PMT16-03074 City of Menifee Permit No.: PMT16-03074
29714 HAUN RD.
'r;NCCE LP� MENIFEE. CA 92586 Type: Residential Addition
MENIFEE Date Issued: 09/1612016
P E R M I T
Site Address: 29687 NORTHSHORE ST, MENIFEE,CA Parcel Number: 340-490-044
92584 Construction Cost: $2,300.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 234 SQ FT SOLID ALUMAWOOD PATIO COVER, NO ELECTRICAL
Work:
Owner Contractor
SOLEDAD QUIOAN PSLQ INC
29687 NORTHSHORE ST 28910 RANCHO CALIFORNIA RD
MENIFEE, CA 92584 #206
Applicant Phone:9517954260
JOSH HARRICK License Number: 919885
PSLQ INC
28910 RANCHO CALIFORNIA RD
#206
TEMECULA,CA 92590
Fee Description Qtv Amount($
Building Permit Issuance 1 27.00
Deck/Patio, non-standard 1 133.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1.00
General Plan Maintenance Fee-Building 6.65
$160.65
The issuance of this pennit shall not prevent the building official from thereafter requiring the correction of enrors 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,81dg_PerrnitTeMpIate.rp1 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 perjury 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 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 lepally sell a structure that I have
Expire,--7--Z ignature 5rf built as an owner-bullifing if it has not been constructed in its entirety by licensed
I I erstand 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
D I hereby affirm under penalty of perjury one of the following declarations, submitted or at the followling Web site:
I have and will maintain a certificate of consent of self-insure for workers: http.*//�.leginfo.ca.gov/mlaw.htmi
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
13 1 have and Will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalL I have read this
section 370D 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'compensaflon insurance center and policy number are: With all applicable city and county ordinances and slate laws relating to building
construction.I authorize representatives of this city or county to enter the above-
Carrier T,42�2—A identified property for the inspection purposes.
Poficy# W0110Z)D10,61 Expires 7Z J_�o Dale
Property Owner orAuthorized Agent
Ll 0?2f2-qQ3
(This section need not be completedVt the permit is for City Business License#
one-hundred dollaris—(_$1 00)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 0azardous material equal to or greater that the
rs'compensation provisions of Section 3700 of the Labor
subject to lhecvojk�. I amounts spe9jilet!on the Hazardous Materials Information Guide?
she
all r C',
mp y
Code,I Ith those provisions. DY 040,
Applio ate�-�A—-V 17 Will the intended use of the building by the applicant or future building
a0ft4-D occupant require a pormit for the Construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quali"anagement District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guideli
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 lidi`n�c or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of=001?
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES trINO
CONSTRUCTION LENDING AGENCY 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 checklist.I undpjstand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&_Safiely Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous net reporting
OWNER BUILDER DECLARATONS DYE
/9W—F , Date 9
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER ORALI 'ORIZEDAGENT
next to the applicable item(s)(Section 7031.5.Business and Professions Code:
Any City or county that requires a permit to construct,aller,improve,demolish, EPA RENOVATION,REPAIR AND PAINTING(RRP)
or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a Aigned 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 Utcense Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-cerlified 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-disturbing work themselves or through their
a civil penalty of not More than($500).) employees.For more Information about EPA!s Renovation Program Visit:
www.epa.govilead or contact the National Lead Information Center at
0 1, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the work,and the structure i's '
not intended or offered for sale.(Section 7044,Business and Professions Code; Gvve_lk�
The Contractor's State License 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 properly,
provided that the improvements are not intended or offered for sale.If,however, Certified Firm Name:
the building or improvement is sold within one year of completion.the Owner-
Builderwill 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 License Law does not apply to an owner of a properly
who builds or improves.thereen, and who contracts for the projects with a
DATE PERMIT/PLAN CHECK NUMBERTPfl 1110- 0%�M!+
TYPE: [:]COMMERCIAL [:]RESIDENTIAL [:]MULTI-FAMILY [:]MOBILEHOME E]POOL/SPA OSIGN
SUBTYPE: E]ADDITION OALTERATION F]DEMOLITION 0ELEcTRICAL El MECHANICAL
[:]NEW OPLUMBING F1 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 2- 34 Sci)v-T- , Sd-i6, N)Isk"L&-)ccrj-
PaUO coves . e6 ±t� �nrmse—
PROJECTADDRESS 296sa t\,JW�)Sywye� 5- � I mft)k—e. �N %�)V
ASSESSOR'S PARCEL NUMBER '640 -LAO- 044 LOT I LAJ5 TRACT -,?%q9707
PROPERTY OWN ER'S NAME QI()II 00y)
ADDRESS
PHONE EMAIL
APPLICANT NAME
ADDRESS 2
�9ko RQY)CVY) CW �QynVj,_) Q(I_ -jOi2
PHONE EMAIL
CONTRACTOR'S NAME G,(-e-cn)p� OWNER BUIUDER?L E]YES[JNO
BUSINESS NAME G,(�e(f Y)�)e
ADDRESS nwo coj
PHONE �Iz)\ EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ 1 LSQ FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
ULPAKIMLNI 319TRIBUTION SMIP CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN 100
INVOICE I
AMOU T 1(04& PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
[OWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LETTER 0 YES 0 NO J
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
Soledad Quioan
Plot plan 29687 Northshore St.
Not to Scale Menifee, Ca. 92584
- 805-813-6789 951-458-0211
234 In Alumawood Solid Top Patio Cover. Attached to the house and to
existing concrete. NO ELECTRICAL Setat9' high
-)wn trim with Desert Sand Ceiling 4-Z3 oz>
LEDGER &) TRACK city of menif e
INSPECTION REQUIRED 3uilding & safety Dept.
lot SEP 16 2 16
Receiv d
— 26
an if
alety c
6 211
iV
4 15 51
CITY OF MENIFEE
BUILE ING AND SAFETY DEPARTMENT
PLAN APPROVAL N@M 40
REVII ED Br-00 6111(0 1&
Di-iveway 'DAT�
*Approval of these plans sh a I!not�2 construed to be a permit for,or an
approval of,anyviolationof arryprovisions of the federal,state or city
regulations and ordinances. This set of approve J plans must be kept on the
job�ite until completion.
Sidewalk
Northshore St.