PMT16-03798 City of Menifee Permit No.: PMT16-03798
29714 HAUN RD. Type: Residential Addition
4;i�CCIIEO� MENIFEE, CA 92586
4�, �SA-1 MENIFEE Date Issued: 1112812016
P E R M I T
Site Address: 31436 DAYBREAK CT, MENIFEE, CA Parcel Number: 372402-013
92584 Construction Cost: $6,500.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 518 SO FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 2 FANS,3 LIGHT STRIPS
Work:
Owner Contractor
TRAVIS BRADY WEST COAST SIDING&TRIM
31436 DAYBREAK CT 675 LACEY OAK DIRVE
MENIFEE,CA 925134 CORONA, CA 92881
Applicant Phone:9517353379
DAN SULLIVAN License Number.,615917
WEST COAST SIDING&TRIM
675 LACEY OAK DIRVE
CORONA, CA 92881
Fee Description ON 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 1.00
General Plan Maintenance Fee-Building 1 6.65
General Plan Maintenance Fee-Electrical 1 6.80
$311AS
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of enors in the plans and
spedfications 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 othervorise 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
forlefted.
AA_Bldg_Permit 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 licensure underthe Contractoes State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class-C &I License N By mysignature below I acknowledge that,exceptfOTMY personal residence
Expires �-2 1-2 Signature in which I must have resided for at least one year pritorto completion of
A improvements covered by this pemit.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-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 websfte:
by Section 3700 of the Labor Code,for the performance of work for which www.leginfo.ca.gov/calaw.htmi.
this permit is issued.
7 Poll Date
h,,, 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 ci 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 owner's behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier ac, with all applicable city and county ordinances and state laws relating to
_42-1 building construction.I authorize representatives of this city or county to
Policy# &&-C,7 S�'_P'R6?_Expires cP—t '2 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
a I certify that In the performance of the work for which th is permit is issu ed,
I shall not empl 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 provisions of Section 3700 of the Labor
Code,I shall fo w provisions. Will the applicant or future building occupant handle hazardous material or a
Ap Date 11--AS-116 mixture containing a hazardous material equal to orgreater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING.FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS a Yes 1�r.
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 for guide]l
CONSTRUCrION LENDING AGENCY ci Yes 7N.
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) o Yes crK6
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 California Health&Safety Code,Section 25505 and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazapdous ma I repo ing.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 dYis 0
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 Me a signed suteme nt
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING MRP)
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 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 sale employees.For more Information about EPA's Renovation Program visit:
compensation,Will do I )all of or I )portion of the work,and the structure is wwvv.epa.govItead or contact the National Lead Information Center at
not Intended or offered for sale.(Section 7044,Business and Professions 1-BOD-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,th rough employeee 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 bu rden of proving that it was
nut built or improved for the purpose of sale. In No EPA Lead-Safe Certified Firm is required for th is project because:
o 1,as owner of the property a m 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.
NNW
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
A
"Menifee
DATE -2_�?-1 Lo PERMIT/PLAN CHECK NUMBER
TYPE: 0 COMMERCIAL X-RESIDENTIAL 0 MULTI-FAMILY 0- MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: 0 ADDITION 0 ALTERATION 0 DEMOLITION 0 ELECTRICAL 0 MECHANICAL
aNEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK nL_ofnfq4, yT>3 _�'AT�jn OOVF�jE� -3 Z�li 4 1
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER 40xov�p LOT 10 14 TRACT
OWNER NAME
ADDRESS
PHONE EMAIL
APPLICANT NAME
ADDRESS L_C-\C�C--14 VC>,Y-_ Q�nk_,-)C�LAJA 0-0- :M�
PHONE 9-gi
OWNER BUILDER? 0 YES *NO
CONTRACTOWSNAME_�:�
BUSINESS NAME
ADDRESS
PHON EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION Lp
VALUATION$ 4 e, SQ FT 5-1 LSQFT g-�)a fn
APPLICANT'S SIGNATURE DATE 10
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION SMIP CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN
INVOICIE
AMOU T PAIDAMOUNT OCASH OCHECK# CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 No DL NUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building& Sofety Department 29714 Houn Rd. Menifee, CA 92586 951-672-5777
www.cityofmenifee.us Inspection Request Line 951-246-6213
�4a
6-L& -13t -256-7
LEDGER & TRACK
INSPECTION REQUIRED
City of Menifee
Building & Safety Dept.
NOV 2.�8 2016
OF MENIFEE
ILDING AND SAFETY DEPARqWtft ived
..AN APPROVAL
t'j -aDATE
lq;proval of these Pialls s�" onitrued to be a permit for,or an
approvai of,any violation of ary of the federal,state or city
regulations and ordinances. This set of approved plans must be kept on the
jobsite until completion.
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