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PMT16-02894 City of Menifee Permit No.: PMT16-02894 29714 HAUN RD. Type: Residential Addition -t;kCCFtjA—> MENIFEE,CA 92586 MENIFEE Date Issued: 08131/2016 P E R M I T Site Address: 25379 GANT CT,MENIFEE,CA 92584 Parcel Number: 358-422-017 Construction Cost: $2,825-00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 420 SO FT SOLID ALUMAWOOD PATIO COVER WELECTRICAL 4 POST LIGHTS,2 FANS Work: Owner Contractor MIKE LANTAIGNE PSLQ INC 25379 GANT CT 28910 RANCHO CALIFORNIA RD MENIFEE,CA 92584 #206 Applicant Phone:9517954260 LOIS MONTINI License Number:919885 PSLQ INC 28910 RANCHO CALIFORNIA RD #206 TEMECULA, CA 92590 Fee Description City Amount is Receptacle, Switch, Outlet&Fixture 6 141.00 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 7.05 $316.70 The issuance of this permit shall not prevent the building offidal 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 BldgPennit-Ternplate.rpt Page 1 of 1 City Of Menifee LICENSED DECLARATION 0 [am exempt from licensure 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 wdth 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 is in full force and eff which I must have resided for at least one year prior to completion of License Class a 0 improvements covered by this permit,I cannot legally sell a structure that I have Expires 7- lgnatura�5rf built as an owner-building if it has not been constructed in its entirety by licensed I I contractors.I understand that a copy of the applicable law,Section 7044 of the WORKER&COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is 0 1 hereby affirm under penalty of pedury one of the following declarations: submitted or at the following Web site: I have and wifll maintain a certificate of consent of self-insure for workers' hftp*.Il�.leginfo.ca.gov/mlaw.html. 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 requi owner or authorized to act on the property owners behalf. I have read this red by application and the infinimation I have provided Is correct. I agree to comply section 3700 of the Labor Code, for the performance of the work for which this parmitis issued.Myworkers'compensafion 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- Carder identified property for the inspection purposes. Policy Expires Property Owner or Authorized Agent Date (This section need not be co��dVif the.parridit is for City Business License# 403 one-hundred clollarT(�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 Oazardous material equal to or greater that the rs'rompensation provisions Of SeCUDn 3700 of the Labor subject to Ilewo amounts speofied on the Hazardous Materials Information Guide? sha all n 'on ro In A Code,I y ith those provisions. DYES G-WO Lu Appllc@��EIW�-d 17 Will the intended use of the building by the applicant orfu rebuilding occupant require a permit for the construction or modification from South WARNING: FAILURE TO SECURE WORKERS' CoastAirQua nagement District(SCAOMD)?See permitting checklist COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidef SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND DYES 0 NO CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed g�licllng or modiffed facility be within 1000 feet of the outer 00 DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of ool? LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES MO CONSTRUCTION LENDING�WENC I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm that under the penalty of perjury there is a construction lending permitting che kil t'I d t d requirements under the State of agency for the performance of the work which this permit is issued(Section California Health a Code,Section 25505 and 25534 concerning 3097 Civil Code) hazardous - net reporting. OWNER BUILDER DECLARAT16NS — zv�. Date 6;� a I hereby affirm under penalty of pedury that I am exempt from the Contractor's VORIZEDAGENT License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER ORAL) 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 RENOVATION,REPAIR AND PAINTING(RUP or repair any structure, prior to its issuance, also requires the applicant for the permlit to file a �5fgned 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-1 978 Section 7000)of Division 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 licensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property violation of Section 7031.5 by anyApplicant for a permit subjects the applicant to managers who do the paint-iffsturbing work themselves or through their a civil penalty of not more than($500).) employees.For more information about EPNs Renovation Program visit: www.epa.govAead or contact the National Lead Information Center at 13 1, as owner of the property, or my employees With wages as their so!e 1-800-424-LEAD(6323). compensation,will do( )all of or( )porting of the work, and the structure is not intended or offered for sale.(Section 7044,Business and Professions Code; ' arge-`k� The Contractors State Llicense Law does not apply to an owner of a property 0 An EPA Lead-Safe Certified Renovator will be responsible for this project who, through employees'or personal effort, builds or improves the propeft provided that the improvements are riot intended or offered for sale.If,however, Ceriffied Firm Name: the building or improvement is sold within one year of completion,the Owner- Builder will have the burden of proving that it was not built or improved for the Firm Certification No.: purpose of sale). 0 1, as owner of the property an exclusively contracting with licensed 0 No EPA Lead-Safe Certified Firm is required for this project because: contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's Uicense Law does not apply to an owner of a property who builds or improves.thereon, and who contracts for the projects with a DATE PERMIT/PLAN CHECK NUMBER TYPE: [-]COMMERCIAL [9'RESIDENTIAL F]MULTI-FAMILY F]MOBILEHOME EJPOOL/SPA F]SIGN SUBTYPE: F]ADDITION F]ALTERATION DDEMOLITION DELECTRICAL []MECHANICAL ONEW F]PLUMBINGE]RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK I-lAn P-( 9L &112914U)nQA PROJECTADDRESS 61 -A, ASSESSOR'S PARCEL NUMBER Lf4 X01 LOT TRACT PROPERTY OWNER'S NAME ADDRESS C!� -5 ";� OT PHONE EMAIL APPLICANT NAME -Lal-s> i1Yv1o7-1,.v11 ADDRESS �c PHONE EMAIL CONT%AcroR'S NAME OWNERBUILDER? [-]YES[:]NO BUSINESSNAME ADDRESS EMAIL PHONE CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ JSQ FT LSQFT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMEIff DISTRIBU"11ON 110 SMIP V0 LITYL)kMLMrnMS]Nt55LICEN5ENUMBLK BUILDING PLANNING ENGINEERING FIRE GREEN INVOICE PAIDAMOUNT AMOUNT 0 1 1 1 0 CASH 0 CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES I PAID AMOUNT I 1 0 CASH 0 CHECK It OCREDITCARD VISA/MC_ OWNER BUILDER VERIFIED OYES 0 No DILNUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building&Safety Department 29714 Haun Rd. Menfee, CA 92586 951-672-6777 www.cityofmenifee.us Inspection Request Line 951-245-6213 0 LQ - - -- - - - - - - - - - - - - - - - m On n E13 Ko w 0 o Z > 9- �f 0� x 3� 5zf & = M� n 9CD = a3 z , �z M 0 0 0 :E n - -1 - <CD ry --f — CD 'o ZO > 0 .0 4 F= -< < z 41. 0 �MW CD c�= OCD 0 > > o Z CD m 0 rL 0 0 > rn <m 0 z z > 0 0 Ln rm ,31 > M m M C- > > CL rn > m 0 Z Z m hi .rn LO C) m PUBLIC NJ > Ul z 5 7 co (D --I z fD ri --I > w fD n z 0 m -4 -1 r kb 0 GANT 00 Grrq