PMT16-03965 City of Menifee Permit No.: PMT16-03966
29714 HAUN RD. Type: Residential Addition
't��CCEJLA-> MENIFEE. CA 92586
MENIFEE Date Issued: 1210512016
P E R M I T
Site Address: 30643 VIEW RIDGE LN, MENIFEE, CA Parcel Number: 364-29M51
92584 Construction Cost: $6,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 916 SF SOLID ALUMAWOOD PATIO COVER WITH 3 FANS,8 POST LIGHTS
Work:
Owner Contractor
ROGER LYNCH JUSTIFIED LANDSCAPING
30643 VIEW RIDGE LANE 22741 BLUE TEAL DR
MENIFEE, CA 92584 CANYON LAKE, CA 92587
Applicant Phone:9517952222
ALEX ALVAREZ License Number.975513
JUSTIFIED LANDSCAPING
22741 BLUE TEAL DR
CANYON LAKE, CA 92587
Fee Description Qtv Amount
Receptacle, Switch,Outlet&Fixture 11 166.00
Building Permit Issuance 27.00
Deck/Patio, non-standard 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 8.30
$342.95
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of en-cm 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 Menifse.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_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 o 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 C—Z) License No. GA Cf By my signature below I acknowledge that,except for my personal residence
Expires S—3 k —1 J6 Signature Q-,� in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
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 webs[te:
by Section 3700 of the Labor Code,for the performance of work for which www.leginfo.ca.gov/calaw.htmi.
this permit is issued.
Policy# Date
o I have and mfill maintain workees 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 workees 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# Expires 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
,At 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 UCENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply w!�`hose provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applicant OkG— Data amounts specified an the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURI WORKER'S COMPENSATION COVERAGE IS o Yes a No
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 guidelines
CONSTRUCTION LENDING AGENCY in Yes o 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) o Yes a No
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 hazardous material reporting.
checkmark(s)I have placed next to the applicable ftem(s)(Section 7031.5 oYes o No
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 oe 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(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)or that he or she is exempt from Ucensure 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 RAP-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
m I,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 I I portion of the work,and the structure is www.epa.govilead 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 Contractoes 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 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. 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 RRP rule please fill out the RAP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
All
Wenifee
19M&N2�e"t
D 'DC, C 'D 2-D It PERMIT/PLAN CHECK NUMBER
ATE em-0 -0,23PM5
TYPE: 0 COMMERCIAL P RESIDENTIAL 0 MULTI-FAMILY _0 MOBILE HOME 0 POOL/SPA O_SIGN
SUBTYPE: 0ADDITION OALTERATION ODEMOLITION 9DELECTRICAL OMECHANICAL
ONEW OPLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK Aj0(`nCL
00 Cj 1 0
PROJECTAIDDRESS 30 3 Ve '� L) c,e i (kf�j Q ocsg4
ASSESSOR'S PARCEL NUMBER 3LM- C;R0-e)5t LOT TRACT
ully
OWNERNAME ti c Building & iimety Dept.
ADDRESS DFC 0 5 20
PHONE EMAIL
10 d
APPLICANTINIAME
ADDRESS oll\,) p_ TQ q, CCArJ Y t_)� OS KQ- C C�
PHONE (:A5 ( -79SZ11L - EMAIL C,\ LQ_�l a) 41 C',e A I&,a '_,C q
j g,,jj_ -,C+,�
CONTRACrOWSNAME OWNER BUILDER? 0 YES ONO
BUSINESSNAME 705 -FIC ',ed
ADDRESS ?Lj " i P)\,,)e _T r,t,,_
eCIl IV C CA/\-J
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ (�(Dotp . 00 SO FT 9,f� — LSQFT
APPLICANT'S SIGNATURE DATE 12 -5
CITY STAFF USE ONLY __[711TY 7OF
DEPARTMENT DISTRIBUTION MERIFEE BUSINL LILENSE N
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP i
INVOICE OCASH OCHECK# OCREDITCARD VISJVMC
AMOU�T L PAIDAMOUNT
L
PLAN CHECK FEES PAIDAMOUNT -- CASH OCHECK# OCREDITr_ARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building& Safety Department 29714 Haun Rd. Menifee, CA 92586 951-572-6777
www.cityofnienifee.us Inspection Request Line 951-246-6213
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INSPECTION REQUIRED
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ATy OF MENIFEE
UILDING AND SAFETY DEPARTMENT
C) PLAN APPROVAL
��-REVIEWED BY
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Pproval of these plans shall not be construed tobe a permit for,0 an
approval of,any violation of any provisions of the federal,state or ci y n ti,
rdina This set Of approved plans must be ke
regulations and o nces
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