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PMT16-03620 City of Menifee Permit No.: PMT16-03620 29714 HALIN RD. '5A_CCELA> MENIFEE, CA 92586 Type: Commercial Re-Roof MENIFEE Date Issued: 11107/2016 P E R M I T SiteAddress: 26820 CHERRY HILLS BLVD, MENIFEE, Parcel Number: 337-310-016 CA 92586 Construction Cost: $11,000.00 Existing Use: Proposed Use: Description of INSTALL 65 SQ'S OF APOC 252 WHITE COATING Work: Owner Contractor SEVEN SEAS, INC. BERRY ROOFING INC 8835 E 11TH ST 3226 KLLIK LANE LOS ANGELES, CA 90023 RIVERSIDE, CA 92501 Applicant Phone:9519D55116 KEN ALVARADO License Number 691947 BERRY ROOFING INC 3226 KLUK LANE RIVERSIDE, CA 92501 Fee Description Amount Building Permit Issuance 27.00 Inspections not specified 129 129.07 Inspections not specified 129 129.07 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 12.91 $299.05 The issuance of this permit shall not prevent the building official from thereafter requidng the correction of errors in the plans and specifications or from preventing bulliding 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,_l31dg_Perrnjt­Temp1ate.rpt Page 1 of I CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects I hereby affirm is rider 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 a 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 Classi::�, License No. '6fz�%7 By my signature below I acknowledge that except for my personal residence Expires Z;r Signature in which I must have resided for at least one year priorto completion of I 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 csiperjury one of the following declarations:I licensed contractors.I understa[rid that a copy of the applicable law,Section have and will maintain a certificate of consent of self-Insure forworker'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 welosite: by Section 3700 of the Labor Code,forthe performance of work forwhich this permit is issued. www.IeRInfio.ca.gov/calaw.htmL P fi # Date ;7h1ve 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 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 Carrier with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy It Expires 4z-/-/7 enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-In undred Date dollars($100)or less PROPERTY OWN ER OR AUTHORIZED AGENT o I certify that in the performance of the work for which this permit is issued, - -11v Ishallnotermil any persons in any manner so as to become subject to the CITY BUSINESS UCENSE# 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 ccrrnp�.vilth those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date /'J4r/'1r mixture containing a hazardous material equal to or greater that the amounts specifflied onthe Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes a No UNLAWFUL,AND SHALL SUBJECT 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($100,000),IN 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 forguldelines CONSTRUCTION LENDING AGENCY o Yes 9rNo 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 boundary of a school? (Section 3097 Civil Code) oYes oNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements underthe State of I hereby affirm under penalty of perjurythat 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 hazardous in I " I orting. checkmark(s)I have placed next to the applicable Itern(s)(Section 7031.5 oYes wN Business and Professions Code).Any city or county that requires a permit to Date construct,a Iter,improve,demolish or repair any structure,prior to its �w issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER OR AUTHORIZED AGENT that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING fiRRP) 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 RAP-certifled firms and comply with an Applicant for a permit subjects the applicant to a civil pena Ity of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing workthemselves or through their o 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA!s Reno"tlon Program visit: compensation,Will do( )all of or( )portion of the work,and the structure is www.epa.gov/­`lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code,The Contractor's State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project p ropertV who,through em ployees'or personal effort,builds or Inn proves the property provided that the Improvements are not Intended or offered for Certified Firm Name: sa le.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. _/No EPA Lead-Safe Certified Firm Is required for this project bemuse: o 1,as owner of the property am exclusively contracting With licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RAP Acknowledgement. & SAFETY PERM IT/PLAN CHECK APPLICATION Menifee DATE PERMIT/PLAN CHECK NUMBER TYPE: WCOMMERCIAL ORESIDENTIAL OMULTI-FAMILY OMOBILEHOME 0 POOL/SPA 0 SIGN SUBTYPE: OADDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-N UMBER OF SQUAIRES_ DESCRIPTION OF WORK AF1 PROJECTAIDDRESS ASSESSOR'S PARCEL NUMBER '�)f 0-ORO LOT TRACT -50019 OWNER NAME ADDRESS PHONE EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? 0 YES 0 NO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION �z VALUATION$ SO FT L SO FT APPLICANT'S SIGNA URE 4�L DATE 1,11711�- DEPARTMENT DISTRIBUTION SMIP CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN = I :::] PA�DAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC PLAN CHECK FEES I PA D AMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES () NO DLNUMBER NOTARIZEDLETTER 0 YES 0 NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofirnenifee.us Inspection Request Line 951-246-6213 00 C) o =r F CD Z5, is E7 eg, Er Li EE 0 a STATE OF CALIFORNIA COMMISSIONING - DESIGN REVIEW SIGNATURE PAGE CEC-NRCC-CXR-05-E(Ravlaed 08/15) (?aU1 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-CXR-05-E Commissioning-Design Review Signature Page (Page 2 of 2) P.JW N..s: D.WPI.pved: 4'1�c DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance clocumentation tftk��TJ Zorriplete. Documentation Author Documentation Auth 51 n t company: Signature Date: 75yC1 Address: CIA/HERS Certification Identification(if applicable); Z-Al, City/State/Zip: phone: Cw- gLL';'-'z ;0�1� . :S�;/C- RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury,under the laws of the State of California: 1. The information provided on this Certificate of Compliance Is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design Identified on this Certificate of Compliance(responsible designer). 3. The energy features and performance specifications,materials,components,and manufactured devices for the building design or system design Identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features Identified on this Certificate of Compliance are consistent with the Information provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application. S. I will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building perni Issued for the building,and made available to the enforcement agency for all applicable Inspections.I understand that a completed signed copy of this Certificate of Compliance Is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature Company: Date Signed: Address: License: City/State/Zip: Phone: CA Building Energy Efficiency Standards-2013 Nonresidential Compliance August 2015 M x m n m 0 rn D M n Z (3 �- 0 0 1 < w Z' < M z o M M j 0 �f 4; W > 0 0 3 0 11 11 M a z v rn 0, m3 'M IF N �r 0 0 < Fi r- o Q M no M > Mo > o --j Z I M 5 ,07 M 0 o 12 m h, z Vm r 0 M 5. M I OW 0 3 M M 05 0 w oc. 3 DM o 0 c > vM FD' 3 z > 0. 0 a D.- -g I.: ri Pi Z z 14 01 0 0 3M 'a 0 0. M V '-44 a M M c 0 0 0 D 00 an 3 w on No wv 01 Cl 3 0 0 C 5 F; o < UT 3 2. 0 M 0 3 M 0 3 0 2. 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