PMT16-04009 City of Menifee Permit No.: PMT16-04009
29714 HALIN RD. Type: Residential Re�Roof
<ACCELA—> MENIFEE, CA 92586
MENIFEE Date Issued: 1210812016
P E R M I T
Site Address: 28835 THORNHILL DR, MENIFEE, CA Parcel Number: 337-361-007
92586 Construction Cost: $8,000.00
Existing Use: Proposed Use:
Description of REMOVE EXISTING COMP ROOF, INSTALL NEW FELT, METAL&OWENS CORNING COOL ROOF
Work: IN OYSTER SHELL
Owner Contractor
SANDY SALVATORE FREEMAN AND SONS ROOFING
28835 THORNHILL DR 28320 AGAVE WAY
MENIFEE, CA 92586 MURRIETA. CA 92563
Applicant Phone:9516727500
VINCENT FREEMAN License Number.965749
FREEMAN AND SONS ROOFING
28320 AGAVE WAY
MURRIETA, CA 92563
Fee Description Qtv Amount($1
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4-90
$130.90
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 pennit 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 BldgPerrnit-Ternplatexpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe 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 ci 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 U e 4-� By mysignature below I acknowledge that,exceptfor mypersonal residence
I Signat re
Expires�T
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 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.leginfo.ca.gov/calaw.htm].
Policy If Date
o 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 VCNT L building construction.I authorize representatives of this city or county to
Policy#(40 VT_1TP—i_160 Expires to 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
a I 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 LICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS M 1ARA III
s ubject to the compensation provision,0,Secto 3700 of the Labor ATERIAIL DEC T N
C de I'. e provisions_ Will the applicant or future building occupant handle hazardous material or a
A Ii Date mixture containing a hazardous material equal to or greater that the
c 'led on the Hazardous Materials Information Guide?
PP amounts sp;ec
W COMP NSAT N COVERAGE 15
ARNING. WORKER'S E ci Yes 'erf o
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
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FO occupant require a permit for the construction or modification from South
R Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelin
CONSTRUCTION LENDING AGENCY 0 Yes ZZ
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 bo:uzdap of a school?
(Section 3097 Civil Code) ci Yes i o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exemptfrom the permitting checklist.I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
haz ous m ena ing.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 �e N
Business and Professions Code).Any city or county that requires a permit to
Date tZA (a
construct,alter,improve,demolish or repair any structure,prior to its ?!�Mm
issuance,also requires the applicant for the permit to file a signed statement PRQ�WNIR�OTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI
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 licensu re receiving comperisation 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
than($500). required practices.This includes rental property owners and property
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 1-80D-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,through 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 burden of proving that it was
not built or improved for the purpose of sale. ci No EPA Lead-Safe Certified Firm is required for this project bemuse:
ci 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.
01101
e n i fe e
DATE PERMIT/PLAN CHECK NUMBER
TYPE: I OC I OMMERCIAL e-CESIDENTIAL 0MULTI-FAMILY OMOBILEHOME OPOOL/SPA OSIGN
SUBTYPE: OADDITION OALTERATION ODEMOLITION OELECTRICAL OMECHANICAL
ONEW OPLUMBING '?,'<E-ROOF-NUMBEROFSO.UARES 24
DESCRIPTION OF WORK
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PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER t�5 7 J�(P( W7 LOT 1(01 TRACT
OWNER NAME —,-Pn\�CV�7W
ADDRESS —�--VkZnP
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PHONE EMAIL
APPLI NT NAME \)x vssu� 3FP-��
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PHONE C�3(- -44'AC,--)- -3�42— EMAIL
CONTRAcroll'S NAME OWNERBUILDER? 0YES &1q6`
BUSINESSNAME
ADDRESS Gq
PHONE EMAIL:T�-' V6 QL k3i\3t
CONTRACTOR'S STATE LIC NUMBER
Im LICENSE CLASSIFICATION
VALUATION$ 1C) SQ FT LSQFT
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APPLICP IGNATU�E— DATE 12— q AG
CITY STAFF USE ONLY ---LICENSE NUMBER
DEPARTMENT DISTRIBUTION IP [--7 CITY OF MENIFEEfSINESS
BUILDING PLANNING ENGINEERING FIRE GREEN S
INVOICE
AMOUNT PAID AMOUNT OCASH OCHECK# OCREDITCARD VISAIMC—
PLAN CHECK FEES PAID AMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 No DLNUMBER NOTARIZED LE17ER 0 YES 0 NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us Inspection Request Line 951-246-6213
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