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PMT16-02238 City of Menifee Permit No.: PMT16-02238 29714 HAUN RD. Type: Residential Addition <A_CCELA_? MENIFEE, CA 92586 MENIFEE Date Issued: 04/24/2017 PERMIT Site Address: 25949 THISTLETOWN CT, MENIFEE,CA Parcel Number: 358-233-014 92584 construction Cost: $30,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL ENGINEERED PATIO COVER 1379 SF,WITH 3 FANS,6 GFI OUTLETS,4 SWITCHES, 16 Work: CAN LIGHTS,AND A FIREPLACE Owner Contractor ERIC GEORGIAN UNIQUE BUILDERS OF CALIFORNIA 25949 THISTLETOWN COURT 41070 VIA DEL TORONJO MENIFEE,CA 92584 TEMECULA,CA 92592 Applicant Phone:9098514330 DAVE CARTER License Number.920943 UNIQUE BUILDERS OF CALIFORNIA 41070 VIA DEL TORONJO TEMECULA,CA 92592 Fee Description Qy Amount lSl Receptacle, Switch, Outlet&Fixture 29 256.00 Gas System 1 116.00 Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 Inspections not specified 129 129.07 Additional Plan Review Building 181 181.35 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Building 1 6.65 General Plan Maintenance Fee-Electrical 1 12.80 $867.87 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 contractors)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: �lZO�r4 License Class License No. 3r By my signature below I acknowledge that,except for my personal residence Expires Signature XL i in which I must have resided for at least one year prior to completion of 'i 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 1 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.Ieginfo.ca.gov/calaw.hImI.permit is issued. Polity# 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 ❑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: G��,,� /' application and the information I have provided is correct.I agree to comply Carrier )I ky tCs 1�y1 Nn with all applicable city and county ordinances and state laws relating to q �i� /,'\ -7 building construction.I authorize representatives of this city or county to Policy# 1 1�—L :ill 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 ❑I certify that in the performance of the work for which this permit is issued, O G O 1 shall not employ any persons in any manner so as to become subject to theI BUSINESS LICENSE# e,J O worker's compensation laws of California,and agree that if I should becomeARDOUS MATERIAL DECLARATION ubject to the workers compensation provisions of Section 3700 of the Labor de,I shall forthwi/�,I(t��/Amply with those provisions. j the applicant or future building occupant handle hazardous material or a Applicant YI/! Date t-I `2L1,0 ture containing a hazardous material equal to or greater that the �— unts sp cified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE ISes o7o UNLAWFUL,AND SHALL SUBIECTAN EMPLOYER TO CRIMINAL PENALTIES the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),INpant require a permit forthe construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FORst Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES uidelines CONSTRUCTION LENDING AGENCY s dNo I hereby affirm that under the penalty of perjury there is a construction l the building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued er boun ary of a school? (Section 3097 Civil Code) s No OWNER BUILDER DECLARATIONS ve read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the mitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the fornia Health&Safety Cade,Section 25505 and 25534 concerning ardous material reporting. checkmark(s)I have placed next to the applicable items)(Section 7031.5 I 'Businessand Professions Code).Any city or county that requires a permit tooff ❑NoDate r "Iconstruct,alter,improve,demolish or repair any structure,prior to its PROPERTY 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 IRRPj 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.epa.gov/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 ❑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 for this project because: o I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7D44,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. & SAFETY PERM IT/PLAN CHECK APPLICATION Menifee DATE • /6 PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL 91RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES 9= Cr j Acsz DESCRIPTION OF WORK �' � .L PROJECTADDRESS S N�'( j TLC zje- q 5V'1 ASSESSOR'S PARCEL NUMBER 35��•23"� •0(yf LOT 5n TRACT Qqk.03CV OWNER NAME [� L �� Buildqiitc' ofallptyMenifee nppt ADDRESS ZS L49 -r14(S I[X—r' JL,jr-) v2n PHONE !-/'L( ?�S" y3•-/[ EMAIL APPLICANT NAMED Received ADDRESS 4-1l0'70 L)l /a �� c�Q-0 5 Z5 G-q PHONE EMAIL S CZ4,N CONTRACTOR'S NAME OWNER BUILDER? OYES 40 BUSINESSNAME ( j50 ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER CF ZO 41 LICENSE CLASSIFICATION VALUATION$ 30( Gal SQ FT L SO FT APPLICANT'S SIGNATURE DATE �7' ( Lj - .I. DEPARTMENT DISTRIBUTION CITY OF MMENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP D 3 p / INVOICE PAID AMOUNT AMOUNT 5 OCASH OCHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH OCHECK# 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 Haun Rd. Menifee, CA 92586 951-672-6 777 www.cityofinenifee.us Inspection Request Line 951-246-6213