PMT16-03701 City of Menifee Permit No.: PMT16-03701
29714 HAUN RD. Type: Residential Addition
.�CCFILAF MENIFEE, CA 92586
MENIFEE Date Issued: 11/16/2016
P E R M I T
Site Address: 30127 VIA PALERMO, MENIFEE,CA Parcel Number: 364-096-007
92584 Construction Cost: $17,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 16X42 SOLID ALUMAWOOD PATIO COVER.2 FANS AND 1 OUTLET.
Work:
Owner Contractor
SYLVIA FRANCISCO TRADER DAN'S ING
30127 VIA PALERMO 840 S ROCHESTER AVE STE C
MENIFEE, CA 92584 ONTARIO,CA 91761
Applicant Phone:9093900555
CHANTEL CAGLE License Number.517575
TRADER DAN'S INC
840 S ROCHESTER AVE STE C
ONTARIO, CA 91761
Fee Description Qtv Amount($1
Receptacle,Switch, Outlet&Fixture 3 126.00
Building Permit Issuance 1 27.00
Deck/Patio, non-standard 1 133.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 3.00
General Plan Maintenance Fee-Building 1 6.65
General Plan Maintenance Fee-Electrical 1 6.30
$302.95
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.
AkBidgPemiri-Template.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 contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and a I am exempt from flcensure under the Contractor's State License Law for
Professions code and my license is in full force and effect. the following reason;
License Class License No. 15/—7 By my signature below I acknowledge that,except for my personal residence
Expires ignature inwhich I musthave resided for at least one year prior to completion of
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 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-insum for workees 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.IeRinfo.ca.gov/caIaw.htmI.
this permit is issued.
Policy# Date
PROPERTY OWN IR OR AUTHORIZED AGENT
':1' ve and will maintain wolees com pen""lon nsuanceas required by
an ..fthe or
section 3�0 of the L.b.,Code,forthe P.form I I k for which o By my signature below I certify to each of the following:I am the property
this Prmts issued.My w.rke ,corn pnat,., nsurancec",er and policy owner or authorized to act on the property owner's behalf.I have read this
number am; 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 Z6140 building construction.I authorize representatives of this city or countVto
Policy v2AM23�&&�6ires 110 enter the above identified property for inspection purposes.
(This section need not to be completed Is the permit is for o-nihndred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
a 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 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 workees compensation provii ons of Section 3700 of the Labor
Code,I sh ;elri�l islons. Will the applicant or future building occupant handle hazardous materialora
all Date mixture containing a hazardous material equal to or greater that the
Applicant /7Z� amounts specified on the Hazardous Materials Information Guide?
WARNING:FAIL
UBE TO SECURE W 'S COMPENSATION M� 0 Yes No
UNLAWFUL,AND SHALL SUBJECT?PEMPLOYERTO CRIMINAL PENALTIES "Q
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 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 forguid lines
CONSTRUCTION LENDING AGENCY oYes T;0
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) 0 Yes kNo
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 Californ a Health&Safety Code,SectiF?5505 and 25534 concerning
Contractor's License Law for the reason(s)Indicated below by the
checkmark(s)I have placed next to the applicable itemis)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY O*NEf-61R-Al7rHORI1WAGENT
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 Contractoes state EPA RENOVATION,REPAIR AND PAINTING JRRPI
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 Rcensure 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 RRP-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($500). managers who do the paint-disturbing work themselves or through their
a 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or I )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at
not Intended or offered for sale.(Section 7044,Business and Professions 1-SOD-424-LEAD(532.3).
