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PMT16-03081 City of Menifee Permit No.: PMT16-03081 29714 HALIN RD. '�A—CCF--U^'3' MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 12/1412016 P E R M I T Site Address: 29156 LORETTA AVE, MENIFEE, CA Parcel Number: 372-150-016 92584 Construction Cost: $19,794.72 Existing Use: 1 &2 Family Residence Proposed Use: Description of NEW DETACHED GARAGE 24'X 46'-NO ELECTRICAL Work: Owner Contractor JORGE&INEZ MAR11NEZ 29154 LORETT AVE MENIFEE, CA 92584 Applicant License Number, JORGE&INEZ MARTINEZ 29154 LORETT AVE MENIFEE, CA 92584 Phone:95116798673 Fee Description pty Amount($1 Plan Check Fee 103 102.50 Building Permit Issuance 1 27.00 Inspections not specified 516 616.28 Additional Plan Review Building 158 157.50 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 &GO New Construction Permit Fee 1 91.06 General Plan Maintenance Fee-Building 1 25.81 General Plan Maintenance Fee-New 1 4.55 Construction $928.70 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 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.B1dg_Pemnft-Template.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 contractors)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— License No. By my signature below I acknowledge that,except for my personal residence Expires_Signature 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 it has not been constructed in its entirety by o 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 certfficate 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 www.leginfo.ca.gov/`ca law.htm 1. this permit is issued. Policy# Date o 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 �6 By my signature below I certify to each of the following: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 relating to Carrier building construction.I authorize representatives of this city or county to Policy# Expires t th b identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred I - si&� Date dollars($100)or less PROPERTY OWNER OR AUTK&IZED 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 worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply 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 Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes a No UNLAWFUL,AND SHALL SUBJECr 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 o Yes a No I hereby affirm that under the penalty of perjurythere 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 o No 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 exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractoes License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes a No Business and Professions Code).Any cityar countVthat requires a permitto Date construct,alter,Improve,demolish orrepair anystructure,priorto its PROPERTY OWNER OR AUTHORIZED AGENT Issuance,also requires the applicant forthe permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRP1 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-certified 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 o 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 I all of or( )portion of the work,and the structure is www.epa.govllead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractoes State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves t a property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within oneyear of Firm Certification No.: completion,the Owner-Builder will havethe burden of provingthat itwas not builtorimproved forthe purpose of sale. o No EPA Lead-Safe Certified Firm is required forthis projectbecause: kas ownerof the propertyarn exclusively contracting with licensed c"tractors to constructthe projectfSection 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.