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PMT16-02207 City of Menifee Permit No.: PMT16-02207 29714 HAUN RD. Type: Residential Alteration �ACCEI-A MENIFEE, CA 92586 " MENIFEE Date Issued: 07/1 312 01 6 PERMIT Site Address: 29331 WINDING BROOK DR, MENIFEE, Parcel Number: 340-230-045 CA 92584 Construction Cost: $7,500.00 Existing use: 1 &2 Family Residence Proposed Use: Description of REMOVE EXISTING TUB, INSTALL NEW WALK IN TUB, INSTALL NEW 20 AMP CIRCUIT, DRYWALL Work: PATCHWORK Owner Contractor DENNIS EYNON SAFE STEP WALK-IN TUB COMPANY INC 29331 WINDING BROOK DR 15262 PIPELINE LANE MENIFEE, CA 92584 HUNTINGTON BEACH,CA 92649 Applicant Phone:7143738545 JESSE MULCAHEY License Number:983603 SAFE STEP WALK-IN TUB COMPANY INC 15262 PIPELINE LANE HUNTINGTON BEACH,CA92649 Fee Description Owl( Amount($) Receptacle, Switch, Outlet&Fixture 1 116.00 Plumbing Fixtures and Vents, fixtures 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 5.80 General Plan Maintenance Fee-Electrical 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 effect. the following reason: License Class �z Ucen a No. 360 33 By my signature below I acknowledge that,exceptfor my personal residence Expires S`.3/—1 / Signature in which I must have resided for at least one year priorto completion of improvements covered bythis permit.I cannot legally sell a structure that I cWORKER'S COMPENSATION DEC_ ON have built as an owner-builder if it has not been constructed in its entirety by 'd1 hereby affirm under penalty of perjury one of the following dec arations:11 licensed contractors.l 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 bythe Director of Industrial Relations as provided for this application is submitted or at the following webslte: by Section 3700 of the Labor Code,for the performance of work for which www.leainfo.ca.eov/calaw.html. this permit is issued. Policy# gGoaq77a0/h 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 �o� with all applicable city and county ordinances and state laws relating to Carrier `� CG e J�/7L building construction.I authorize representatives of this city or county to Policy#9'Plbd`/ 77aC> f Expires I 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 in I certify that in the performance of the work for which this permit is Issued, ��(.Sy I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# VVV JJJ 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 fort) ith complywith those provisions. Will the applicant or future building occupant handle hazardous material of a 43 mixture containing a hazardous material equal to or greater that the 7 Applicant Date 7 amounts spem ed on the Hazardous Materials Information Guide? WARN :FAILU O SECURE WO COMPENSATION COVERAGE IS o Yes LIMA FUL,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 for guideline CONSTRUCTION LENDING AGENCY c Yes bAo 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 boun y of a school? (Section 3097 Civil Code) o Yes o 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 California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous aerial reporting. checkmark(s)I have placed nextto the applicable item(s)(Section 7031.5 oyes ` /Z Business and Professions Code).Any city or county that requires a permit to Ae� i/ 'r Date construct,alter,improve,demolish or repair any structure,prior to its p ERTY q}4/ ER OR AUTHORIZ ENT 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 D PAINTING[RRP) 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 Rcensure 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 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.eoa.eoy/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 Contactors 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 ❑No EPA Lead-Safe Certified Firm is required for this project bemuse: not built or improved for the purpose of sale. ❑I,as owner of the property am exclusively contacting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contactors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill outthe RRP Acknowledgement Menifee DATE PERMIT/PLAN CHECK NUMBER daO TYPE: O COMMERCIAL t' RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION GeALTERATION O DEMOLITION (1'€LECTRICAL O MECHANICAL ONEE/W &PLUMBING 0RE-RO�qOF-NUMBER OF SQUARES DESCRIPTION OF WORK !C OV �CiSTI 7u . It a,l walk--IL 4u�. Tit a11 vLe L,) D rM . Goal( pa4ckL_1crk. PROJECTADDRESS "ti 'A ,,,,CC � Q ASSESSOR'S PARCEL NUMBER � ' D`�JLOT D I TRACT AW69 OWNER NAME /e hOdl ADDRESS 01 .31 AA 'f C(9Ok a s4 Y PHONEC76a )a 7 g -i13 EMAIL APPLICANTNAME ADDRESS /S 602 I I! ll f'L • (� PHONE-7 1 Y A - aUd EMAIL CONTRACTOR'S NAME(('' - OWNER BUILDER? OYES BUSINESS NAME }.-e. �,� - jV LJ (� ADDRESS / 02r I !�,ti.e� l�l� . /I�(sl. •1 Vl. C,�• (aL(0 7 PHON4-7 / y��/�..,rjZ(J� EMAIL CONTRACTOR'S STATE LIC NUMBER "3 6-23 LICENSE CLASSIFICATION VALUATION$ U' U, � SQ FT L SO,FT APPLICANT'S SIGNATURE DATE 7'i.3-/6, CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION I CITY OF MENIFEE BBLLSl�.fNFSSS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN V4 SMIP INVOICE �1 .�Q PAIDAMOUNT AMOUNT 0CASH 0 CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us inspection Request Line 951-246-6213 \ zmq 000 2w ( Q 0 a - � Z m � � / 9Mo " M � a » an 2 a 0 kO2m 2 2 3 ¢ 2 2 / 0 f g_ / LA � 0 \ 7 � m m z ' q \ / \ 0 -4 I > OZ 0 wz ) � ¥ m � / * \ Z m \g k w R F \\ r < \ 2 CD / /\ 0q } 0 ? > f � D 0 w 0 m I C > \ z 46 z l m (D � boG) � 0 . \ \ � 2 MM ODOmt 8 mrr _ \ co > > m / / � w D $ 0 2 0 � �� o;Qcr7 rrY