PMT16-03360 City of Menifee Permit No-: PMT16-03360
29714 HAUN RD. Type: Residential Addition
<^—CCEL^--' MENIFEE,CA 92586
MENIFEE Date Issued: 10/1212016
P E R M I T
Site Address: 27823 PORTAL WAY, M ENIFEE. CA Parcel Number: 333-700-034
92585 Construction Cost: $3,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 560 SQ FT SOLID ALUMAWOOD PATIO COVER, NO ELECTRICAL
Work:
Owner Contractor
ROD HUGGINS SUPASITES CONTRACTING
27823 PORTAL WAY 208 NORTH VIOLET STREET
MENIFEE, CA 92585 CORONA,CA 92882
Applicant Phone:9514546478
BENJAMIN TAMEIFLINA License Number:706861
SUPASITES CONTRACTING
208 NORTH VIOLET STREET
CORONA, CA 92882
Fee Description Amount($1
Building Permit Issuance 27.00
Deck/Patio, non-standard 133.00
GREEN FEE 1.00
SMIP RESIDENTIAL 1.00
General Plan Maintenance Fee-Building 1 6.65
$168.65
The issuance of this permit shall not prevent the building officlial from thereafter requiring the correction of errors in the plans and
specifications or from preventing buillding 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.BidgPennit—Ternplate.ript 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 contractur(s)pursuant to the Contractors State License Law).
Chapter9(commencing With section 7000)of Division 3 of the Business and ci 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 F� 1(�—_S LIC 9 By my signature below I acknowledge that,except for my penonal residence
Signature '�:�'_JSL in which I must have resided for at least one year prior to completion of
Expires C-3 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 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.m.Roy/calaw.htmi.
Policy# ez — Date
ci 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 n 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 an 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# lf'13—a/9 e<'46 Epi re� 17 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 PROPERTY 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 asto become subject to the CITY BUSINESS UOENSE#
worker's compensation aws o California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the a s pens tion provi.sions of Section 3700 of the Labor
Code,I shall in Ith th se provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containingA hazardous material equal to orgreater that the
amountssp ified on the Hazardous Materials Information Guide?
WARNING:FAILURETOSEC40kORKER'S COMPENSATION COVERAGE IS aYes X"
UNLAWFUL,AND SHALL SUBJECrAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modiflotion 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 guideli
CONSTRUCnON LENDING AGENCY a Yes =
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 outer bound rV of a school?
(Section 3097 Civil Code) u Yes 20
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 W&Safe Code,Se ion 25505 and 25534 concerning
I_ P
Contractor's License Lawforthereason(s)inclicitted below by the ��dous mat po mg.
checkmark(s)I have placed next to the applicable Rem(s)(Section 7031.5 a in No.
Bushuess and Profmions Code).Any city or county that requims a permit to 'e" Date /'9
construct,alter,improve,demolish or repair any structure,prior to Its PROPERTY OWNER OR AUTHbftlZED 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(RRP)
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 mmt work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childmre facility to be RRP-certified firms and comply wilth
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( )all of or( )portion of the work,and the structure is www.epa.gov/Iead 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 n An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,th rough employeee or personal effort,builds or im proves 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 bemuse:
ci 1,as owner of the property am exclusively contracting With licensed
contractors to construct the project(Section 70",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
""Menifee
DATE PERM IT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL *RESIDENTIAL OMULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN
SUBTYPE: OADDITION OALTERATION �DEMOLITION OELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES_
DESCRIPTION OF WORK AWI�,AAWOO'l;> POO C6�4D�'-
,I �l
PROJECTADDRESS /— tl?z VAA�Nl IF Ei:-:T c-A- 9 9-�S�
ASSESSOR'S PARCEL NUMBER ?07�1'100-Cr*54 LOT b4 TRACT
IP
O-P
OWNER NAME
ADDRESS W !�d "15N CA 9 :?-�
PHONE (
9q) -+V - EMAIL
APPLICANT NAME !�-,u T�ks; i c-,F.>N T'P�-n &16
ADDRESS 90S � �QLAel- 51- CDOC^� A CA-
PHONE 4S; (04/�r7 EMAIL izwolej I r\A e�act-wl"I
-M, j'T:�ffJAOWNERBUILDER? OYESWNO
CONTRACTOR'S NAME "F
BUSINESSNAME ClC)NJTyZA
ADDRESS Z-OS' \1101,t�T S-F cZ 90N A co"\ 11
PHONE (flt�j) EMAIL kbk*hei-hA MP6701 '�OM
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ SO FT 5(00 LSQFT
APPLICANT'S SIGNATURE DATE 1c)A
CITY STAFF USE ONLY
DEPARTMENT D15TRIBUTION too Cl I Y UF MENIFEE BU51NE5S LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICT�(Ot PAID AMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
AMOUNNE I I
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES rl NO OIL NUMBER NOTARIZED LEITER 0 YES 0 NO
City of Menifee Building& Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-5777
www.cityofinenifee.Lis Inspection Request Line 951-246-6213