PMT16-03627 City of Menifee Permit No.: PMT16-03627
29714 HAUN RD. Type: Residential Re-Roof
<A-CCEL:A-'*J' MENIFEE,CA 92586
MENIFEE Date Issued: 11/0812016
P E R M I T
Site Address: 25781 LANCASTER DR, MENIFEE, CA Parcel Number: 335-092-002
92586 Construction Cost: $5,600.00
Existing Use: Proposed Use:
Description of REMOVE EXISTING LAYERS, INSTALL NEW COOL ROOF SHINGLES
Work; CRRC#0890-0011
Owner Contractor
JOANAWEBER FREDERICK RICHARDSON CONSTRUCTION
25781 LANCASTER DRIVE 11187TVIALIGHTWAY
MENIFEE, CA 92586 MORENO VALLEY,CA 92555
Applicant Phone:9516536132
FREDERICK RICHARDSON License Number:643209
FREDERICK RICHARDSON CONSTRUCTION
11187 TVVILIGHT WAY
MORENO VALLEY, CA 92555
Fee Description Qtv Amount
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREENFEE 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 emors 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 Menifiae.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.
AkBldg_PerrnIt_TernpIate.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).
Chapter9(commencing with section 7000)of Division 3 of the Business and u I am exempt from licensure under the Contractor's State Ucense Law for
Profess' C d d 16cense Is In full force and e the following reason:
License Class ,�_Licens N By my signature below I acknowledge that,except formy personal residence
ExpirUM/_-7-�0 S��e Af J11 in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally Sella structure that I
WC DEILA ON. 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 www.leginfo.ca.goy/calaw.litmi.
this permit Is Issued.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
have and will maintain workees compensation insurance,as required by
6"I'tion 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 a m the property
this permit is issued.My worker's compensation insuTa nce carrier and policy owner or authorized to act an the property owner's beha If.I have read this
number a re: 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 Itif-7 Expires 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 OWN ER OR AUTHORIZED AGENT
in I certify that In the performance of the work for which this permit Is issued,
I she 11 not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
k r' U n la!wts!f Cat:forrura, d ree thatif I should become HAZARDOUS MATERIAL DECLARATION
0 in -g T
a 0
sa
ens
w R e2
r, c
_p
,,ZK,e, si5t M. ke- S np.alsions of Section 3700 of the Labor
Core,.l shall fin ,ttmp V� th thos provisions. Will the applicant or future building occupant handle hazardous material or a
pli � W I Da mixture containing a hazardous material equal to or greater that the
A., Z vne� te
amounts specified on the Hazardous Materials Information Guide?
WARNlNr-/1FAI1 I IRE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes oNo
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 forguidellnes
CONSTRUCTION LENDING AGENCY ci Yes a No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be mfithlo 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 ciNo
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 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 hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 aYes o No
Business and Professions Code).Any city or county that requires a permit to Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement
that he or she is li;ensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRPJ
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-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
c 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( I portion of the work,and the structure is www.epa.Rov/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 a 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 bemuse:
o 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Cocle:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA FIRP rule please fill out the RRP
Acknowledgement.
& SAFETY PERMIT/PLAN CHECK APPLICATION
Nen'fee
DATE///0740 PERMIT/PLAN CHECK NUMBER
TYPE: OCOMMERCIAL ORESIDENTIAL eMULTI-FAMILY 0MOBILEHOME CPOOL/SPA OSIGN
SUBTYPE: 0 ADDITION -ALTERATION 0 DEMOLITION 0 ELECTRICAL 0 MECHANICAL
ONEW OPLUMBING )<RE-ROOF-NUMBER OF SQUARES at
DESCRIPTION OF WORK rD b)EZ-K-�7
Co�4p
Q
PROJECTADDRESS o -5-793, (4WCA5TzE_;ve T)vz CtZ_OK_.o
ASSESSOR'S PARCEL NUMBER :j!6- - �= LOT TRACT City of Menifee
OWNER NAME JDANA, Vj6P-6P— -BUII(Iing &Safety Do
ADDRESS Q5-79t NOV 0 8 2016
P H 0 N E 1) 4P79 — 94f-30 EMAIL R@Geived
APPLICANT NAME _�ogt,�j
ADDRESS IL197 7-A)'1Lj6jk"-_1&jAy (_2A ,!,c1-k0
4
PHONErQ'!51) EMAIL
CONTRACTOWSNAME �COWNERBUILDER? OYESXNO
BUSINESS NAME ���4ie
ADDRESS
PHON 4 EMAIL
CONTRACTOR'S STATE LIC NUMBER 49Z19a6e1? LICENSE CLASSIFICATION 2W
VALU14TION$ L SQ FT
APPLICANT'S SIGNATUR k A& gd_(eZe��RATE
.R.4 6N
11ITTISTMAMMUSt 7
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP X
INVOICE PAID AMOUNT
AMOUNT I I OCASH ()CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT I I OCASH COCHECK# 0 CREDIT CARD VISA(MC
OWNER BUILDER VERIFIED 0 YES 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.cityofmenifee.us Inspection Request Line 951-246-6213
m
0 c
0
w 0
E
0 41 cl
ou ix m ! CC
w ao,
w m 0 E o
D E OC
E
w w E
z E
W UJ X M
LC
z
E 0
H
W
0
0
L
<
w 0 E
C;
R x
u
>
0
a a 42
0
It!
