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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 N(tk PROJECTADDRESS ASSESSOR'S PARCEL NUMBER t�5 7 J�(P( W7 LOT 1(01 TRACT OWNER NAME —,-Pn\�CV�7W ADDRESS —�--VkZnP -tO'tkt�-L C�rD PHONE EMAIL APPLI NT NAME \)x vssu� 3FP-�� ADDRESS 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 T, 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. 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