLANNING ENGfNEEP.ING FIRE GREEN TT 0CREDIT CARD VISA/MC
INVOICE '. �O PAIDAMOUNT 3 v O CASH C%CHE[K;#
AMOUNT
DCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0 cAsH O[HECK
NOTARIZED LETTER O YES 0 NO
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
Brian Palmer
Plot plan 26553 Trumble Rd.
Not to Scale Menifee, Ca. 92584
909-762-5494
672 sq. ft. Solid Alumawood Patio Covers. Attached to the house and to
the existing Concrete slab. (2) Ceiling Fan and (12) LED ceiling lights.
City of Menifee
Bulldin9 & Safety Dept' O
LEDGER & TRACK 401 JUN 14 2016 W
INSPECTION REQUIRES Received U
LL
U.
O
¢ 2!
�10 " ❑ ® ❑ ® ❑ ® ❑ ® ❑ $.
Cl-qENIFEE T
BUILMAND SAFETY ['EPARTM
PLAN APPROVAL 9
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BYDAT
oran•Approve rovisioncityapproval of, nYyWnY Pon theregulations d ordinances. This set of aprovepept
jobsite until ompletion,
Sidewalk
Trumble Rd.