E
E
> a E
M 0 0
- W
0 M , " - a E
0 0 0
0 0 0 0
0 0 0 0 u E I
0 cm 2 w c w
u >
a cc
o 4i w 0
< 0 > WU -
w o -. W E
2
0 1
E '6 0
, - 6 00 �u
40 w a w
E 0 0
m M C
m 2 E ww m
0 a
dOW00 a w A �x 4 . c
w m < 00 a
:2 0
w cq 0 3
C 0 Z �5 m
M 0
ou Ou
't Aw L2 E
u C) 0 0
0 12
E �Q U. 0, @
M cO 0 E
0
0
3: M� E c o
0 W 2
0 "
0 > E 0 w 0
z E 0 %7j C a .2 -m o
m M 0 C
LL E -c 0 0
0 r 2 E t; 'o m
er 0 0 0 a
0 E --
0 :� is- 'o 4� -0 2
0 0 W 3 =
u 0 E
tm �O =3 t; E
w
u
> 0
0 0 0
0 c
0
-2 m m -0
w E
0 m
x =Z
W X w
0
0 ui .2 3: w 0 n w o
E - ll� i- < 9
z 0 0 3
U
w a A 2 :5 H 'a z
E 0 w u = . E 4 w < -,;, :a -6
z U w Z 3q
W r: 0- - p W w c 0 M
0 �s -1 . w E
x
0 s
0
0
0
E
w -u 00 08 w ma w
C
� 1 0
0 E n z j7 .2
0 0 u
z 0 L
0
13 A U E
a x
z < 'o
0 Q) 0
P: u o 1! E -o
z 0 u E >w o
:3 0 < 0 E -2 0 M
< Ou 2 ;R 0
L
0 w 0 M C u
0 w 0 M
92 w u E 0 x
m 0
0 Z v 0 m c E
9 0 m 0 E 0
w �s w 0 m 6 �c
Lu o
L5 E �4 ni ni
w :L 5 2
0 2 0
:3
ul J Z o 3: o c
0
0
0 C-4
0 w
tw
cy E
0
3:
42
w
u 0
a w 0
-Y 0
75 M M
u I
0
m
0 0
0 tL 0
w m 0
w 0
0 0 >
'D E 7s w
0 .2 4j W W
of
0
u 0- 0
'y to Ut
E b
mu 0
I
TJ
-zb .2 0
U
a: u IE
Q 0
u OP
7 u� - S . w a , - c 1�
m a 2 , w z 0
m u u -0
.5 W 0 % w
3i m m 0 , u w Q. u
z Z 6 a
.2 .4 W
W6 a3 w
M
W 0 0 0
w U C -
. I w - - - E w
M .2 =� -
0
u 0 m 0 0 0
w 0 > - . 0
u 0 0
w E z
C 0
0 0
a -
0 0
a 0 w
U
0 2 ai
0 m.
0
41
o u m m Cc
X w t; 0
0 , m
u
E
0 0 0
0 0
w 0
Mw u - , 0 , E
E 0 u 75 E
u U -Z :F 0
z
0 W 0 0 w c
w z o - 6 =0 2 M = , a E
qi a 0 = :5 . . E < 0
CL o - -r u m 12 T c w 0 5 -a
0 0 .2
w -
m
0 CD > m
ca
E E E R
6 Om E E E
>
u 0 0 o 0 0
I
a z
lu -a.