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PMT16-03264 City of Menifee Permit No.: PMT16-03264 29714 HAUN RD. Type: Residential Re-Roof <A_CCiELA" MENIFEE,CA 92586 MENIFEE Date Issued: 1010512016 P E R M I T Site Address: 28770 SNEAD DR, MENIFEE, CA 92586 Parcel Number: 337-391-001 Construction Cost: $8,000.00 Existing Use: Proposed Use: Description of TEAR OFF EXISTING ROOF, REROOF WITH OWENS CORNING COOL ROOF IN AMBER Work: Owner Contractor FREDRICKA VOYLES HOUSETOP ROOFING 28770 SNEAD DR 31760 BRIGGS ROAD MENIFEE,CA 92586 MENIFEE, CA 925134 Applicant Phone: 9516798369 RICH CARROLL License Number:371783 HOUSETOP ROOFING 31760 BRIGGS ROAD MENIFEE,CA 92584 Fee Description Qtv 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 from thereafter requiring the correction of effors 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 Bldg Perryfit—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 contractor(s)pursuant to the Contractors State License Law). Chapter!)(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Ctmtractoes State License Law for Professions Code and my license is in full force and effect. the following reason: I License Class 'q License No._311 I.P-3 By my signature below I acknowledge that,except for my personal residence Expires/;// Signature In which I most have resided for at least one year prior to completion of Improvements covered by this permit.I cannot legally sell a structure that I WORKI RAi?Nr have built as an owner-builder if it has not been constructed in its entirety by c 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 vvww.IeRinfo.ca.Rov1caIaw.htmL this permit is issued. Policy 4 Date >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 a 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 ovimer's behalf.I have read this number are: application and the information I haw provided is carrect.I agree to comply C with all applicable city and county ordinances and state lam relating to Carrier I—L"f'J building construction.I authorize representatives of this City or county to Policy N Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit i;for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT a 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 If worker's compensation laws of California,and agree that if I should become 14AZARDOUS 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 3&Z& amounts specified on the Hazardous Materials Information Guide? WARNING:KAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes JIM0 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($100,00),IN occupant require a permit for the construction or modificallon from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQM Dj?See permitting checklist IN SECrION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCrION LENDING AGENCY aYes 00 I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 10DO 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) 0 Yes AND 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 Contractor's Umnse 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 �Wes 0 0 Bumess and Professions Code).Any city or county that requires a permit to I-e e�l'� Date construct,alter,improve,demolish or repair any structure,prior to Its PROPr OWNER OR AUTHORIZED AGENT Issuance,also requires the applicant for the permit to file a signed Statement ENO that he or she is licensed pursuant to the provisions of the Contractor's State EPA ENOVATION,REPAIR AND PAINTING lRFpj 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-1979 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 Applica nt 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 mom information abou I EPKs Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gowlead 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 u 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.It,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will haw the burden of proving that it was not built or Improved for the purpose of sale. u No EPA Lead-Safe Certified Rrm is required for this project because: a 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 RAP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ' 2`Menifee DATE /Z 1:� PERMIT/PLAN CHECK NUMBER IF TYPE: COMMERCIAL *IlrESIDENTIAL 0- MULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL ONEW OPLUMBING X<E-ROOF-NUMBER OF SQUARES--.2,0- DESCRIPTION OF WORK PROJECTADDRESS ? 40 ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME ADDRESS PHONE 02-0 '0 EMAIL APPLICANT NAME ADDRESS 7,0 0 ae,0kZ- PHONE EMAIL 1,41 S--Zt' CONTRACrOWS NAME —Xlel�l OWNER BUILDER? ',') YES ONO BUSINESS NAME ADDRESS PHONE EMAIL 00/ I f 4 .-cc CONTRACTOR'S STATE LIC NUMBER 37/79P_3 LICENSE CLASSIFICATION (? VALUATION$ goao SOFT L SQ FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP I INVOICE I 1-�k, 0101 PAIDAMOUNT OCASH OCHECK# Q CREDIT CARD VISA/MC AMOUNT PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES 0 No DILNUMBER NOTARIZEDLETTER 0 YES 0 N:O:::� City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92585 951-672-6777 wwi,v.CitvOfmemfEe.us Inspection Request Line 951-245-6213 * . . Z �> C� r) 0 CW 0 ��i > r1l 0 ;u m 0 m m I m om > 0 Z* o 3 0 0 0 w 9: 6 (0 0 'M M n m Z 0 xm m m M Ei. 0 m 13 '4� M > o 0 o m M 3 on m m > > z 7' 0 3 0 m v ;Q M m M 0 - o SL " — 0 �o m n 5, �: r m m 0 m m > z ;a m n 3 a = m V M z o K 3 m 0 cm m < 0 m zn Z5 2. 1 z o o w 0 3 m . n z 0 > m > Z 0 LD. g — 0 Z 0 X > > W M > I (-) 3 . m 0 M zi 0 cn m 0 Z m M 0 = % m 0, > -R m 0 � 0 1 =! 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