PMT16-04237 City of Menifee Permit No.: PMT16-04237
29714 HAUN RD. Type: Residential Addition
-�A—CCELA—> MENIFEE, CA 92586
MENIFEE Date Issued: 12119/2016
PERMIT
Site Address: 26659 CACTUS CREEK WAY, MENIFEE, Parcel Number: 338-35D-008
CA 92586 Construction Cost: $5,950.00
Existing Use: I &2 Family Residence Proposed Use:
Description of INSTALL COMBO LATTICE/SOLID 558 SQ FT ALUMAWOOD PATIO COVER WELECTRICAL 2 FANS
Work:
Owner Contractor
RICHARD GLAUSER PSLQ INC
26659 CACTUS CREEK WAY 28910 RANCHO CALIFORNIA RD
MENIFEE, CA 92586 #206
Applicant Phone:9517954260
JOSH HERRICK License Number.919885
PSLQ INC
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description My Amount($1
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 bulliding 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.
AA.B1dg_Perrnft-Ternplate.rpt Page I 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 o I am exempt from licensure under the Contractor's State License Law for
Professions Code argy license Is in full force and effect. the following reason:
License Class License N qmxx 5 By my signature below I acknowledge that,except for my personal residence
Expires Signature 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.htmi.
Policy# Date
6 PROPERTY OWNER OR AUTHORIZED AGENT
91 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 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
Carrier with all applicable cityand county ordinances and state laws relatingto
building construction.I authorize representatives ofthis city or countVto
Policy# I IV-1 q 5 OiO TS 7— Expires 147-JI enterthe above identified property for inspection purposes.
(Thissection need notto 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,
Ishallnotemplo any persons in any manner so as to become subject to the CITY BUSINESS LICENSE III
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's pensa i.on provisions of Section 3700 of the Labor
Code,I shall forthwith ply with those provisions. 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
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURi MFU SECURE WORKER'S COMPENSATION COVERAGE IS o Yes d�C
UNLAWFUL,AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building bythe applicant or future building
AND CIVIL FINES UPTO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permitforthe 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 forguidelines
CONSTRUCTION LENDING AGENCY o Yes P*O�
I hereby affirm that underthe penalty of perjurythere isa construction Will the proposed building or modified facility be within 1000 feet of the
lending agency forthe performance of thework whichthis permit is issued outer boundary of a school?
(Section 3097 Civil Code) 0 Yes *416-
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 exemptfrorn the California Health&SaIlty Code,Section 25505 and 25534 concerning
Contractor's License Law for the reasons)indicated below by the �haz�aus material rting.
checkmark(s)I have placed next to the applicable Rem(s)(Section 7031.5 es , I
Business and Professions Code).Any city or county that requires a permit to es o No f /Z -)
construct,alter,Improve,demolish or repair any structure,prior to its S-36114 UaXe
issuance,also requires the applicant for the permit to file a signed statement PROPERTY OVJhEWdFi AUTHOR—IZ—EWGENT
that he or she Is licensed pursuant to the provisions of the Contractor's 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(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work thatfisturbs 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-cerified 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-ifisturbing work themselves orthrough 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 thestructure 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-BOG424-LEAD(5323).
Code;The Contractors 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 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. o No EPA Lead-Safe Certified Firm is required forthis project because:
o 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
4", menifee
DATE 1; -14-lb PERIMIT/PLAN CHECK NUMBEREM10-04,;x3-1
TYPE: EICOMMERCIAL [JIRESIDENTIAL []MULTI-FAMILY F]MOBILEHOME F]POOL/SPA [-]SIGN
SUBTYPE: F]ADDITION F]ALTERATION F]DEMOLITION F]ELECTRICAL [-]MECHANICAL
F]NEW F]PLUMBING D RE-ROOF-NUMBER OF SQUARES—
woog�m bin
DESCRIPTION OF WORK 558SCIFTofsolld Patio Cover.Attached to house with 2 fans.
PROJEcTADDRESS 26659 Cactus Creek,Menifee CA 92586
ASSESSOR'S PARCEL NUM13ER :br7.75 - 6D?LOT TRACT -E,
PROPERTY OWNER'S NAME Richard Glauser
ADDRESS SAME AS PROJECT ADDRESS
PHONE (951)301-0037 EMAIL
APPLICANTNIAME SAME AS CONTRACTOR
ADDRESS
PHONE 5)-3-11 -qo�-q EMAIL
CONTRACTOR'S NAME Greenbee-Luis Bentivengo OWNERBUILDER? F]YES20-0
BUSINESSNAME Greenbee
ADDRESS 28910 Rancho California Rd,Temecula CA92590
PHONE (951)234-0356 EMAIL Josh@greenbeeservice.comorLuis@greenbeeservice.con
CONTRACTOR'S STATE LIC NUMBER 919885 LICENSE CLASSIFICATION
VALLIATION$ $5,950.00 SO FT 558 L SO FT
APPLICANT'S SIGNATURE DATE— 09
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I F9 SMIP
INVOICE PAIDAMOUNT
AMOUNT rZirg-70 I I 1 0 CASH 0 CHECK# OCREDITCARD V1
PLAN CHECK FEES I PAIDAMOUNT I 1 0 CASH 0 CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERII HED OYES 0 NO DLNUMBER NOTARIZEDLETTER 0 YES 0 NO
City of Menifee Building&Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.c1tyofmenifee.us Inspection Request Line 951-246-6213
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