PMT16-02738 City of Menifee Permit No.: PMT16-02738
29714 HAUN RD. Type: Residential Addition
'5A-CCELA-> MENIFEE,CA 92586
MENIFEE Date Issued: 08122/2016
P E R M I T
Site Address: 30324 CAROB TREE CIR, MENIFEE, CA Parcel Number: 360-621-038
92584 Construction Cost: $4,150.00
Existing Use: I &2 Family Residence Proposed Use:
Description of INSTALL 312 80 FT SOLID ALUMAWOOD PATIO COVER WELECTRICAL 2 FANS,2 LIGHTS
Work:
Owner Contractor
MISHAEL YOUSSEF PSLQ INC
3.0324 CAROB TREE CIR 28910 RANCHO CALIFORNIA RD
MENWEE, CA 92584 #206
Applicant Phone:9517954260
LOIS MONTINI License Number: 919885
PSLQ INC
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description Qtv Arnount($)
Receptacle, Switch,Outlet&Fixture 4 131-00
Building Permit Issuance 1 27.00
DeckJPatio, 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 6.55
$306.20
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
ordinanm of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced writhin 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 0 lam exempt from licensors under the Contractors'State License Law for the
I hereby affirm under penalty or pedury that I am licensed under provisions of following reason:
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that,except for my personal residence in
Professions Code and"license i.s in full force and ff which I must have resided for at least one year prior to completion of
License Class Licerisqq. . eq n/ Q improvements covered by this permit,I cannot legally sell a structure that I have
�Nc
ignature built as an owner-building if it has not been constructed in its entirely,by licensed
Explres_2::�� opy of the applicable law. Section 7044 of the
contractors.I understand that a r
WORKER&COMPENSATION DECLARATION Business and Professions Code.is available upon request when this application is
submitted or at the following Web site:
0 1 hereby affirm under penalty of pedury one of the following declarations httj3*ffwww.leginfo.m.ciov/calaw.html.
I have and will maintain a certificate of consent of self-insure for wonkeis
compensation,issued by the Director of Industrial Relations as provided for by Date
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. Property Owner orAuthorized Agent
Policy# 0 By my Signature below, I certify to each of the following: I am the property
0 1 have and Will maintain workers' compensation insurance, as required by owner or authorized to act on the property owners behalf. I have read this
section 3700 of the Labor Code, for the performance of the work for which this application and the Information I have provided is correct. I agree to comply
permit is issued.My workers'compensafton insurance carder and policy number are: With all applicable city and county ordinances and state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
Carrier fs identified property for the inspection purposes.
Policy# We,/ NOON Expires Date
L-1-11 Ll Property Owner or-Authorized Agent
(This section need not be complefe-d4f the permit is for City Business Ulmnse# CPY25403
one-hundred dollars($100)or less)
HAZARDOUS MATERIAL DECLARATION
0 1 certify that in the performance of the work for which this permit is issued,I
shall not employ any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers'compensation laws of California, and agree that if I should become mixture containing 0azarclous material equal to or greater that the
subject amounts specofied on the Hazardous Materials Information Guide?
Code,l DYES 0-90'
Applad Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air QuagWartagentent District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL for guldelitissr
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND OYES 0 NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Wilitheproposed ildirig or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of=0011?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES b"NO
CONSTRUCTION LENDING AGEN I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of pedury there Is a construction lending permitting checklist.I tmIdle tend my requirements under the State of
at
agency for the performance of the work which this permit is iss h _,a
ued (Section California Healt,,& Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous dialdnal reporting.
)ER DECLARATIONS DY I NQ=1 / // _. -
OWNER BUILL Date_c;�
1 hereby affirm under penalty of pedury that I am exempt from the Contractor's — J 4L
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR A1.11140RIZED AGENT
next to the applicable item(s)(Section 7031.5.Business and Professions Code:
Any city or county that requires a permit to construct,alter,improve,demolish, EPA RENO ION,REPAIR AND PAINTING RRP)
or repair any structure.prior to its issuance,also requires the applicant for the
permit to file a gigned statement that he or she is licensed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law(Chapter 9 (commencing With receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Diviision 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply With
she is exempt from ficensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees.For more information about EPNs Renovation Program Visit:
www.epa.govAead or contact the National Lead Information Center at
0 1, as owner of the propeft or my employees with wages as their sale 1-800424-LEAD(5323).
compensation,will do( )all of or( )porting of the work,and the structure is '
not intended or offered for sale.(Section 7044,Business and Professions Code; evpte_lk�
The Contractor's State License Law does not apply to an owner of a property 0 An EPA Lead-Safe Certified Renovator wfll be responsible for this project
who, through employees'or personal effort, builds or improves the property,
Certified Firm Name:
provided that the improvements are not intended or offered for sale.If,however
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the Firm Certification No.:
purpose of sale).
0 1, as owner of the property an exclusively contracting wifth licensed 0 No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
...I- __ 4 ...6� —1—M, f�,fh� �r�!�H� with a
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
iili k"I'ly M e n i f e e
Admb�z-
DATE PERMIT/PLAN CHECK NUMBER
TYPE: []COMMERCIAL DRESIDENTIAL [:]MULTI-FAMILY [:]MOBILEHOME [:]POOL/SPA FISIGN
SUBTYPE: []ADDITION E]ALTERATION [-]DEMOUTION DELECTRICAL EIMECHANICAL
[]NEW []PLUMBING ORE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK 'S N �(J, Al UJ-VI(A-WCXYJ o rjo ver.
P\4n(-�d � z) -ns wQ' n �S .
PROJECTADDRESS 50-�—,2H Cafd) T( e-e Qjc,
ASSESSOR'S PARCEL NUMBER LOT TRACT
PROPERTY OWNER'S NAME
ADDRESS
PHONE 4- - 19619 EMAIL
APPLICANT NAME
2L% P400hD CQJ -A -a�� U�� (A
ADDRESS
gPHONE EMAIL
CONTRACrOR'S NAME cei%�Oee— OWNERBUILDER? OYESDNO
BUSINESS NAME �ffZl Pan(ki(� Co t Zal,, -02?tfa�Pa-)
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER 7lefg'S- LICENSE CLASSIFICATION
S
VALUATION$ r;L-, L SO,FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBhK
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT I 1 0 CASH 0 CHECK# OCREDITCARD VISAINIC
PLAN CHECK FEES PAIDAMOUNT I I OCASH OCHECK# OCREDITCARD VISAIMC_
OWNER BUILDER VERIFIED OYES 0 No DLNUMBER NOTARIZEDLETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
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