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PMT17-00101 City of Menifee Permit No.: PMT17-00101 29714 HAUN RD. Type: Residential Addition <A_CCEL/!_>. MENIFEE,CA92586 MENIFEE Date Issued: 02122/2017 PERMIT Site Address: 27889 CLIFF TOP CT, MENIFEE, CA Parcel Number: 336-360-013 92585 Construction Cost: $82,585.80 Existing Use: 1 &2 Family Residence Proposed use: Description of ROOM ADDITION,495 SF,WITH ELECTRICAL AND HVAC Work: Owner Contractor MARK&ALISA O'NEILL MARQUIS ASSOCIATES INC 27889 CLIFF TOP COURT P O BOX 454 MENIFEE,CA 92585 WILDOMAR, CA 92595 Applicant Phone: 9517576803 SYLVAIN BELLEMARE License Number:856889 MARQUIS ASSOCIATES INC P O BOX 454 WILDOMAR, CA 92595 Fee Description Q�l Amount 1$1 Services,Switchboards, Control Centers&Panels 1 116.00 Receptacle, Switch, Outlet&Fixture 25 236.00 Building Permit Issuance 1 27.00 Inspections not specified 129 129.07 Additional Plan Review Building 336 335.84 Additional Plan Review Building 129 129.07 Additional Plan Review Building 45 45.00 GREEN FEE 1 4.00 SMIP RESIDENTIAL 1 11.00 New Construction Permit Fee 1 379.89 General Plan Maintenance Fee-New 1 18.99 Construction $1,431.86 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 carded 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_Bidg_Permit_Template.rpl Page 1 of 1 CITY OF MENIFEE (Expires ENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contrector(s)pursuant to the Contractors State License Law). reby affirm under Penalty of perjury that I am under provisions of pter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractor's State License Law for fessions Code and my idense is in full force and e �k the following reason: nse Class 1 Ucei o. ��_ u By my signature below I acknowledge that,except for my personal residence / 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 1 F ER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by reby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section nd will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when nsation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website: tion 3700 of the Labor Code,for the performance of work for which www.leeinfo.ca.eav/calaw.html. rmit is issued. Date PROPERTY OWNER OR AUTHORIZED AGENT ve and will maintain workers compensation insurance,as required byn 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 rmit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this er area: + _ ^ /� application and the information I have provided is correct.I agree to comply r J✓ �' ` / J NY—� with all applicable city and county ordinances and state laws relating to /! ) /, building construction.I authorize representatives of this city or county to Policy# 7 ` / 4-5 3 Expires LZ) enter the above identified property for inspection purposes. (This section need not to be completed is the permit is far one-hundred Date dollars( 0)or less PROPERTY OWNER OR AUTHORIZED AAGENjr certify that in the performance of the work for which this permit is issued, OqOW I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE g workers compensation la California,and agree that if l should become AZARDOUS MATERIAL DECLARATION subject to the worke ompensation provisions of Section 3700 of the Labor e,I shalllffa rth comp) 'Na-Htpse a _rS. Will the applicant or future building occupant handle hazardous material or a IicazK Date Z2 mixture containing a hazardous material equal to or greater that the �p amounts specl n the Hazardous Materials Information Guide? GNARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes r> UNLAWFUL,AND SHALLSUBIECTAN EMPLOYERTO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FIN ES 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 forguidelmes CONSTRUCr10N LENDING AGENCY ❑Yes p•No 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 school? (Section 3097 Civil Code) o Yes gyro OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and.the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of California Health&Safety C action 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the haza s material re ng. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 o No Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish or repair any structure,prior to its RO RTY 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRPI License Law(Chapter9(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 more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their D 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( j all of or( )portion of the work,and the structure is www.epa.Roy/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 70",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. CAPPLICATION Menifee DATE ItPERMIT/PLAN CHECK NUMBER TYPE: ❑COMMERCIAL ESIDENTIAL MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA ❑SIGN SUBTYPE: �DDITION ❑ALTERATION [-]DEMOLITION []ELECTRICAL El MECHANICAL ❑NEW�J❑,-,PPLLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK / �"� D�l✓ �vaLJ 3 PROJECT ADDRESS e ASSESSOR'S PARCEL NUMBER �Q i% ��LOT TRA/CEO, ,/ "Ding & Safety Dept. PROPERTY OWNER'S NAME ��'-7/�-�� j(S C/�l/C�t:�- JAN 17 2117 ADDRESS �/'d�i PHONE 7 J 7�` !�/-7— (mo 03 EMAIL /�l[�l � Cfi!/Yy�L'C D / APPLICANT NAME ADDRESS ✓� 0---713G:,>AC- 7 SS`T T//��G�0 ,4--�G�_ Caq/ F2-9 j'S PHONE �J <J —! ��7��—� �J EMAIL/ /✓jf�c�ly �L.Cw� CONTRACTOR'S NAME Nr /�72 l/S SS'�- WNERBUILDER? ❑YES ONb-- BUSINESSNAMME ADDRESS Z 5�7 1 PHONE J 5-�I- 7-7.-7&Z03 EMAIL CONTRACTOR'S STATE LIC NUMBER ��_ r�U / LICENSE CLASSIFICATION VALUATION$ jib �. Q 1-7 FT J� URE2 L SO FT APPLICANT'S SIGNAT DATE l OTY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF M(�, 1111 BUSIN ICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP 11 r v INVOICE Q PAIDAMOUNT AMOUNT • V I I I OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT I 0CASH OCHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZED LETTER 0 YES O NO City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213