PMT16-01946 City of Menifee Permit No.: PMT16-01946
29714 HAUN RD.
cnCCELA? MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 0 612 31201 6
PERMIT
Site Address: 29101 LIGHTHOUSE CT, MENIFEE, CA Parcel Number: 333-381-004
92585 Construction Cost: $4,400.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 15'x 28'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS&6 LED LIGHTS
Work:
Owner Contractor
ESMERELDA VILLESCAZ PATIOS &MORE
29101 LIGHTHOUSE COURT 32897 MONTE DRIVE
MENIFEE, CA 92585 TEMECULA, CA 92592
Applicant Phone: 9519722000
TRACY ALVES License Number: 1001577
PATIOS&MORE
32897 MONTE DRIVE
TEMECULA, CA 92592
Fee Description Qtv Amount($1
Receptacle,Switch,Outlet&Fixture 8 151.00
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 7.55
$327.20
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 Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
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 Ucense No. i r By my signature below I acknowledge that,except for my personal residence
in which I must have resided for at least one year prior to completion of
Expires Signatr�� Y P P
improvements covered by this permit.I cannot legally sell a structure that 1
WORKER'S COMPENSATION DECLARATION 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.leainfo.ca.aav/calaw.html.
this permit is issued.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
❑I have and will maintain workers compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which o By my signature below l 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 Date
dollars($300)or less PROPERTY OWNER OR AUTHORIZED AGENT
I certify that in the performance of the work for which this permit is issued,
hall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwi comply with
those provisions. /� Will the applicant or future building occupant handle hazardous material or a
J Date�(lJ 2 z17��j mixture containing a hazardous material equal to or greater that the
Ap licant amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE t0r4ECURE WORKER'S COMPENSATION COVERAGE IS o Yes o No
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
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 forguldellnes
CONSTRUCTION LENDING AGENCY o Yes o 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) o Yes o No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the
Contractors License Law for the reason(s)indicated below by the California Health alSafety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
oyes o No
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(RRPI
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
o 1,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.eoa.eov/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 be 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. o 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 RAP rule please fill out the RRP
Acknowledgement.
BUILDING PERMIT/PLAN CHECK APPLICATION
®Menifee
DATE b PERMIT/PLAN CHECK NUMBER
TYPE: G COMMERCIAL XRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: D ADDITION 0 ALTERATION C DEMOLITION O ELECTRICAL 0 MECHANICAL
)(NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 4 /vm4W ✓ooJ Pa4ioCOep, SO/I �� e2 FCh5
6 ) ;s ats
PROJECTADDRESS �27 / d/ G'L, Me-ac4e e4 S
ASSESSOR'S PARCEL NUMBER LOT TRAM,,,City Of Menifee
dinPROPERTY OWNER'S NAME
ADDRESS 9(61 4 i_5 0,14-Ao u/c G C'n : c A 92'r3S
PHONE S li Z_- Y 13 - -7 7 Jr Z- EMAIL deceived
APPLICANT NAME 06r✓A A l ueS
ADDRESS 3.Z$97 J/ -Olc �lr. CyrfGu�a < p �l Zb %Z
PHONE ?,r/" 97Z- $o0o EMAIL /& GC+ -rj0
CONTRACTOR'S NAME eoijtr /4I ut OWNER BUILDER? O YES}$NO
BUSINESS NAME (a r of 1 kno ✓'C_
ADDRESS 3..? t3 7 /ncc, /c G(F. -� cGa 9ZS 1 =
PHONE f,5 7Z-a EMAIL %24Gcr 7 JiUtC_ Go+»
CONTRACTOR'S STATE LIC NUMBER 106 /,"-7 LICENSE CLASSIFICATION
VALUATION$ �<1y U( SO.FT /{Z U L SQ FT
APPLICANT'S SIGNATURE< RT DATE �-as-/
"r.
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP '-
INVOICE PAID AMOUNT �J�^
[AMOU
NTQ .:.bL I 'tl� `OCASH -CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT CASH 0CHECKN "CREDITCARD VISA/MC
WNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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JUN 2 3 2016
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CITY OF MENIFEE I
BUILDING AND SAFETY DEPAR MENT j
PLAN APPROVAL I
REVIEWED BY �tI—Iv—'
DATE
S 1 g L *Appr +dal of these plans shall not be construed to be permit for,or an I
appro al of,poViolation of any provis ons of the fed ral,sta a or city
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15A;2e � S 'de e
), a ulations and ordinance is set o a
a jobsite until completion. I C
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