Code;The Contractor's State License Law does not apply to an owner of a a An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not Intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the pu rpose of sale. ci No EPA Lead-Safe Certified Firm Is required for this project because:
o 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: 0 COMMERCIAL ��ENTIAL CMULTI-FAMILY OMOBILEHOME 0 POOL/SPA OSIGN
SUBTYPE: �"DDIT6 CALTERATION C)DEMOLITION CELECTRICAL CMECHANICAL
11
ONEW OPLUMBING 0 RE-ROOF-N UMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS a
.�Vlzl vz '
ASSESSOR'S PARCEL NUMBER 'jkVL4 - Ol(0 0()7)_ LOT TRACT 20 50
OVINERNAME
ADDRESS
PHONE W EMAIL
APPLICANT NAME A
ADDRESS <; /zz
PHONE ��Q EMAIL
CONTRACTOR'S NAME OWNERBUILDERZ OYES 191�
BUSINESS NAME
ADDRESS
PHONE 0_5S S EMAIL
CONTRACrOWS STATE LIC NUMBER SZ LICENSE CLASSIFICATION
VALUATION$ 17 /W(�) SQ FT LSQFT
APPLICANT'S SIGNATURE r7r�
DATE
DE RTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP 0315 1 45115
INVOICE '%� - PAIDAMOUNT OCASH OCHECK# 0OREDITCARD VISA/MC
AMOUNT L-011� I
PLAN CHECK FEES I PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 No DLNUMBER NOTARIZEDLETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.citVcfmenifee.us Inspection Request Line 951-246-6213
OWNER city ot menifea
riunding Safety DePt
ADDRESS
V\C� Pa
CITY ZIP9Z-�- 2
-34 PHONE
LOT N TRACT APN Re
CONTRAAgER & TRACK
ION REQUIRED
ROOMS N' COVERS PROPOSED ADDITION(S)_
840 S ROCHESTER AVE#C
ONTARIO, CA 91761 '-w'-d 01'urwuuw� CL
LIC. 9-517575 0
909-390-0555 z I/L/3 4—
WORKCOMP
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WSA5000386-07
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CITY 0 MEN&IFE12
BUILDINr- A AID SA FETY OPMTh IENT
PLAN ROVAL
ED BY A\L DATE
*App 9#of these plans shall not be construe4tolbe a pi mk*oran
appri�Yof,any violation of any provisions of&6wl Mordty
regul tions and or di nances. This set of approved plans 9 1 ist be kept on the
STREET
- _J 42430 WInchester Road
Temecula, Callfbmia 92590-2504
71
1�--1 -296-5640
Telephone 951
"Equity Management & ReaE'L'y ZBervic��s Fax 951-296-5524
Web www.equltymgt.com
CIty Of M6nitee
Building & Safcty Dept.
November 3, 2016 NOV 16 2016
L& S Francisco Received
30127 Via Palermo
Menifee CA 92584-8924
Subject: Menifee Master Association
Re: 1 . Application for Architectural Improvements
Account #: 00111-6812
Property Address: 30127 VIA PALERMO
Completion due by: GZ/02o/2017
Dear L& S Francisco:
Thank you for submitting your architectural developments to the Committee for review. Your application
for a patio cover and concrete slab In the rear yard has been approved. An approved copy of your
application is enclosed, Please keep this document with your CC&Rs and be sure to pass it along to any
future owners of your property.
Upon completion of improvements, please submit a copy of the Notice of Completion form (attached)
With photos of the completedlim.provements to.complete the application process,
Should you have any questions, please feet free to contact me at (951) 296-5640.
Sincerely,
Arkj& 6PJ4
Angela Omdoff
Administrative Assistant
On Behalf of the Architectural Committee
/ao
Enclosure
cc: NM File / Owner-File
CORRSKC�FRANCISCD-RY VAMCUS APPROVED.MMA
ASWCW I The loadar in community association mansg-mcnt 800,808.4882 AAMCO
COO/1.00,d (XVA) 60:01- 91-0z/20/1.1.
42430 Winchester Road
Temecula, California 92590-2504
City of Menifee
Telephone 951-296-5640
Equity Management L, Reality ServI661"'9 & Safety Dept. Fax 951-296-5524
I Web www.equltym9t,com
�00kf 16 2016
November 3, 2016
L&S Francisco
30127 Via Palermo
Mentfee CA 92584-8924
Subject: Menifee Master Association
Re: I I Application for Architectural improvements
Account #: 00111-5812
Property Address: 30127 VIA PALERMO
Completion due by: 03/03/2017
Dear L &S Francis=
Thank you for submitting your architectural developments to the Committee for revivvv. Your application
for a patio cover and concrete slab In the rear yard has been approved. An approved copy of your
application is enclosed, Please keep this document with your CC&Rs and be sure to pass it along to any
future owners of your property.
Upon completion of impriovements, pi.e.a I se Sul.bmit a copy of the Notice of Completion form (attached�
with photos of the completed improvements to.complete the application process.
Should you have any questions, please feel free to contact me at (951) 296-5640.
Sincerely,
ARf 120 aAJ4
Angela Orncloff
Administrative Assistant
On Behalf of the Architectural Committee
/ao
Enclosure
Oc; NM File / Owner-File
CORRS�AMFRMC[SOO-RY VARIOUS APPROVEDYKA
AssocW I Tho loadar In community association managumani 800.608.4882 AAMe
C00111-00 I d (XVA) 6t1:01. 91.0z/90/1.1.