PMT16-04070 City of Menifee Permit No.: PMT16-04070
29714 HAUN RD. Type: Residential Addition
'1XCCEL:A_> MEN[FEE, CA 92586
MENIFEE Date Issued: 1211312016
P E R M I T
SiteAddress: 30219 TATTERSAIL WAY,MENIFEE, CA Parcel Number: 364-230-012
92584 Construction Cost: $2.000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 15'x 16SOLID ALUMAWOOD PATIO COVER WITH 2 LIGHTS
Work:
Owner Contractor
JOSH&KATIE BRANZ PATIO GUY ALUMAWOOD CONTRACTOR
30219 TATTERSAI L WAY 41197 GOLDEN GATE CIR STE 108
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone:9513330056
LOIS MONTINI License Number:872839
PATIO GUY ALUMAWOOD CONTRACTOR
41197 GOLDEN GATE CIR STE 108
MURRIETA, CA 92562
Fee Description P!X Amount
Receptacle, Switch, Outlet&Fixture 2 121.00
Building Permit Issuance 1 27.00
Deck/Patio, 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 6.05
$295.70
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of effors in the plans and
specifications or from preventing builicling 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 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.
AkBldg_Pe"it_Template.rp1 Page 1 of 1
CITY OF MEN I FEE
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 wifth a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter!)(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 a my license is in full force and effe the following reason:
License Class Lice 9 By my signature below I acknowledge that,except for my personal residence
in which I must have resided for at least one year prior to completion of
Expires /p,8�0-17 signature improvements covered by this permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
E3 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 a nd Professions Code,is available upon request when
com pensation,issued by the Director of industrial Relations as provided for this application is submitted or at the following welisifte:
by Section 3700 of the Labor Code,for the performance of work for which www.Ieginfs.ca.goy/caIaw.IitmL
this permit is issued.
Policy If Date
PROPERTY OWNER OR AUTHORIZED AGENT
ci I have and will maintain worker's compensation insurance,as required by
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 Insura nce ca rder a nd policy owner or authorized to act on the property owner's beha If.I have rea d this
number am: 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 �Kd zV q building construction.I authorize representatives of this city,or county to
Policy# E-xpi—r� enter the above identified property for inspection purposes.
(This section need not to be co.mplated 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,
Ishallnotermil any persons in any manner so as to bewme subject to the CITY BUSINESS LICENSE# 0 y_J%51
workees compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workees compensation provisions of Section 3700 of the Labor
Cccle,lshallfo wi Is comply with those provisions. Will the appliont or future building occupant handle hazardous material ore
mixture containing a hazardous material equal to orgreater that the
App Date amounts spa Ertl on the Hazardous Materials Information Guide?
MLARNING-FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS L V0
UNLAWFUL,AND SHALL SUBJECTAIN 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($10D,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 Ma nagem ent District(SCAQM D)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldelines
CONSTRUCTION LENDING AGENCY 0yes
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within iollo feet of the
lending agency for the performance of the work which this permit is issued outerbounclaryof -school?
(Section 3097 Civil Code) 0 Yes 0
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 mate al re o i.ng.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 riYes ci
Businessand Profes;sfions Code).Any city or county that requires a permitto 16� Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR 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 Contractoes 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(ARP)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 fa :
ality to be RRP-certiried firms and comply With
an Applica nt for a permit subjects the applicant to a civil penalty of not more reci uIred pracrices.This includes rental property owners and property
than($500). 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 EPXs Renovation Program visit:
compensation,will do( )all of or( I portion of the work,and the structure is www.epa.goy/lead 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 Contractor's State License Law does not apply to an owner of a c;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:
safe.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 sa le. cs No EPA Lead-Safe Certified Firm is required forthis project bemuse:
o 1,as owner of the piropertV am exclusively contracting wifth licensed
contractors to construct the project(Section 7044,Business and Professions
Cade:The Contractor's State License Low 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
DATE 42 PERMIT/PLAN CHECK NUMBER aw
TvPE: 0- COMMIERCIAL 9. RESIDENTIAL QMULTI-FAMILY 0MOBILEHOME -- PQOv5PA --slo
SUBlYPL: UAUDIIIUN uALTERATIUN uDEMOLITiC)N C) ELEC-iRiCAL QMECHANiCAL
%lrEW OPLUMBING 0 RE-ROOF.NUMBER OF SQUARES
DESCRIP11ON OF WORK / x / & S 0 L lb L 11"T4 Z�Ozn-06 �'4VZ)
LnVES - 9. L194T,5 -
PROJECTAIDDRESS
ASSESSOR'S PARCEL NUMBER
LOT TRACT
OWNER NAME -Kq-)7E- �jqy
ADDRESS
-F7E-P\
L,,L)/'4)/ C 141 0,1=1 e
PHONE qczs:)-) EMAIL
APPLICANT NAME VZ5 A27--/7 A,� DEC 13 2 16
ADDRESS
�Sl L, Receiv �d
PHONE ?,641- ':�
EMAIL
CONTRACTOR'S NAME 0 YES Vwd-
BUSINESS NAME E477D v QWNER BUILDERI -j-- i A
ADDRESS 6�
91,
PHONE
-'�J,,,EMAIL a nw, paa A
CONTRACTOR'S$TATE LIC NUMBER As LICENSE CLASSIFICATION
VALUATION L SO FT
APPLICANT'S SIGNATURE- DATE..
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE 1.
AMOUNT () I PAIDAMOUNT 0 CASH 0 CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES I PAIDAMOUNT OCASH ()CHECK# 0 CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED 0 YES 0 No DL NUMBER NOTARIZED LETTER 0 YES 0 NO
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0
0
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LEDGER & TRACK 0
INSPECTION REQUIRED
G'Aryft5l ] I arT7E City of Menifee
0
Building & Safety Dept.
'j e, DEC 13 2016
q Received
Sapmr 01�.q-b
A
CITY OF MENIFEE
]h Cz f-qLtftDgNG AND SAFETY DEPA MIENT
PLAN APPROVAL
REVIEWEDBY
DATE
*Approval of these plans shall jjt In cd trued tobeapennitfor,oran
approval of,any violation of anrMoDsi s of the federal,state or city
regulations and ordinances. This set of proved plans must be kept on the
jobsite until completion.
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