PMT16-03235 City of Menifee Permit No. PMT16-03235
29714 HAUN RD. Type: Residential Re-Roof
<ACCELX—> MENIFEE,CA 92586
MENIFEE Date Issued: 1010312016
P E R M I T
Site Address: 29639 GREEN HILL DR, MENIFEE, CA Parcel Number: 338-221-008
92586 Construction Cost: $7,350.00
Existing U50: Proposed Use:
Description of REMOVE ONE LAYER,30 LB FELT,2 X 2 DEIP METAL, REROOF W/OWENS CORNING COOL ROOF
Work: IN AMBER
Owner Contractor
ALAN WALKER DAVID MURRAY KENNEDY
29639 GREEN HILL DR 24025 JUNIPER SPRINGS ROAD
MENIFEE, CA 92586 HOMELAND, CA 92548
Applicant Phone: 9519265298
DAVE KENNEDY License Number: 859185
DAVID MURRAY KENNEDY
24025 JUNIPER SPRINGS ROAD
HOMELAND, CA 92548
Fee Description Ply Amount
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
The issuance of this permit shall not prevent the building official firom thereafter requiring the correction of errors in the plans and
specificallons 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 otherv0se 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 Bldg Peant—Ternplate.rat Page 1 of 1
CITY OF MENIFEE
ENSED DECLARA71ON property who builds or improves thereon,and who contracts forthe projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contTactor(s)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 C�34 U Ti)e No. s�5� 1 $S:'
Expires 7 Signature e4- By my signature below I acknowledge that,except for my personal residence
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 DECLARLICIN 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 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
this permit is issued. www.leginfo.ca.gov/calaw.htmi.
Policy# QLq%1-?q PROPERTY OWNER OR AUTHORIZED AGENT Date
o I have and will maintain worker's compensation insurance,as required by
section 3700 of the Labor Code,forthe performance of the work for which o 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
Carrier 7T��'o with all applicable city and county ordinances and state laws relating to
Policy# Siq�16g� — building construction.I authorize representatives of this city or county to
-Expires IZ-01-41 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less ROPERTY OWNER OR AUTHORIZED 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
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Y.firm
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License Class
\Osubjecttotholftrker'sco pensat on provisions o Sectlon3700o t eLa or FHAZAA ER
DOUS M T I
C C.c Jsh fo withoo pl wit thosepr�jsions. Will t the applicant or future building occupant handle hazardous material or a
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mixture containing a hazardous material equal to or greater that the
Date lo-3-16 t�
A?ica amounts sp cified on the Hazardous Materials Information Guide?
ic
WARN NG:FAIIIJUREZO SWWL RE WORKE COMPENSATION COVERAGE IS o Yes 17.0
L L I
UNLA FUL,ANDS LLSUaJECTANE LOYER 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 t require.P
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
CL 0
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidel'i as
CONSTRUCTION LENDING AGENCY oYes ;7ho
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 permitis issued outer boundary of a school?
(Section 3097 Civil Code) o Yes GMo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCACMD
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 ha cl�ps'Qterlal rep
checkmarks)I have placed next to the applicable item(s)(Section 7031.5 Yes, Ef I o/ /
Business and Professions Code).Any city or county that requires a permit to Or/'
2'� Date /J9
construct,alter,improve,demolish or repair any structure,prior to its P TY OWN EA ORVHORIZED 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 IFIRPI
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)orthat he or she is exempt from licensure receiving compensation for most workthat disturbs paint In a pre-1978
and the basis forthe 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
n 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPNs Renovation Program visit:
compensation,will do I )all of or( )portion of the work,and the structure is www.epa.goyllead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5373).
Code;The Contractor's State License Law does not apply to an owner of a ci 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. o No EPA Lead-Safe Certified Firm is required for this project because:
o 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 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.
& SAFETY PERMIT/PLAN CHECK APPLICATION
4-
"Menifee
DATE C) 4Z) PERMIT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL /RESIDENTIAL OMULTI-FAMILY OMOBILEHOME 0 POOL/SPA 0 SIGN
SUBTYPE: OADDITION OALTERATIO 0DEMOUTION OELECTRICAL OMECHANICAL
ONEW OPLUMBINC PRE-ROOF-NUMBER OF SQUARES-'L
DESCRIPTION OF WORK gEANE Ok)E . ISO 16:&2 :Exz Del 1)0 qF-�
,&75qt�jGff 3b vr--,k
PROJEcTADDRESS 2A63q Geffk) AAL� j joP� 15jvj CA)�
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME A6,fA-) VJAAV-e�
ADDRESS 2-C16,3Q GfEE(,,) LLQ OP, G(Att) MV
PHONER�' 49'3,18V,7id EMAIL
APPLICANT NAME C)I;iNUiF—
ADDRESS
PHONE Q2 EMAIL
CONTRAcroWS NAME OWNERBUILDER? OYESONO
BUSINESS NAME CNV,3,)q- V-E�ZW A UkX-
ADDRESS 15(mu(j"5 PV�
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
IV 4�? QFT, Z30cl
VALUATION$ 5 L SO FT
APPLICANT'S SIGNATURL 4 11;W— V-/&/-���DATE In-3-16
CITY STAFF USE ONLY
DEPAKTMENI DISIHIMUIIUN CITY OF MENIFEE B-0!I-NT=ENSE NUMB-
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP ER
INVOICE PAIDAMOUNT
AMOUNT 1 1��-90 1 0 CASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT C)CASH 0 CHECK N 0 CREDIT CARD VISAIMC
OWNER BUILDERVERIFIED 0 YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-245-6213
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