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PMT16-02838 City of Menifee Permit No.: PMT16-02838 29714 HAUN RD. Type: Residential Alteration <A-CCELX—> MENIFEE,CA 92586 MENIFEE Date Issued: 08/2912016 P E R M I T Site Address: 31031 BYERS ST,MENIFEE, CA 92584 Parcel Number: 358-130-012 Construction Cost: $6,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of NEW SHOWER VALVE, NEWTOILET FLANGE, NEW EXHAUST FAN, NEW DRYWALL Work: Owner Contractor KATHLEEN SWEENEY A A A RESTORATION INC 31031 BYERS ST 29850 2ND STREET MENIFEE, CA 92584 LAKE ELSINORE, CA 92532-2420 Applicant Phone:9514715828 LANCE REMINGTON License Number:834839 A A A RESTORATION INC 29850 2ND STREET LAKE ELSINORE,CA Fee Description Qtv Amount($ Receptacle, Switch, Outlet&Fixture 1 116.00 Plumbing Fixtures and Vents. fixtures 2 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 5.80 General Plan Maintenance Fee-Electrical 1 5.80 $271.60 The issuance of this permit shall not prevent the building official from thereafter requifing 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 othermse 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.131dg_PermiLTemp1ate.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 contractor(s)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: License Class'D PC—�.C—3:3 Liceng No.�K8vga? By my signature below I acknowledge that except for my personal residence Expires 31ag ZO IV Signature��IiiFoe�e:;��_ in which I an ust have resided for at least one year prior to completion of — .0::;, 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 cr 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 La bar Code,for the performa nce of work for which this permit is Issued. www.leginfo.ca.goy/calaw.htmi. Policy#Ag�� Date ci I have 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 *y my signature below I certify to each of the fallowing: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 relatingto Carrier AwLe--<',-s-,vQ building construction.I authorize representatives of this City or county to Policy#C;S—1 1560-77&7 Expires q11 1001::2 enterthea ve ident"M property for inspection purposes. —_ F�- (This section need not to be completed Is the permit Is for one-hundred Date dollars($100)or less 4�ZPROPERTYC /ONER�OORIZED AGENT o I 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 CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that If I should become HAZARDOUS MATERIAL DECLARATION subject to the workees compensation provisions of Section 3700 of the Labor Code,I shall fort th camp ,JvJIth 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 Applican%��o ehv. e��_Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECA&CIRKER'S COMPENSATION COVERAGE IS c Yes ;ko 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 uYes IdNo 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? (Section 3097 Civil Code) a Yes XNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQVID permitting checklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractor's license Law for the reason(s)indicated below by the hazardous rn en.al re Ing. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es 0 1 Business and Professions Code).Any city or countythat requires a permit to A Ze —Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY 6WNER OWiROTHORIZED AGENT issuance,also requires the applicant for the p ermit to Me 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-certlfied 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 themselvesor through their a 1,as owner of the property,or my employee with wages as their sole employees.For more Information about EPXs Renovation Program visit: compensation,will do( I 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 7W,Business and Professions 1-800424-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 for this p!Oject property who,through employees'or personal effort,builds or improves the lu property provided that the improvements are not intended or offered for Certified Firm Name: A A F—AsSiw4i taK TKe_ 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 bemuse: in 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 E PA RRP ru le plea se fill a ut th e R R P Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION DATE IGC) I (t2 PERMIT/PLAN CHECK NUMBER F"11(0 TYPE: 0 COMMERCIAL KRESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME () POOL/SPA 0 SIGN SUBTYPE: OADDITION �ALTERATION 0DEMOUTION XELECTRICAL OMECHANICAL ONEW XPLUMBING 0% RE-ROOF-NUMBER OF SQUARES- DESCRIPTION OF WORK Nd,,j,�, N4tx,�- Nc_-X,� PROJECTADDRESS ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME e4e�C_- ADDRESS PHONE EMAIL APPLICANT NAME Le,.4 C��_ ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNERBUILDER? 0YES9N0 BUSINESSNAME ARi� ADDRESS _09'g52D QA -,<,4 A 905 Z;,Q PHONE LI_TI -,GVZ9 EMAIL CONTRACTOR'S STATE LIC NUMBER f3llsg-1 LICENSE CLASSIFICATION cpa VALUATION$ 6,60C> SO FT L SQ FT APPLICANT'SSIGNATU DATE 'J�ji ;J"I, - I I DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUS INESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP 0 *570-56) INVOICE I AMOUNT 0_:l 1.(jo�� PAIDAMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES I PAID AMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LEITER 0 YES 0 NO City of Menifee Building&Safe ty Depoi tinen t 29 714 HoUn Rd. Men ifee, CA 92586 951-6 72-6777 www.cityofmenifee.cis Inspection ReqUeSt Line 951-246-6213 -4- z vC19 ------ Idin &-�Mait"YeeDieP JI BU J.. Locielve L S� ea. X.; A I F I Wit t T11 A j -AFEY"EOA*ME14T'- 6IN4 ANO S N APOROV') ----------- hE IEWED OY -T--T D Approal of these plau J. lss�alln6tbe�ns�adtobe'apeimk�roriafi 1 1 Approyal of)any irlola�.ion oi an4mitt� thle federal,Itatebr city et -4 r6ulaiions,�nd 6rdin�ncesi This s df apkIlOpta pt 6n#_ ta s mik betke jobsitiq until completicin. I J— It g! -------