PMT16-04031 City of Menifee Permit No.: PMT16-04031
29714 HAUN RD. Type-, Residential Addition
<A_CCELA_> MENIFEE,CA 92586
MENIFEE Date Issued: 12/09/2016
P E R M I T
Site Address: 29485 WOODEN BOAT DR, MENIFEE, Parcel Number: 333-710-077
CA 92585 Construction Cost: $2,675.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL SOLID ALUMAWOOD PATIO COVER-260 SOFT 1 FAN
Work:
Owner Contractor
TROYSANDERS PSLQINC
29485 WOODEN BOAT 28910 RANCHO CALIFORNIA RD
MENIFEE, CA 92585 #206
Applicant Phone: 9517954260
JOSH HERRICK License Number:919885
PSLQ INC
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description Qtv Amount(S)
Receptacle, Switch,Outlet&Fixture 1 116.00
Building Permit Issuance 1 27.00
DecktPatio, 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
$290.45
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 othemise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work cminmenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA.Bldg_PennftTemplate.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 contraictors)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and a I am exemptfrom 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 By my signature below I acknowledge that,except for my personal residence
Expires Signature <_� Z inwhich I musthave resided for at least one year prior to completion of
I f) improvements covered bythispermit.I cannot legally sell a structurethat I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
ci 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.htmi.
Policy# Date
W,Wv'..nd 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 ci 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 am: application and the information I have provided is correct.I agree to comply
'p,04 ,P 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# JAr)—cka&7_57_ 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
ci 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 MATERIAL DECLARATION
subject to the worker's comperption provisions of Section 3700 of the Labor
Code,I shall forthwit corn t ose r " 'ons. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greater that the
f, -11 amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO ECURE WORKER'S COMPENSATION COVERAGE IS o Yes diTo—
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES Will the intended use ofthe building bythe applicant orfurture building
AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$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 ci Yes ci o
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) a Yes qYr,
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 haz��materia
checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 ows 0 No
Business and Professions Code).Any city or county that requires a permit to �9� Date /Z- 94
construct,alter,Improve,demolish or repair any structure,prior to its PROPERTY OWNtR 69 AUTHORIZED AGENT
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 Contractors 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 mom 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 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 portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at
not intended or offered far sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code,The Contractor's State License Law does not apply to an owner of a ci 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. in No EPA Lead-Safe Certified Firm is required forthis project because:
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.
CItV Of MPnifpn
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Received Menlfee
DATE 1210912016 PERMIT/PLAN CHECK NUMBER
TYPE: F-1 COMMERCIAL E]RESIDENTIAL []MULTI-FAMILY []MOBILEHOME OPOOL/SPA [:]SIGN
SUBTYPE: []ADDITION F]ALTERATION F]DEMOUTION []ELECTRICAL E]MECHANICAL
[]NEW []PLUMBING [—]RE-ROOF-NUMBEROFSCtUARES
DESCRIPTION OF WORK 260 SCIFT Solid Alumawood Patio Cover.Attached to house With 1 fan.
PROJECTADDRESS 29485 Wooden Boat Dr,Menifee CA 92585
ASSESSOR'S PARCEL NUMBER '61-b --1 10 LOT TRACT SO wp
PROPERTY OWNER'S NAME TroySanders
ADDRESS SAME AS PROJECT ADDRESS
PHONE (909)795-6230 EMAIL
APPLICANITNAME SAME AS CONTRACTOR LrA A
ADDRESS
PHONE n- 9 oily EMAIL
CONTRACTOR'S NAME GREENBEE OWNERBUILDER? [-]YESF]NO
BUSINESS NAME GREENBEE
ADDRESS 28910 Rancho California Rd#206,Temecula CA 92595
PHONE (951)234-0356 EMAIL josh@greenbeeservice.comorLuis@greenbeeservice.com
CONTRACTOR'S STATE L(C NUMBER 919885 LICENSE CLASSIFICATION B
VALUATION $ $2,675.00 SO.FT 260 L SO FT
APPLICANT'S SIGNATURE DATE
7W,
DEPARTMENT DISTRIBUTION SMIP CITYOFMENIFEEB INESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GRIN I
O-TrPAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISIVIVIC
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED C YES 0 No DLNUMBER NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.cityolimenifee.us Inspection Request Line 951-246-6213
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