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PMT16-04530 City of Menifee Permit No.: PMT16-04530 29714 HAUN RD. Type: Residential Addition �A_CCEL/_> MENIFEE, CA 92586 MENIFEE Date Issued: 1 212 912 01 6 PERMIT Site Address: 28447 SECRET HARBOR DR, MENIFEE, Parcel Number: 333-523-023 CA 92585 Construction Cost: $7,000.00 Existing Use: 1 &2 Family Residence Proposed use: Description of INSTALL 14'x 24'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS,2 LIGHTS,2 POST LIGHTS, Work: 180 L FT U/G ELEC LINE FOR FUTURE SPA WITH 2 OUTLETS AND FUTURE WATER FEATURE, 110 L FT U/G GAS LINE FOR FUTURE FIRE PIT AND FUTURE BBQ Owner Contractor JONATHON ROSE SOCAL HOME IMPROVEMENT 28447 SECRET HARBOR DRIVE 16331 LAKESHORE DR#G161 MENIFEE, CA 92585 LAKE ELSINORE, CA 92530 Applicant Phone:9512364282 TROY CRISWELL License Number: 930540 SOCAL HOME IMPROVEMENT ` 16331 LAKESHORE DR#G161 LAKE ELSINORE, CA 92530 Fee Description Qtv Amount fEl Receptacle, Switch, Outlet&Fixture 6 141.00 Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 Inspections not specified 116 116.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 1.00 General Plan Maintenance Fee-Building 1 12.45 General Plan Maintenance Fee-Electrical 1 7.05 $438.50 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 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 Bldg_Perm@_Template.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 contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and in I am exempt from Iicensure under the Contractors State License Law for Professions Code and my li nse Is in full force and eff et D the following reason: License Class License By my signature below I acknowledge that,except for my personal residence Expires 100 Signat 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 DECLARATIO have built as an owner-builder if it has not been constructed in its entirety by ❑I hereby affirm under penalty,of rjury one ofthe 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 workers 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 www.leginfo.ca.gov/calaw.html. this permit is issued. P///olicy p Date p I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT /section 3700 of the Labor Code,for the performance of the work for which m By my signature below I certify to each of the following:I am the property this permit is issued.My workers compensation insura ce carrier and policy /owner or authorized to act on the property owners behalf.I have read this number are: I application and the Information I have provided is correct.I agree to comply Carrier IL'G, ✓ s, with all applicable city and county ordinances and state laws relating to �1 building construction.I authorize rep entativ f this city or county to Policy q Expires / enter the a identified prope for in ion purposess. (This section need not to be completed is the permit is for one-hundred Date yj 5 dollars($100)or less PRO NER OR AOTF rORIZED AGENT ❑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 SINESS LICENSE q workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers sation pro i f Section 3700 of the Labor Code,I shall fo i tcc ywith or sions. Will the applicant or future building occupant handle hazardous material or mixture containing a hazardous material equal to or greater that the App` t Date amounts ecified on the Hazardous Materials Information Guide? WARNIN 1 TO RE WORKER'S COMPENSATION COVERAGE IS ❑Yes No UNLAWFU D SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CI FINES UP TO ONE HUNDRED THOUSAND DOLLARS($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 guide)1hnes CONSTRUCTION LENDING AGENCY ❑Yes 9No 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) ❑Yes No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that am exempt from the permitting checklist.I understand my requirements underthe State of Contractors License Law for the reason(s)indicated below by the California Health&Safety Cade,Sectio 5 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous m reporting. Yes o / .L Business and Professions Cade).Any city or county that requires a permit to Date Z' y construct,alter,improve,demolish or repair any structure,prior to its PROP O HORIZED 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 A V ON REPAIR AND PAINTING RRP License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EP Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from Iicensure rece ving 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 more than($500). required practices.This includes rental property owners and property managers who do the paint-disturbing work themselves or through their ❑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.eoa.eov/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 Contractors State License Law does not apply to an owner of a ❑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. ❑No EPA Lead-Safe Certified Firm is required for this project because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors 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. 7��UILDING &' SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE 2 2.h ku PERMIT/PLAN CHECK NUMBER Fj TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK I q x1b, I U' QG O (1i;ivw K1/ GIui l`C4 C'lcs 'IJPROJECTADDRESS Zl 1 � 6 62f ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME 4m, City ADDRESS G(W,.(� Building & Safety Dept. PHONE / EMAIL DEC 2 9 2016 APPLICANT NAME CI I Sw( n r?I n, ._ ADDRESS PHONE EMAIL CONTRACTOR'S NAME Yam/ kk 0ro64aVX,4-OWNERBUILDER? OYES O BUSINESS NAME 11- ADDRESS L 2;/ � 170Y{- PHONE wo 23A 526 EMAIL Tr ` TVLW CONTRACTOR'S STATE LIC NUMBER /�D LICENSE CLASSIFICATION VALUATION$ SQ FT 73�' L SQ FT APPLICANT'S SIGNATUR Aoor DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING EN�14EERING FIRE GREEN SMIP 1 INVOICE �M PAID AMOUNT l l AMOUNT ���0 "1 OCASH OCHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT OCASH OCHECKN 0 CREDIT CARD VISA/Mc OWNER BUILDER VERIFIED O YES © NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 City of Menifee LEDGER & TRACK Building $ Safety Dept. 41P; 7 3MN REQUIRED DEC 2 9 2016 Received IqX cw-er r �,•��,� �O Z� ^ r i L1I�r^A fbv �t i�� LDS 6 VY i -2 � I1 l 61e�1� G• �r ENIFEE Q f'UILDIN AND SAFETY DEPART ENT � PLAN AP ROVAL 11 AA REVIEWED BY D TE 1 n( 6 I 'Approval of these plans shall not be construed to �a permit fa or fapproval of any violation of any provisions of the I deral,state or clN regulations and ordinances. This set of approved plain must be kept on the jobsite until completion.