PMT16-01830 City of Menifee Permit No.: PMT16-01830
29714 HAUN RD.
�CCELA> MENIFEE,CA 92586 Type: Residential Addition
MENIFEE Date Issued:
06/14/2016
PERMIT
Site Address: 29170 BLUE SPRUCE CIR, MENIFEE, CA Parcel Number: 339- 43-012
92584 Construction Cost: $2,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 12'x 14'SOLID ALUMAWOOD PATIO COVER WITH 1 FAN,2 LIGHTS
Work:
Owner Contractor
KRISTEN REID PSLQ INC
29170 BLUE SPRUCE CIRCLE 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 Oft Amount 1E1
Receptacle,Switch, Outlet&Fixture 3 126.00
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 6.30
$300.95
The issuance of this permit shall not prevent the building official from thereafter requidng 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 ❑ lam 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 7000)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 (). which I must have resided for at least one year prior to completion of
License Class Uce s/, o. Y 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
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, http://www.leginfo.ca.gov/calaw.htmi.
I have and will maintain a certificate of consentt for workers;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 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 carrier and policy number are: with all applicable city and county,ordinances and slate laws relating to building
construction.I authorize representatives of this city or county to enter the above-
Carrier � �t identified property for the inspection purposes.
Policy# W011a!/yD601 Expires / 1� ' Date
L� Property Owner orAulhorized Agent
(This section need not be comp)3dgf the permit is far City Business License# ��q03
one-hundred dollars($100)or less)
❑ 1 certify that in the performance of the work for which this permit is Issued,I 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 9!h compensation provisions of Section 3700 of the Labor amounts spec' on the Hazardous Materials Information Guide?
Code,I shall o w h comply ilh those provisions. / I/— ❑YES f3�N0
Applic t; ete; � L � /ICJ 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 ❑YES ❑NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Wi11 the proposed it rd 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 b 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 checkiist I und�tand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health 5 €h'Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous diet nal reporting.
OWNER BUILDER DECLARATIONS ❑Y — -7
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Date 6�
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR A4141DRIZEDAGENT
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(RRP)
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 licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by anyApplirant 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.gov4ead 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 . /1
not intended or offered for sale.(Section 7044,Business and Professions Code; GL
The Contractors 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).
❑ 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 Contractors 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 State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
-
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DATE �( '�� r PERMIT/PLAN CHECK NUMBER 0\ 3
TYPE: ❑COMMERCIAL ❑RESIDENTIAL ❑MULTI-FAMILY QMOBILE HOME ❑PODL/SPA Q'SIGN
SUBTYPE: []ADDITION DALTERATION ❑DEMOLITION FIELECTRICAL []MECHANICAL
NEW ❑PLUMBING'-❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS CAM slu
ASSESSOR'S PARCEL NUMBER - �d
LOT TRACT
PROPERTY OWNER'S NAME IS Clty &Sty Dept.
ADDRESS - 4 2016
EMAIL
PHONE �iTj� C� •
APPLICANTNAME`
QQ 1(�
ADDRESS EMAIL aGD�I} V ' �uo.6'
PHONE 1lJ `J � t/' ' v l `
OWNER�DER? ❑YES®NO
CONTRACTOR'S NAME
BUSINESS NAME nx-
ADDRESS
PHONE
CIsngaiD �OD f � l
EMAIL .r
LICENSE CLASSIFICATION
CONTRACTOR'S STATE LIC NUMBER
rA, SO FT LSQFT
LUATION$ V
DATE
APPLICANT'S SIGNATURE -
c CITY OF MENIFEE BUSINESS LICENSE NUMBER
DEPARTMENT DISTRIBUTION SMIP
BUILDING PLANNING ENGINEERING FIRE GREEN 0CREDIT CARD VISA/MC
INVOICE :OF
J PAIDAMOUNT �j� Q5 OCASH OCHECK#
AMOUNT `�
PLAN O CASH
CI CHECK# G CREDIT CARD VISA/MC
CHECK FEES PAID AMOUNT
OWNEP.BUILDER VEP,IFIED AYES � NO DL NUMBER
NOTARIZED LETTER 0 YES O NO
City of Menifee Building&Safety Deportment
HDun Rd, Menijee, CA 92596 951-672-6777
www.cityofinenifee.u5 inspection Request Line 951-246-6213
Plot plan Kristen Reid
Not to Scale 29170 Blue Spruce Cir.
Menifee, Ca. 92584
- - —=- 949-533-0409
168 sq. ft. Solid Alumawood Patio Covers. Attached to the house and to the
existing concreteslab. 9.0' high (1) fan (2) lilg tts >,,
yLY Set at >kb :e ceiling Value $2000 CL,
U
City of Menifee 11j
Building & Safety Dept. U
LEDGER & TRACK JUN 14 2016 LL
INSPECTION REQUIRED 21' LL
Received
� 14'
39' 1�. 7'
22
C
CITY OF MENIFEE
BUILDING AND SAFETY rEPAF TMENT
PLAN APPROVALp I
REVIEW ID BY L�ft
DATE
'Approval of these plans shall not be construed totes pesmitfor,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
Blue Spruce Cir.