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PMT16-03982 City of Menifee Penrnit No.: PMT1 6-03982 29714 HAUN RD. Type: Residential Addition <^—CCIEL;;�? MENIFEE,CA 92586 MENIFEE Date Issued: 12/0612016 P E R M I T Site Address: 26699 OPALESCENT DR, MENIFEE,CA Parcel Number 360-810-022 92584 Construction Cost: $2,650.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 10'x 30'SOLID ALUMAWOOD PATIO COVER WITH 1 FAN Work: Owner Contractor RICHARD ZERKEL STEVE BENDORF CONST 26699 OPALESCENT DR 28493 BAUVARDIA WAY MENIFEE, CA 92584 MURRIETA,CA 92563 Applicant Phone:9516791502 STEVE BENDORF License Number.610842 STEVE BENDORF CONST 28493 BAUVARDIA WAY MURRIETA,CA 92563 Fee Description Qtv Amount Receptacle, Switch, Outlet&Fixture 1 116.00 Building Permit Issuance 1 27.00 DecklPatio, 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 5.80 $290AS 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 caffiLd 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 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 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. J��t lr`�PA-12 By my signature below I acknowledge that,except for my personal residence Expires 2—2-e'�� 7 Signature 41TZAA� in which I must have resided for at least one year prior to completion of "I improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owneT-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 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 this permit is issued. WWW.Ieginfa.�.gov/calaw.htmi. Policy# Date ci I have 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 o 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 countyto 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 Ycertify that in the performance of the work for which this permit is issued, "hall 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 subjectto the worker's compensation provisions of Section 3700 of the Labor Code,I shall forth��Vy witivtbose pro isions. Will the applicant or future building occupant handle hazardous material or a Applicant r, 2, Date mixture containing a hazardous material equal to orgreater thatthe amounts specified an the Hazardous Materials Information Guide? WARNING:FAILURETO SECURE WORKER'S COMPENSATION COVERAGE IS Q Yes 0 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 o 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 schoo17 (Section 3097 Civil Code) ci Yes ci No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements underthe 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 ciYes o No Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OWNER OR AUTHORIZED AGENT issuance,also requires the applicant forthe 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 IRRP) 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 o 1,as owner of the prope�tv,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 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-BOD424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a m 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. c No EPA Lead-Safe Certified Firm is required for this project bemuse: m 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 "I'Menifee All DATE PERMIT/PLAN CHECK NUMBER fM 112 10250%a TYPE: 0 COMMERCIAL XRESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME 0 POOL/SPA O—SIGN SUBTYPE: AADDITION OALTERATION 0DEMOUTION OELECTRICAL OMECHANICAL ONEW OPLUMBING 0 RE-ROCIF-NUMBER OF SQUARES— DESCRIPTION OF WORK Nuk�� PROJECTADDRESS '7,1�,CC)S) ASSESSOR'S PARCEL NUMBER LOT TRACT CIlyol.K.,nl!,,e OWNERNAME j2_jC,)I4P\LV) 2;r� -Zy Bu 5g N a Y_Dept. ADDRESS 2-CZ,- '239 f D'E'Em- DEC 0 6 201E PHONE EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME 12,C "QQE�:� OWNEREIMILIDER? OYES�,NO BUSINESSNAME ADDRESS 2JE�)4'9->Z PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION E.'�) SO FT L SQ FT I APPLICANT'S SIGNATURE DATE ) 2- 6 CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE jgpo. L445 PAID AMOUNT AMOUNT I I OCASH OCHECK# 0 CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT I 1 0 CASH 0 CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED 0_YES 0 NO DLNUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92SS6 951-672-6777 www.cityofmenifee.us Inspection Request Line 951-246-6213