PMT16-03702 City of Menifee Permit No.: PMT16-03702
29714 HAUN RD. Type: Residential Alteration
<A_CCiELjA_> MENIFEE,CA 92586
MENIFEE Date Issued: 11/1612016
P E R M I T
Site Address: 27239 GRANADA WAY, MENIFEE, CA Parcel Number: 336-011-006
92586 Construction Cost: $11,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 300 SQ FT SOLID DURALUM PATIO ENCLOSURE WELECTRICAL 4 OUTLETS, I
Work: PORCHLIGHT
Owner Contractor
STEVE STENLAKE TRADER DAN'S INC
27239 GRANADA WAY 840 S ROCHESTER AVE STE C
MENIFEE, CA 92586 ONTARIO, CA 91761
Applicant Phone:9093900555
CHANTAL CAGLE License Number.517575
TRADER DAN'S INC
840 S ROCHESTER AVE STE C
ONTARIO, CA 91761
Fee Description Qtv Amount
Receptacle, Switch, Outlet&Fixture 5 136.00
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 6.80
$312.45
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._Bldg_PermitTemplate.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 a in under provisions of with a licensed contractorfs)pursua nt 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 Ucense Law for
Professions Code an cerise is in full force and effect. the following reason:
License Class License!No. By my signature below I acknowledge that,except for my personal residence
Expires Signature V,/ inwhich I must have resided for at least one year prior to completion of
improvements covered bythispermit.I cannot legallyseil a structure that I
WORKER'S COMPENSATION DECLARATI 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 crF 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.Ieginfo.ca.gov/caIaw.htmI.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
\-gave and will maintain worker's compensation insurance,as required by
(Section 3700 of the Labor Code,forthe performance of the work forwhich a 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 on the property ownees behalf.I have read this
numberare: application and the information I have provided is correct.I agree to comply
�-,0 with all applicable city and county ordinances and state laws relating to
Carrier 1==� building construction.I authorize representatives of this city or county to
Policy If A-n.�WTpr-n ta enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-h I
undred 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,
Ishallnotemcil 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 Vheworker's compensation pr . . S ct' 3700 of the Labor
'Wions a e ion
Code,I all fin with with th rovisions. Will the applicant or future building occupant handle hazardous material or a
Applic t Date mixture containing a hazardous material equal to or greater that the
I . -1 amounts specified onthe Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE OR R'S COMPENSATION COVERAGE 15 0 Yes kNo
UNLAWFUL,AND SHALL SUBJE 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 guidi�fines
CONSTRUCTION LENDING AGENCY Dyes No
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 No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
p P wittin g ch Pcklist.I understand my req uirements under the State of
I hereby affirm under penalty of perj ury that I am exem pt from the California Health&Safety Code,Section 25505 a nd 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazard us in
natre
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes Tu
Business and Professions Code).Any city or county that requires a permit to 1 4;6
construct,alter,improve,demolish or repair any structure,prior to Its PROPERTY A ORIZED GENT
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 Contractor's State EPA BEN VATION.REPAIR AND PAI -'-BPI
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
a nd the basis for the a Ileged exemption.Any violation of Section 7031.5 by residence or childca re facility to be RRP-certified firms and comply with
a n Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes renta I property owners and property
than($500). managers who do the paint-ifisturbing work themselves 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 Renovation Program visit:
compensation,will do( I all of or( )portion of the work,and the structure is www.epa.goirtlead 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 ci 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. cr No EPA Lead-Safe Certified Firm is required for this project because:
a 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
Wenifee
DATE PERM IT/PLAN CHECK NUM�BERFI
TYPE: 0 COMMERCIAL t)OMESIDENTIAL 0MULTI-FAMILY OMOBILEHOME CPOOL/SPA OSIGN
SUBTYPE:/-CIDDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES—
I 64��01 5"
DESCRIPTION OF WORK z?4/ h-�
PROJEJADDRESS 277 7-39 C;z 12P'110?dz yoio, Nd Z7- L1,251510
ASSESSOR'S PARCEL NUMBER 513(p -011 - OOV LOT 11L e TRACT 1!012.-
OWNERNAME atz/z
ADDRESS z ��5,7
PHONE EMAIL
APPUCANTNAME —CA�&
ADDRESS f
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? 0 YES 0,)W
BUSINESS NAME
ADDRESS wv
PHONE W �� EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION $ SO FT L SO FT
APPLICANT'S SIGNA'TURE 7�.45�e DATE
DEPARTMENT DISTRIBUTION CITY OF MEWIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP D-6 dy
INVOICE � PAIDAMOUNT
AMOUNT I I I OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT 0 CASH 0 CHECK# 0CREDtTCARD VISAIMC
OWNER BUILDER VERIFIED OYES 0 NO DILNUMBER NOTARIZEDLMER 0 YES 0 NO__j
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
LEDGER & TRACK
OWNER S-bek'iJ�MSPECTION REQUIRED,
ADDRESS —2-77--t>9 (--7r-aKQ-CL0, 000�
CITY ZII`ItZ�PHONE (J�)
LOT NO. TRACT APN
CONTRACTOR
ROOMS N' COVERS PROPOSED ADDITION(S)
840 S ROCHESTER AVE#C
ONTARIO, CA 91761 ot x C�q
LIC. B-517576
909-390-0555
WORKCOMP
ICW GROUP
WSA5000386-07
City of Menifee
EXP6/14/2017 Building & Safety Dept.
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