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PMT16-02101 City of Menifee Permit No.: PMT16-02101 29714 HAUN RD. Type: Residential Plumbing �CCELA-' MENIFEE,CA 92586 MENIFEE Date Issued: 07/0612016 PERMIT Site Address: 29715 GLENNEYRE WAY, MENIFEE, CA Parcel Number: 364-380-021 92584 Construction Cost: $375.00 Existing Use: Proposed Use: Description of UNDERGROUND ELECTRICAL CONDUIT&GAS LINE FOR FUTURE USE Work: Owner Contractor ROGER LOGAN BRIAN'S CONCRETE SERVICE 29715 GLENNEYRE WAY P 0 BOX 17490 MENIFEE, CA 92584 ANAHEIM, CA 92817 Applicant Phone: 9493373413 BRIAN LOGUE License Number:868289 BRIAN'S CONCRETE SERVICE P 0 BOX 17490 ANAHEIM, CA 92817 Fee Description gty Amount(S) Plumbing Fixtures and Vents,fixtures 1 116.00 Building Permit Issuance 1 27.00 Inspections not specified 116 116.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 5.80 General Plan Maintenance Fee-Plumbing 1 5.80 $271.60 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 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 effgAt� 2 p� the following reason: License Class G 8 License Ncc�� O By my signature below I acknowledge that,except for my personal residence ExpiresSignature / in which l must have resided for at least one year prior to completion of 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 l 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,lezinfo.ca.cov/calaw.html. this permit is issued. Policy 8 Date PROPERTY OWNER OR AUTHORIZED AGENT o 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 I 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 Carrier ✓ -al Ar- lqmdl with all applicable city and county ordinances and state laws relating to p huilding construction.I authorize representatives of this city or county to Policyfi Expires f/U 116 enter the above identified property for inspection purposes. (This section need not to be completed Is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT o I certify that in the performance of the work for which this permit is issued, I shall not employ 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 forthwl comply with those provisions. Will the applicant or future building occupant handle hazardous material or a r W mixture containing a hazardous material equal to or greater that the Applicant /��Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes No UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future huilding 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 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY Dyes NNo 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 cjwo 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 under the State of California Health&Safety Code,Section 255D5 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 dales N,> Business and Professions Code).Any city or county that requires a permit to -J o]��— 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 IRRP) License Law(Chapter 9(commencing with Section 700D)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.epa.eov/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 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. ❑No EPA Lead-Safe Certified Firm is required far this project because: o 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 Menifee DATE 7 PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL k<RESIDENTIAL 0- MULTI-FAMILY O MOBILE HOME O POOL/SPA C SIGN SUBTYPE: O ADDITION O ALTERATION C DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK V1 d L.L 76 P1 d 11 l' A`kk r �ti� to✓t G�� PROJECT ADDRESS e��7 �! n I Gl/,,VY Pi Y'z ASSESSOR'S PARCEL NUMBER 3 L4A-39D-OA Q LOT C' 1 TRACT OWNER NAME v b! • r ADDRESS 2oj-) 15� t Ci& PHONE (9S Q 3�2 S 1 c)? EMAIL APPLICANT NAME I (I V ADDRESS PHONE (Htd�) a12 --54 I'3 EMAIL CONTRACTOR'S NAME OWNER BUILDER? C YES C9 O BUSINESS NAME "1r S Gc��Gv-c�'�-Z_ .Se`�D I L-e� cC�� ADDRESS l a, ZCJ PHONE�t{°l) 3 � -3 4 3 EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION C`� VALUATION$ ''3-1 SO FT L SQ FT APPLICANT'S SIGNATURE DATE ! �� CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION \ CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT n, A CCASH OCHECK# CREDIT CARD VISA/MC MOUNT PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# 0CREDIT CARD VISA/Mc OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586951-672-6777 www.cityofmenifee.us Inspection Request Line 951-246-6213 PLOT/SITE PLAN REAR PROPERTY LINE City of Menifee Building & Safety Dept. CITY OF MENIFEE BUILDING AND SAFETY DEPARTMENT JUL 0 6 2016 PLAN APPROVAL Received �J REVIEWED BY f1oR� I �0 DATE 'Aporwal of these plans snail: . '> •«ued to be a permit for,or an approval of,any violation of any prc•,,stons of the federal,state or city regulations and ordinances. This set of approved plans must be kept on the jobsite until completion. w w z Z J J CY Q S<�'Ut�J � Lv C) w C� �u��r o � a 1 � \ 1 " MEND c• � V r FRONT PROPERTY LINE 9 Property Owners Nome /�Z01:�7I Cv��ccn r Property Address a-97 i s— Show all Property Lines SAMPLE PLOT/SITE PLAN Provide location, height and lineal and indicate any slopes footage of all proposed block or wood on the property fences and block retaining walls ------- ------------- ---- ---I Distance 5'-0" Min. Pools only, all other structures Ml Distance 19-0" Min I Dis a� Io'-0" Dimension Dist ¢ 5'-0" "n I Show proposed and/or ' lance 5'- Min existing additions and Distal a 5'-0" identify use, ie... Roam Addition, Patio Lover, I Balcony, etc... Include , o j Show proposed and or location, dimensions and i1t'O . i existing Detached setbacks - n Accessory Structure(s), nd identify use, !a.- Garage, Workshop, Pool or Spa. Include location, dimensions and setbacks I Distance 5-0" Min I I I I I Distance 5'-0" Min I I I EXISTING DWELLING I I I I i I i i i i i i i i i i I Q N H � I � I Nlenifee OUR STREET Requirements: • Plans and notes shall be legible.Each plan shall fill a minimum 81/1"x IV sheet of paper.Include homeowners name and property address • Show all property lines and the distances of all structures to the property lines.Show all buildings and/or structures on the property, existing and proposed and the distances between those buildings and/or structures • Three(3)copies of the plot plan are required.Some projects may require approval from the Planning Department priorto permit issuance.Please contact the Planning Department to verify minimum setbacks requirements. • Show a North Arrow on the Plot/Site Plan • For proposed Gas,Electrical and/or Plumbing improvements,show meter locations,conduit size,number of wires,breaker and wire sizes,linear square footage and their respective locations for each of the trades. City of Menifee Building&Safety Department 29714 Houn Rd.Menifee,CA 92586951-677-672-677 wwwcityafinenifee.us