PMT16-02621 City of Menifee Permit No.: PMT16-02621
_ 29714 HAUN RD.
'i_CCELA�. MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 07/2612017
PERMIT
Site Address: 28028 WATSON RD, MENIFEE, CA 92585 Parcel Number: 329-330-008
Construction Cost: $7,600.00
Existing use: 1 &2 Family Residence Proposed use:
Description of CONSTRUCT 2 OPEN PATIO COVERS 2X 9X56 DETACHED POST/BEAM
Work:
Owner Contractor
JOSE MENDOZA
3411 BEVOS ST
SAN DIEGO, CA 92111
Applicant License Number:
JOSE MENDOZA
3411 BEVOS ST
SAN DIEGO, CA 92111
Phone: 6195724454
Fee Description Q Amount
Building Permit Issuance 1 27.00
Deck/Patio, non-standard 1 133.00
Additional Plan Review Building 148 148.37
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 1.00
General Plan Maintenance Fee-Building 1 6.65
$317.02
The issuance of this permit shall not prevent the building official from thereafter requidng the correction of errors in the plans and
specifimtions 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.
CONDITIONS
Condition Comment
1 Code Case-Compliance
Agreement
AA_Bldg_Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION roperty who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contractors Stale 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 ❑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 License No. By my signature below I acknowledge that,except for my personal residence
Expires Signature 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
❑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.leginfo.ca.goy/calaw.html.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 ❑By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's 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 entert ove identified property for inspection purposes os .
(This section need not to be completed is the permit is for one-hundred Date 7 /6 /,7-
dollars($100)or less OPERTY OWNER OR AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit Is issued,
1 shall 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 forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide.
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes D 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 for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes ❑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?
,ction 3097 Civil Code) ❑Yes D No
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 25505 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 Dyes ❑No
Business and Professions Code).Any city or county that requires a permitto 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(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 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
❑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.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 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 for this project because:
❑1,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.
CITY OF MENIFEE
CODE ENFORCEMENT DIVISION
eNiFe 29714 Haun Rd., Menifee,CA 92586
P: 951-672-6777 1 r: 951-679-3843
COMPLIANCE AGREEMENT
May 31,2017
TO: JOSE MENDOZA
RE: 28028 WATSON RD,MENIFEE,CA 92587
(PROPERTY ADDRESS)
CASE NO: CE-13-1133
This is an AGREEMENT between City of Menifee and Jose Mendoza made as of May 31,2017, by and
between the undersigned Parties.
I.CONSIDERATION
The undersigned hereby form a Compliance agreement in,that the incurred costs of$5,002.24 for code
enforcement activities at 28028 Watson Rd will be paid in 3 monthly payment installments.
11.TERMS OF PAYMENT
The following terms of payment will be paid in installments of$1,667.41 except for the last installment
which will be$1,667.42 In addition a onetime administrative fee of$126 will be paid with the first
payment installment.
III.CONDITIONS
The conditions of this agreement are;after the second Payment, City of Menifee Building&Safety
department will release responsible parties permit once the third and final payment is made and cleared
with finance,City of Menifee will Release Notice of Pendency.
ACKNOWLEDGEMENT
I hereby acknowledge that I have read, understand and agree to comply with the City of Menifee's
Compliance agreement conditions and terms.
oG - CV zo/
ignature Date
J 0sz A .
Print Name
City of Menifee Code Enforcement Division 129714 Flaun Rd, Menifee,CA 92586
P: (951)672-6777 1 17: (951) 679-3843
Menifee
DATE PERMIT/PLAN CHECK NUMBER ' - 02
TYPE: O COMMERCIAL !RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 0SIGN
SUBTYPE: *ADDITION C ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
C NEEW'''O PP. l'�T LUU�MBING C RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORKLoob-�rr Ill GIA 71Q{
2 ^ " t Sol
PROJECTADDRESS 1l Ar'C�v'pl� Me-Ll GAS
ASSESSOR'S PARCEL NUMBER ?jZ J "33O 005LOT 3 TRACT 02 (031.
OWNER NAME J t6s tstowtio-ttl ^ Q
ADDRESS 34`� ��. tl S �c Lav,D C,Ps 12 t k
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PHONE `(p�-L> 'S (2 - 454 EMAIL On Dlla C ( & Q/1- /y
APPLICANT NAME k
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? BYES NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CON c TRACTOR'S STATE LIC NUMBER 'L LICENSE CLASSIFICATION
UATION$ (�Q. QO SO FT �I.J y L SO FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE 1/� PAIDAMOUNT
AMOUNT `�y • OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK# OCREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building& Sofet;l tmen``t..29714 Houn Rd. Menifee, CA 92550'951-672-6777
ottwenlrrOPY
r tion Request Line 951-246-6213