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PMT16-03088 My of Menifee Permit No. PMT16-03088 29714 HAUN RD, Type: Residential Alteration <A-CCELA." MENIFEE,CA 92586 MENIFEE Date Issued: 09/2012016 P E R M I T Site Address: 29847 TWIN LAKES RD, MENIFEE, CA Parcel Number: 333-591-019 92585 Construction Cost: $22,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of REPAIR FRAME DAMAGE TO GARAGE TO INCLUDE FRAMING, DRYWALL AND INSULATION Work: Owner Contractor ALLEN CRUTHERS RENOVATION PROS 29847 TWI N LAKES ROAD 32848 PINE CIRCLE MENIFEE, CA 92585 TEMECULA,CA 92592 Applicant Phone: 9515517361 GREG AMOROSO License Number:911353 RENOVATION PROS 32848 PINE CIRCLE TEMECULA,CA 92592 Fee Description oty Amount Building Permit Issuance 1 27.00 Inspections not specified 516 516.28 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 25.81 $570.09 The issuance of this permit shall not prevent the building offidial 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_B1dq_Perrnit-Teff1p1ate.rpt Page 1 of 1 CITY OF MENIFEE LICENSED�DICLARATIQN 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)pursuaritto the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from ficensure underthe Contractor's State License Law for professions Code and my license is in full force and effect. the following reason: License Class Jucen N 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 priorto 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 ci 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 workees 7044 of the Business and Professions Code,Is available upon request when compensation,issued by the Director of Industrial Relations as provided for this appliotion 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/calaw.htmi. this permit is issued. Policy# CST sw-??O,�— Date a 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 ci 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 Bre: 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# C51 SM2765— —Expires V—z ce h7 enter the above Identified property for inspection purposes. (This section need not to be completed is the permit Is;or one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ri I certify that in the performance of the work for which this permit is issued, Ishallnoternolo 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 coTpensation provisions of Section 3700 of the Labor Code,I shall fortWith cpfnply with those provisions. Will the applicant or future building occupant handle hazardous material or a Date mixture containing a hazardous material equal to or greater that the amounts ecified on the Hazardous Materials Information Guide? WARNINGV�ARE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes X ,- UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building ),IN AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000 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 forguid Il es CONSTRUCTION LENDING AGENCY 0 Yes XO 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 cuterhou daryofaschool? (Section 3097 Civil Code) ci Yes 3zo OWNER BUILDER DECLARATIONS I have mad 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 Contractor's License Law for the reason(s)indicated below by the hazarclo%matt;ogreporting. checkmark(s)I have placed 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 or repair any structure,prior to its fr/ Date Pk6PERTY OWNER OR AUTHORIZED AGENT issuance,also requires the applicant for the 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(RRPI 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, ci 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( )all of or( )portion of the work,and the structure is www.epa-Rov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-BGD-424-LEAD(5323). Code,The Contractor's State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this proj property who,through employees'or personal effort,builds or Improves the property provided that the improvements are not intended or offered for Certified Firm Name: 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. ci No EPA Lead-Safe Certified Firm is required for this project because: cr 1,as owner of the property am exclusively contra cting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractoes State License Law does not apply to an owner of a If you r project does not comply with EPA RRP rule please fill out the RRP- Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ""'Wenifee _21--k"I", DATE PERMIT/PLAN CHECK NUMBER Lo -naz!& TYPE: 1)COMMERCIAL ARESIDENTIAL OMULTI-FAMILY OMOBILEHOME OPOOL/SPA --SIGN SUBTYPE: OADDITION OALTERATION ODEMOLITION CELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-N UMBER OF SQUARES DESCRIPTION OF WORK k0bt�4 ;��kAtf j C150 V,*C&A, PROJECTADDRESS 01 1.-.... ASSESSOR'S PARCEL NUMBER LOT TRACT BUY ng& Safety )ept. OWNER NAME 64110— SEP 2 0 20 6 ADDRESS ,IqS(t7 —7 ko:v InI4� &,h^,) C4 02 -?IC n WU U I vu d PHONE EMAIL APPLICANTNAME ADDRESS z cd PHONE EMAIL CONTRACTOR'S NAME 4kvorioo OWNERBUILDER? OYESONO BUSINESSNAME (�C—NOV_0440 ?ro ADDRESS \, �_ I PHONE EMAIL CONTRACTOR'S STATE LICNUIMBER 1�3h 3S-3 LICENSE CLASSIFICATION VALUATION$ �FT L SO FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP )c I INVOICE PAIDAMOUNT 0 CASH 0 CHECK# AMOUNT 5-lmmi OCREDITCARD VISA/MC PLAN CHECK FEES I PAIDAMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building & Safety Department 29714 Houn Rd. Menifee, CA 925B5 951-672-6777 www.cityofmer7ifee,us In5pection Request Line 951-246-6213 0 Ld 0 City of Menifee Nj auilding & Sa�ety Dept. SEP 2 0 2016 00 Received 4 MY 0 NIFEE BUILDING ND S ETY DEPA PLAN APP OVAL M ' G At it PP ( I REVIEWED BY *Approval of these plans shall not be construedtat approval of,any violation of any provisions of theft regulations and ordinances. This set of approved pl jobsite until CoMpletion, City of Menifee Building & Safety Dept. SEP 2 0 2016 Received \j �j 14 S TMENT IC30 IV DATE a pw*for,or an �ral,m or city FRO M Q m 1 0 Im P'Fempt On the— cl,