PMT16-02644 City of Menifee Permit No.: PMT16-02644
29714 HAUN RD. T Residential Re-Roof
�A_ EA?CC � MENIFEE,CA 92586 yam'
MENIFEE Date Issued: 08/12/2016
PERMIT
Site Address: 26632 OAKMONT DR, MENIFEE, CA Parcel Number: 337-353-023
92586 Construction Cost: $7,500.00
Existing Use: Proposed Use:
Description of REFOOF-NOT COOL ROOF VERIFY R-38INSULATION
Work:
Owner Contractor
CHRIS TOURVILLE ZUPPARDO CONSTRUCTION
26632 OAKMONT DR 30160 PEBBLE BEACH DR
MENIFEE, CA 92586 MENIFEE, CA 92586
Applicant Phone:9513135009
CHUCK ZUPPARDI License Number.744346
ZUPPARDO CONSTRUCTION
30160 PEBBLE BEACH DR
MENIFEE, CA 92586
Fee Description Qtv Amount ISI
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
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 perjurythat I am under provisions of
Chapter9,(commencing with section 7000)of Division 3 of the Business and ❑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:
License Class Ucense No. By my signature below I acknowledge that,except for my personal residence
Expires Signatur'�°� 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
❑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 worker's 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.eov/calaw.html.
this permit is issued.
Polity#
Date
❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
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 worker's compensation insurance carrier and policy owner or authorized to act on the property owner's 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
i
llars 0)or less PROPERTY OWNER OR AUTHORIZED AGENT
certify that in the performanceof the work for which this permitisissued,
all not emolov any persons in any manner so as to become subject to the CRY BUSINESS LICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall rt with o/1v with those visions. Will the applicant or future building occupant handle hazardous material or a
�m6- ���T /12_2 a mixture containing o hazardous matous Mal equal In or ration thatGuide?
the
Applicant G G Date J . G amounts spe d on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes AINO
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)7 See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelin
CONSTRUCTION LENDING AGENCY o Yes KNo
1 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 hound of a school?
(Section 3097 Civil Code) ❑Yes
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
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
ha ' jiteriat reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 e I¢ ,
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 p PERTY OWNE R THORIZED 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 Contractor's 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($500). managers who do the paint-disturbing work themselves or through their
o I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible forthis project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Building e
'Menifee AUG 12 20%
DATE PERMIT/PLAN CHECK NUMB
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES4-41
DESCRIPTION OF WORK
PROJECTADDRESS rQ�Q,j�. ;<"i(4//���'
ASSESSOR'S PARCEL NUMBER �_J�✓ Q?T LOT 100 TRACT
OWNER NAME // 2 9/$ Q.� /I [,,E•
ADDRESS CL�/y 3V �i t 9?.5e6
PHONE EMAIL
ZAPPLICANT NAME /9/2Z-0
ADDRESS
PHONE — D09 EMAILL Oh F!// �DD• my2
CONTRACTOR'S NAME OWNER BUILDER? O YES NO
BUSINESS NAME
ADDRESS 22 �
PHONE g�� '�I/ .JSD�/ ' EMAILi/'cl��'
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ 75O S L SO FT
APPLICANT'S SIGNATUR •�- L DATEOTYSTAFFUSE
I ,.
DEPARTMENT DISTRIBUTION 1� �� CITY OF MEN�IFgyEJB S LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GJEN SMIP
INVOICE I
I D -lO PAIDAMOUNT n
AMOUNT OCASH OCHECK 71 CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK N O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES C) NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building& Sufety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-5213
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