The URL can be used to link to this page

PMT16-03898 City of Menifee Permit No.: PMT16-03898 29714 HAUN RD. Type: Residential Addition <A_CCEiLj� MENIFEE,CA 92586 MENIFEE Date Issued, 1210212016 P E R M I T SiteAddress: 28313 SUNRISE SKIES WAY,MENIFEE, Parcel Number: 333-560-071 CA 92584 Construction Cost: $5.800.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 525 SO FT SOLID ALUMAWOOD PATIO COVER WELECTRICAL 2 FANS Work: Owner Contractor RUSSELL BREEDING ANTHONY COCILOVA 28313 SUNRISE SKIES WAY 31321 PALOMAR ROAD M ENIFEE, CA 92584 MENIFEE, CA 92584 Applicant Phone:9513146910 ANTHONY COCILOVA License Number.962132 ANTHONYCOCILOVA 31321 PALOMAR ROAD MENIFEE, CA 92584 Fee Description Qty Amount Receptacle, Switch, Outlet&Fixture 2 121.00 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 6.05 $295.70 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_Perrnit_TernpIate.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 pena Ity of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter!)(commencing with section 7000)of Division 3 of the Business and a I am exem pt 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 License N q�' By my signature below I acknowledge that,except for my personal residence Expires Signature in which I must have 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 entirely by Vhereby affirm under penalty of perjury one of the followmg declarations:I licensed contractors.I understand that a copy of the applicable law,Section have a nd 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 www.leginfo.ca.goy/calaw.htmi. this permit is issued. C4 n — Policy# f Date PROPERTY OWNER OR AUTHORIZED AGENT o I have and will maintain worker's compensation insurance,as required by 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 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 with all applicable city and county ordinances and state laws relating to Carrier building construction.I authorize representatives of this city or county to Policy#- —&D-P—irpires 1—/0 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 ORAUTHORCEED AGENT ci I certify that in the performance of the work for which this permit is issued, Ishallnotemolo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#_ otmlltp 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 fiorthwi o ywit W! S. Will the applicant or future building occupant handle hazardous material ora AppIicantZ&W—=m'e1r Date mixture containing a hazardous material equal to or greater that the amou nts specified on the Hazardous Materials Information Guide? MLARNING-FAILURE TOtq4RE WORKER'S COMPENSATION COVERAGE IS ci Yes Wo UNLAWFUL,AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES Will the Intended use of the building by the applicant or future building AND CIVIL FIN ES 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 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY a Yes "0 I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 100D feet of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 31397 Civil Code) o Yes Wo 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 "05 and 25534 concerning Contractor's License Law for the reason(s)indicated below by the hazardous mat rial reportingr,� 0 UT u0WTY checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ae —16 oYe 0 _. Date Business and Professions Code).Any city or county that requires a permit to AA 1Z construct,alter,improve,demolish or repair any structure,prior to its PR R A HORIZEDAGENT 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 RENOVATION,REPAIR AND PAINTING IFURPI 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 a fleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a perm it subjects the applimnt to a civil pena Ity of not more required practices.This includes renta I property owners and property than($500). managers who do the paint-disturbing work themselves or through their ci 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( )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 1-800424-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 improvesthe 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-Builderwiii have the burden of proving that ltwas not built orimproved forthe purpose of sale. ci No EPA Lead-Safe Certified Firm is required forthis project bemuse: In 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 ,4q e12 PERMIT/PLAN CHECK NUMBER TYPE: OCOMMERCIAL )(RESIDENTIAL 0MULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN SUBTYPE: OADDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK A/7-6 nde ie PROJECTADDRESS 17-3/ S Sillwt�5,e -Skliles �Jofse, ASSESSOR'S PARCEL NUMBER 7j' LOT 167 T R AOC'T VA OWNER NAME , ADDRESI :Ski I P—S; (Ja�K PHONE ( -7.4�Z EMAIL APPLICANITNAME ADDRESS &,war PHONE V EMAIL (09 CONTRACTOR'S NAME iGhiAnv1,, OWNERBUILDER? OYESANO BUSINESSNAME 5 ADDRESS M,94141 Ifa PHONE ?2/Ll EMAIL &fD4f-,r/0149�3 4�AIZ) 0!�Mll CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION 4012 ) 5 a ev VALUATION SO,FT LSQFT APPLIG DATE CITY STAFF USE ONLY NIFEE BUSINESS LICENSE NUMBER DEPARI MENT DISTRIBU I ION CITY OF ME BUiLDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE I pq%;>-79PAID AMOUNT AMOUNT I 1 0 CASH 0 CHECK# -CREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT I I OCASH OCHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES _0 NO DLNUMBER NOTARIZEDLE17ER 0 YES 0 NO City of Menifee Building& Safety Department 29714 HOUn Rd. Menifee, CA 92586 951-672-6777 www.rityofmenifee.us Inspection Request Line 951-246-6213 r1l r. FT ri m m rri CA C/D a3 -10 M rn rn CD M (0� — C) :Z CD c= CD M z�� rn C7- 00 CD CD m -4- Cl) V�i C rr'f �120pe-