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PMT16-03639 City of Menifee Permit No.: PMT16-03639 29714 HAUN RD. Type: Residential Addition <A-CCELA> MENIFEE, CA 92586 MENIFEE Date Issued: 11109/2016 PIERMIT Site Address: 30131 MUIRLANDS, MENIFEE, CA 92584 Parcel Number: 364-370-064 Construction Cost: $8,350.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 528 SOFT SOLID ALUMAWOOD PATIO ATTACHED TO SLAB.2 FANS&2 POSTS Work: Owner Contractor COLLIE PROVENCE PSLQ INC 30131 MUIRLANDS 28910 RANCHO CALIFORNIA RD MENIFEE,CA 92584 #206 Applicant Phone:9517954260 JOSH HERRICK License Number:919885 PSLQ INC 28910 RANCHO CALIFORNIA RD #206 TEMECULA, CA 92590 Fee Description ON Amount($1 Receptacle,Switch, Outlet&Fixture 4 131.00 Building Permit Issuance 1 27.00 Deck/Patio,non-standard 1 133.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 2.00 General Plan Maintenance Fee-Building 1 6.65 General Plan Maintenance Fee-Electrical 1 6.55 $307.20 The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors 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 BidgPermit Terniplate.rpt Page I of 1 CITY OF MENIFEE LICENSED DECLARATION 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 contractor(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 s�in full force and effect. the following reason: License Class— Uce-n M No. ) By my signature below I acknowledge that except for my personal residence Expires Sign,tur<:::LJJJ;:Z� in which I must have resided for at least one year prior to completion of I 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 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 mainta in a certificate of consent of self-insu re 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 La bar Code,for the performance of work for which this permit Is Issued. w%vw.IegInfia.ca.Rov/caIaw.htmL Policy It Date aP(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 u 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 am: application and the information I have provided is correct.I agree to comply R 1 with all applicable city and county ordinances and state laws relating to Carrier - Z� building construction.I authorize representatives of this city Or county to Policy# 4- 5?— 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 OWNER OR AUTHORIZED AGENT ci I certify that in the performance of the work for which this permit is issued, Ishallnotempi 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 subject to the worker's compensation provisions of Section 3700 of the Labor Code,I sha ose provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date mixture containing a hazardous material equal to or greater that the amounts specifiW on the Hazardous Materilals Information Guide? A TO SECURE WORKER'S COMPENSATION COVERAGE is 0 Yi MIN6' WARNING:FAILU UNLAWFUIL,ANO SHALL SUBJECTAN EMPLOYER TO CRIMINAL PENALMES 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(SCAQM D)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY ci Yes I hereby affirrin 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) o Yes umo� OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCACIMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist I understand my requirements under the State of California He:I h&S:fe y Code,Section 25505 and 25534 concerning in ti Contractoes license Law for the reason(s)indicated below by the hazardous teri,l r chei:kmark(s)I have placed next to the applicable item(s)(Section 7031.5 V6 a No Business and Professions Code).Any city or county that requires a permit to <:�::M <_� Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNEPIQAUTHORIZED AGENT issuance,also requires the a pplicant 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 Ilcensure 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 childure facility to be RRP-certified firms and com ply with an Applicant for a perm it 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 theirsole employees.For more information about EPXS Renovation Program visit: compensation,will do( )all of or( )portion of the work and the structure is www.epa.gay/lead or contact the National Lead Information Center at not intended or offered for sa le.(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 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 itwas not built or improved for the purpose of sale. ci No EPA Lead-Safe Certified Firm is required for this project because; n 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 dam not apply to an owner of a If your project does not comply with EPA RRP role please fill out the RRP Acknowledgement. DATE PERMIT/PLAN CHECK NUMBER TYPE: EICOMMERCIAL RRESIDENTIAL [:]MULTI-FAMILY E]MOBILEHOME []POOL/SPA FISIGN SUBTYPE: F]ADDITION F]ALTERATION [-]DEMOLITION F]ELECTRICAL E]MECHANICAL [:]NEWE]PLUMBING EIRE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Solgsq-� AlufnkmA saha �oL, co�,,c-, 9�%Aied m PROJECTADDRESS ASSESSOR'S PARCEL NUMBER $10 (JO LOT X144� TRACT ',P)i 2,2 PROPERTY OWN ER'S NAME Ff-pjjEna ADDRESS PHONE 119 EMAIL �jf At-e SA) ci !�M4-t C-q� APPLICANT NAME ADDRESS PHONE EMAIL c,e CONTRACTOR'S NAME OWNERBUILDER? [:]YES:KNO BUSINESS NAME [�Men nee_ MlaADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION $ a 350 , 1 1 SQ FT L SO FT APPLICANT'S SIGNATURE�� DATE cr � tp-ji" DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP I PAID AMOUNT CASH CHECK# 1: CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT CHECK# CREDIT CARD VISA/MC CASH OWNER BUILDER VERIFIED OYES --' No DL NUMBER NOTARIZED LETTER YES 0 NO -laun Rd. Mer�,"- 17A 92586 951-,: �-Itv of Allen.ifee Bulf ding & Sqfery Departnient 2-9714 1 1 - - v1wimcit�"Ofinnenifee.us Inspectfon Request Line 951-246-6213 C-) 4�b 0-- - - -- - - - - - -- - - - - - - 0 0 m z LA ga 0 -j , Z --1 0 C) 20 -1 (a) m 0 m m 0 > '6* rn n Z > wc- 23 m C) in rm m r- rM rn rn I 2 rL -0 M (D (D SP rn > rn 0 Z z In m ,rn CD 5 r) rrl I e 0 > kD m s Dnzn6 Ln -0 CD x G) 00 Z CS a 0 Ln < CD M ro z 0 m '-4 sa NVIbInAE Copy Om C) SOIrl