PMT16-03145 City of Menifee Permit No. PMT16-03145
29714 HAUIN RD. Type: Residential Addition
<A-CCr=LA—> MENIFEE, CA 92586
MENIFEE Date Issued: 09/2312016
P E R M I T
Site Address: 27684 APPLE BLOSSOM CIR, MENIFEE, Parcel Number: 336-451-022
CA 92586 Construction Cost: $5,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 20'X 22'&10'X 4"SOLID ALUMAWOOD PATIO COVER WELECTRICAL 1 FAN,3 PLUGS
Work:
Owner Contractor
BRIAN AGNER M W BEST CONSTRUCTION
276B4 APPLE BLOSSOM CIR 345 JUEL LANE
MENIFEE, CA 92586 HEMET, CA 92544
Applicant Phone:9519279634
MICHAEL BEST License Number: 614364
M W BEST CONSTRUCTION
345 JUEL LANE
HEMET, CA 92544
Fee Description Qtv Amount
Receptacle,Switch, Outlet&Fixture 4 131.00
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 6 55
$306.20
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 building 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 mmmenced within six
months after issuance,or where the work commenoed is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA,_B1dg_PerrnR-Ternp1ate.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter!3(commencing with section 7000)of Division 3 of the Business and a I am exempt from licensure under the Contractoes State Llcense Law for
Professions Code and my license is in full force and.effect. the followmig reason:
License Class —8-1 License No. Intl By my signature below I acknowledge that,except for my personal residence
Expires,3--3 1' -/-7 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
a 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 Labor Code,for the performance of work for which www.leginfo.ca.gov&alaw.htmL
this permit Is issued.
Policy# PROPERTY OWN ER OR AUTHORIZED AGENT Date
n I have and will maintain worker's compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which a By my signature below I certify to each of the following:I am the property
this permit is issued.My workees 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 enter the above identified property for inspection purposes.
(This section need not to he completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
'/.Lcertify that in the performance of the work for which this permit is issued,
lshallnotempl any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 5LA440
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 applimirt or future building occupant handle hazardous material or a
C--7:) mixture containing a hazardous material equal to or greater that the
Applicant 041 W--� Date Z17-2711 amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ci Yes Ao
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or futu re building
AND CIVIL FINES UP TO ONE H UNDRED THOUSAND DOLLARS($100,0110),1 N occupant reci uire a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQM D)?See permitring checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY oYes *0
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or mod ified fa cilitv 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 >40
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCACIM D
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 2SS34 concerning
Contractor's License Law for the reasons)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.S uYes 'PMO
Business and Professions Code).Any city or county that requires a permit to ze_a�� Date
G7
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUNORIZED A ENT
issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursua nt to the provisions of the Contractor's State EPA RENOVATION.REPAIR AND PAINTI G(RRP)
License Law(Chapter 9(commencing wilth 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
a 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( I portion of the work,and the structure is www.ePa.Rov1lead 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 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 project
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 bemuse;
ci 1,as owner of the property am exclusively contracting with licensed
contra ctors to construct the project(Section 7044,Business a nd Professions
Code;The Contractor's State License Law dam not apply to an owner of a If your project does not comply With EPA RRP rule please fill out the RRP
Acknowledgement
.1111 IN ILI 10-4110MA 12 MChvAlf"W-Al 0 94 so 101 rMARRI I lowl—Al I M kl
_kMenifee
D ' Z -0
ATE C/ 2 - // (�,' PERMIT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL ;<RESIDENTIAL C) MULTI-FAMILY OMOBILEHOME OPOOL/SPA COSIGN
SUBTYPE: OADDITION OALTERATION ODEMOLITION XELECTRICAL OMECHANICAL
WNEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES—
DESCRIPTION OF WORK ,;2-c> X :Z-�- 6 -5011D IV-u4v4uxx)D Ce4ce /Oxc/
('AJ, LeGr 5
PROJECTADDRESS .27Zo gq jq-4-)pL,6
ASSESSOR'S PARCEL NUMBER LOT '22 TRACT uv
OWNER NAME Z P,I A k-4 t4 a iz
ADDRESS .2-7 (oPlq 4 PPIb::' 8LO53011�
P H 0 N E (96-1 5-4/4,1' - -7q;2 2- - EMAIL
APPLICANTNAME
ADDRESS -3//S-
PHONE 9.27 - 9 A
EMAIL
CONTRACTOR'S NAME rylic-tigeL Ret-;,r- OWNERBUILDER? OYESXNO
BUSINESS NAME al Q.)-j�r.5�r-
ADDRESS IF<'— &yj
PHONE q27 - 9S3CI' EMAIL
CONTRACTOR'S STATE LIC NUMBER �P/(43160 C/ LICENSE CLASSIFICATION
VALUATION$ SO FT -119n L SQ FT
APPLICANTP-S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE E NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN 4 Ito SMIP
INVOICE PAIDAMOUNT
AMOUNT �5I[r)6��j I I OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES I PAIDAMOUNT I I OCASH OCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.citvof,menifee.us Inspection ReqUest Line 951-246-6213
PLOT/SITE PLAN
REAR PROPERTY LINE
City of Menifee
Building & safety Dept. (0
SEP 2 3 2016 1
Received
LEDGER & TRACK
INSPECTION REQUIREC'
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FRONT PROPERTY LINE
Property Owners Name C�k ifl A C4�1�,--
Property Address 27(PL/ A?F1—6 /L 0 87SO ell