PMT16-02691 City of Menifee Permit No.: PMT16-02691
29714 HAUN RD.
'5A—CCIEU� MENIFEE,CA 92586 Type: Residential Addition
MENIFEE Date Issued: 08117/2016
P E R M I T
Site Address: 31938 ARIEL CIR, MENIFEE, CA 92586 Parcel Number: 339-362-001
Construction Cost: $5.265.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 2 PATIOS-16X19&56X8 SOLID ALUMAWOOD PATIO COVER. I FAN. 1 OUTLET
Work:
Owner Contractor
DAN RAFFERTY TRADER DAN'S INC
31938 ARIEL CT 840 S ROCHESTER AVE STE C
MENIFEE,CA 92586 ONTARIO, CA 91761
Applicant Phone: 9093900555
DON DAUGHENBANGH License Number:517575
TRADER DAN'S INC
840 S ROCHESTER AVE STE C
ONTARIO,CA 91761
Fee Description ON Amount
Receptacle, Switch, Outlet&Fixture 2 121.00
Building Permit Issuance 1 27.00
Deck/Patio, non-standard 1 133.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 1.00
General Plan Maintenance Fee-Building 1 6.65
General Plan Maintenance Fee-Electrical 1 6.05
$295.70
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 bulliding operations being carded 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.Bidg_Perrdt-Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION propertywho builds orimproves thereon,and whocontracts forthe projects
I herebyaffirm under penalty of perjurVthat I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and n I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. -75- the following mason:
License w No—=Q!5
By my signature below I acknowledge that,except for my personal residence
Expires!q4d ��Slgmrtum_-A— 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: has not been constrincted in its entirety by
it
n 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
this permit is issued. www.leginfin.ca.goy/calaw.huni.
Policy# Date
p-�ve and will maintain worker's 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 cartify to each of the following:I am the property
this permit is issued.My worker's compensation insura nce carrier a nd policy owner or authorized to act an the property owner's beha If.I have read this
number are: application and the information I have provided is correct.I agree to comply
with all applicable ft and county ordinances and state laws relating to
LL) building construction.I authorize representatives of this city or county to
Carrier I-
Policy# W5..,1�6W3960 pires :Z 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 OWN ER OR AUTHORIZED AGENT
ertify that in the performance of the work for which this permit is issued,
,F47t,
Ishallnotemplo any persons in any manner so as to become subject to the CITY 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 sha wi with those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applicant Datelb /& amountsspec ed on the Hazardous Materials Information Guide?
WARNING:'FA�) �WORKEIR'S COMPENSATION COVERAGE IS 0 Yes �V I
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYERTO ChIMINAL PENALTIES Wilithe intended use ofthe building bythe applicant or future building
AND CIVILFINES UPTO ONE HUNDREDTHOUSAND DOLLARS($100,000),IN occupant require a permitforthe construction or madificationfrom South
ADDITIONTOTHE COSTOF COMPENSATION,DAMAGESAS PROVIDED FOR CoastAlrQuallty Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldell
CONSTRUCTION LENDING AGENCY a Yes
I hereby affirm that under the penalty of perjury there Is a construction Will the proposed building or mad ified facility he within 1000 feet of the
lend Ing agency for the performance of the work which this permit is Issued outer boundapyrof a school?
(Section 3097 Civil Code) o Yes ciNo
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 exemptfrorn the California Health I�Safety CpdI575iastiom 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazardousnuiWq�ad rep
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ciYes idNo
Business and Professions Code).Any city or county that requires a permit to k'-7��D.te
construct,alter,improve,demolish or repair any structure,prior to its FROPERTY OWNElibit-of-HdRIZED AGENT
issuance,also requires the applicant for the permit to flie 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 wilth 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 childa re facility to be FIRP-certifted 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
ri 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( I all of or( I portion of the work,and the structure Is www.epe.gov/lead or contact the National Lead Information Center at
not intended or offered for sa le.(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 u 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 am 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. a No EPA Lead-Safe Certified Firm is required for this project because:
o 1,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
AUG 17 2016
M e n i f e e
DATE PERMIT/PLAN CHECK NUMBER 07. to C1
TYPE: COMMERCIAL 94ASIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA C,SIGN
SUBTYPE: eADDITION OALTERATION ODEMOLITION -,e-CLECTRICAL 0 MECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES_
DESCRIPTION OF WORK k two,'lp
cow,)c g 1?119t�.,
PROJECT ADDRESS q 3 5
ASSESSOR'S PARCEL NUMBER Tol LOT ZIJ TRACT 224,40
OWNER NAME ZA r) +-�
ADDRESS 31115(� AVItPl AIMA-R—
PHONE qFj-q7j)-; 67,li EMAIL
APPLICANT NAME DO IV [)kk�i�e ltl�4-PL:2
ADDRESS
PHONE EMAIL
CONTRACTOWSNAME �00k)15 ,V ) aVfr-S OWNER BUILDER? 0 YES
BUSINESS NAME
ADDRESS lqo 13, 4ut- at44zv,,Lq e�,* ot) 7w
PHONE CfC2q--�40 -055-5-- EMAIL
CONTRACTOR'S STATE LIC NUMBER 577,575- LICENSE CLASSIFICATION
VALUATION$ 5-2 � 5-- -3 4) Z L SO,FT
FT
APPLICANT'S SIGNATURE DATE 5 )IM.
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING FJVGINEERING FIRE � GIEN SIP 0STI *3
INVOICE PAIDAMOUNT
AMOUNT 1 1 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT I 1 0 CASH C)CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 l4aun Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
City of Menifee
Building & Safety Dept.
OWNER -Dxn AUG 17 2016
ADDRESS C7z— VV 0 Rece ved
CITY z I P P H 0 N E, Z/
LOT No. TRACT APN
CONTRACTOR LEDGER & TRACK
ROOMS N' COVERS PROPOSED AD�ITIO�(S) J-Q�01\1 REQUIRED
840 S ROCHESTER AVE#C 4(44
ONTARIO, CA 91761 //v/Y 'y
LIC. B-517575
909-390-0555
WORKCOMP
ICW GROUP C/�z z
WSA5000386-07
EXP6/14/2017
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CITY OF MENIFEE
BUILDING AND SAFETY DEI'ART ENT rte,,UdWCL�
PLAN APPROVAL
Air j)/ '51
REVIEWED BY LLF
DATE
'Approvalaffte0antshall not be construe tobeaormitfororan
approval of,any vi6latim of anyprovisioi t e Wed,state or c4
regulations and ordinances. This set of al ild plans most be kept on the
jobsite until completion.
STREET