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PMT16-03693 City of Menifee Permit No.: PMT16-03693 29714 HAUN RD. Type: Residential Addition '5A-CCELX-> MENIFEE, CA 92586 MENIFEE Date Issued: 12/0812016 P E R M I T Site Address: 25788 BUFFALO CIR, MENIFEE,CA Parcel Number: 358-502-022 92584 Construction Cost- $12,000.00 Existing Use: I &2 Family Residence Proposed Use: Description of INSTALL 1 1X15 DETACHED PATIO COVER SOLID Work: NO ELECTRIC Owner Contractor BYRON&MAUREEN SPONSELLER CAPITAL CONSTRUCTION INC 25788 BUFFALO RD 41558 EASTMAN DR STE D MENIFEE, CA 92584 MURRIETA, CA 92562 Applicant Phone: 9519900394 NATHAN JONES License Number: 941031 41558 EASTMAN DR STE D MURRIETA,CA 92562 Fee Description ON Amount Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 Additional Plan Review Building 158 157.50 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 2.00 General Plan Maintenance Fee-Building 1 6.65 $327.15 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.Bidg_Pennit-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). ChapterSi(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 Class—il A 3 License J1116. By my signature below I acknowledge that,exceptfor my personal residence Expires 141"11,2 Signature in which I must have resided for atleast one year prior to completion of Improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION D LARATIO have built as an owner-bullder if it has not been constructed in its entirety by Kc a 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-ca.gov/ca law.htm 1. Policy# Date awrgv'eancl 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 o By my signature below I certify to each of the following:I am the property this permit is Issued.My workerjs compensation insurance carrier and policy owner or authorized to act on 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 -7 d with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# Expires 7 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, 1) I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# worker's compensation laws of('31"ornia,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the work sc p ation provisions ofSection 3700 of the Labor Code,I shall fort ith y 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 ApplicantA, Date IZ-41-16 amounts specified on the Hazardous Materials Information Guide? WARNING:FAlyJ16E TO SECURE WORKER'S COMPENSATION COVERAGE 15 ci Yes ci No UNLAWFUL,AND SHALL SUBJECTAN 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 for guidelines CONSTRUCTION LENDING AGENCY ciYes ciNo 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) ci Yes ci No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of California Health&SafqpEode,Section 25505 and 25534 concerning Contractoes License Law for the reason(s)indicated below by the haza"rus matoa a rting. checkmark(s)I have placed nextto the applicable item(s)(Section 7031.5 Business and Professions Code).Any city or county that requires a permit to "s ci No X P-0 Date construct,alter,improve,demolish or repairany structure,priorto its PROPERfYi ORAUTHORIZED AGENT issuance,also requires the applicantforthe permittofile a signed statement that he orshe Is licensed pursuant tothe provisions of the Contractor's State IPA R=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)arthat 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.Anyviolation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more than($500). required practices.This includes rental property owners and property managers who do the paint-disturbing work themselves orthrough their ci 1,as owner of the property,or my employee with wages as their sale 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.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 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 forthe purpose of sale. o No EPA Lead-Safe Certified Firm is required for this project because: 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 RAP rule please fill out the RRP Acknowledgement. c1t, o, leo xx— BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ceived Menife(R- e DATE PERMIT/PLAN CHECK NUMBER TYPE: COMMERCIAL &I'ESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0_ POOL/SPA 0 SIGN SUBTYPE: ADDITION -D'ALTERATION 0 DEMOLITION 0' ELECTRICAL ') MECHANICAL C NEW () RE-ROOF 0 PLUMBING -NUMBER OF SQUARES_ DESCRIPTION OF WORK —lixts a_42v_At� 'Ph-hr,, C6a�-r 145s_p PROJECT ADDRESS 2_570'?� dcj-(?Zlo oe-cL,4_ ASSESSOR'S PARCEL NUMBER f/IE,/ LOT TRACT t05 lb-,So - J�� OWNER NAME 9/v,)/-) A Ac)rlmn QA 5'4 ADDRESS 2-5 7 /1, PHONE crG i- vn Y4-74 EMAIL. APPLICANTNAME ADDRESS 41155':a F,�z 12 Awrmk e& _66-� PHONE EMAIL 17o2g*1140"I,� z4:w5A4)6d -V CONTRACTOR'S NAME OWNER BUILDER? 0 YES �4-M BUSINESS NAME ADDRESS PHONE ;oy-- 1z EMAIL d7,;o U 3 CONTRACTOR'S STATE LIC NUMBER 74163 ( LICENSE CLASSIFICATION VALUATION$ L)OC) //SQFT L SO FT APPLICANT'S SIGNATURE DATE lbzlea DEPARTMENT DISTRIBUTION SMiP CITY OF MENIF,�;TnSYUMBER BUILDING PLANNING ENGINEERING FIRE � GREEN 01 INVUCE AMO NT PAID AMOUNT C CASH -CHECK# C;CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0 CASH Q CHECK# OCREDITCARD VISAIMC OWNER BUILDER VERIFIED OYES () NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building &Safety Department 29714 HOUn Rd. Menifee, CA 92580'951-672-6777 www.cityofmenifee.Lis Inspection Request Line 951-246-6213