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PMT16-01902 City of Menifee Permit No.: PMT16-01902 29714 HAUN RD. �A\CCEL/_> MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 0 611 612 01 6 PERMIT Site Address: 28897 CYPRESS POINT DR, MENIFEE, Parcel Number: 340-121-003 CA 92584 Construction Cost: $3,900.00 Existing Use: 1 &2 Family Residence Proposed use: Description of INSTALL 319 SF SOLID ALUMAWOOD PATIO COVER WITH 25 FANS,3 LIGHTS Work: Owner Contractor HOLLY MACARTHUR WEST COAST SIDING&TRIM 28897 CYPRESS POINT DRIVE 675 LACEY OAK DIRVE MENIFEE, CA 92584 CORONA, CA 92881 Applicant Phone: 9517353379 DANIEL SULLIVAN License Number: 615917 WEST COAST SIDING&TRIM 675 LACEY OAK DIRVE CORONA, CA 92881 Fee Description DIN Amount fsl 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 $311.45 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 property who builds or improves thereon,and who contracts for the projects I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractar(s)pursuant to the Contractors State License Law). �� Chapter9(commencing with section 7000)of Division 3 of the Business and o Qexemptfrom licensure underthe Contractors State License Law for Professions Cade anddry license Is in full force and effect./ the following reason: License Class l� Lic se o.4(011 By my signature below I acknowledge that,except for my personal residence Expires Signature I in which I must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by ❑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 ap lication is.submitted or at the following website: by Section 3700 of the Labor Code,for the performance of work for which this permit is issued. ww .le tf a. ov calaw.html. Policy k Date �1 have and will maintain workers compensation insurance,as required by PROPS TY OWN ER 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 fallowing:l 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 Carrier &41911AN with all applica le city and county ordinances and state laws relating to building r coon.I authorize representatives of this city or county to Policylf � 6655Z Expires i��l(6 enter eab eidenti ed property for inspection purposes. (This section need not to be completed is the permit is for one-hundred _ Date dollars($100)or less PRO l5'O NER OR AUTHORIZED AGENT Cpertify that in the performance of the work for which this permit is issued, hall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE p workers compens,ion laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to thems or eY,s compensation provisions of Section 3700 of the Labor Code,I shall.fo n comp]with those provisions. Will the applicant or future building occupant handle hazardous material or mixture containing a hazardous material equal to or greater that the Applicant Date V Its amounts specified on the Hazardous Materials Information Guide? WARNING:F ILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes q(No UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the iY.-nded 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 ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCNON LENDING AGENCY ❑Yes 0. 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 1p Np OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt From the permitting checklist.I understand my requirements underthe State of Contractors License Law for the reason(s)Indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable item(5)(Section 7031.5 oyes fi�o Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT issuance,also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING MRPI 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 licensure receiving compensation for most work that disturbs paint in a.pre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with an 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 ❑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( )all of or( )portion of the work,and the structure is www.et)a.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible forthis 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 rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION �t-. Menifee DATE (/ 16 ' M PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL O RESIDENTIAL C MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION *ALTERATION O DEMOLITION C ELECTRICAL O MECHANICAL O NEW O PLUMBI11NG OI RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 1 j w ',I;O 0( 3 5 PROJECTADDRESS li (/SS ,•�� ASSESSOR'S PARCEL NUMBER -_ (� ^��\ ^�� LOT TRACT OWNER NAME I le (4u/ City of Menitee Building & SaMity Dept. ADDRESS "L C - prj Ila 4 PHONE '�'5 [ - '� EMAIL APPLICANT NAME ADDRESS b715 //,�P.. CJl- G✓I^ Z�6� PHONE `� j -' '�?" 'SJI� EMAIL CONTRACTOR'S NAME I, n OWNER BUILDER? O YES 3<NO BUSINESS NAME (aNi I �i /11P✓c ADDRESS k25 I L'j K (- dVl a121 PHONE 0131, i97 - q)W EMAIL CONTRACTOR'S STATE LIC NUMBER ,j 77�1�7 LICENSE CLASSIFICATION L VALUATION$ �� SO FT L SQ FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP F M INVOICE PAIDAMOUW 2 , 1G AMOUNT .i1\'`�1r.� 3��-IS OCASH O{HECK# OCREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZEDLETTER O YES O NO City of Menifee Building&Safety Deportment 29714 Haun Rd. Menifee; CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 �,Lr) AI�w ram) P�+�'r, 6ji-ar 319 5F k 3 Imird5 1 2- f r6 kl�ll� ��I�nCv�tktw� g51 ' 371' 3l2 Z`�`fPi� tyffe-s Qotnr A iUPni¢[e �'t5 Sri gilt - O City of Menitee U Building & Safety Dept. LU JUN 16 2016 O LL LEDGER & TRA K Deceived LL INSPECTION REQUIRED O' CITY OF MENIFEE BUILDING AND SAF ry 11EPARTMENT PLAN APPROVAL �L REVIEWED BY Ju U ��,t� • DATE *Approval of these plans shall not a construed to be a permit for,or an approval of,any violation of any pr visions of the federal,state or city �5 regulations and ordi nces. This s t of approved plans must be kept on the I »r �i,