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PMT17-00333 City of Menifee Permit No.: PMT17-00333 29714 HAUN RD. Type: Residential Addition <d1CCEL/_> MENIFEE,CA 92586 MENIFEE Date Issued: 0 210 612 01 7 PERMIT Site Address: 25262 LONE ACRES, MENIFEE,CA Parcel Number: 358-420-015 92584 Construction Cost: $5,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of 744 SO FT ALUMIWOOD PATIO COVER WITH THREE(3)FANS,9 LED LIGHTS,2 RECEPTACLE Work: OUTLETS, 3 GAS STUB-OUTS FOR PRE-FAB GAS OUTDOOR FIREPLACE AND PRE-FAB BBQ ISLAND WITH PLUMBING'NEEDS TO BE INSPECTED FOR A PERMANENT COVER OVER THE BBQ ISLAND SINK PER EMWD RULES. Owner Contractor PAUL CHEBAT 25262 LONE ACRES MENIFEE, CA 92584 Applicant License Number. MENIFEE,CA Phone:9518478093 Fee Description Q�t Amount($1 Receptacle, Switch, Outlet&Fixture 14 181.00 Plumbing Fixtures and Vents,fixtures 4 121.00 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-Plumbing 1 6.05 General Plan Maintenance Fee-Electrical 1 9.05 $485.76 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_Pennit_Template.rpt Page 1 of 1 CITY OF MEN EE LICENSED DECLARATION roperty who builds or improves thereon,and who contracts forthe projects with a licensed contractors)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensor der the Contractors 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 in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I have built as an owner-builder If it has not been constructed in its entirety by ❑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 workers 7044 of the Business and Professions Cade,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/c2law.html. Policy# � Date z11117 ❑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 ❑By my signature below I certify to each of the following:I am the property this permit is issued.My workers compensation Insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this number are: 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 building construction.I authorize representatives of this city or county to Policy# Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred \ �— Date 2?-Aw 7 dollars($100)or less PROPERTY OW R OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is Issued, 1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply 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:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes ❑No UNLAWFUL,AND SHALL SUBJECT AN 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($100,000),IN occupant require a permit for the construction or modification from South IN SECTION 37060F ADDITION TO THE HE L COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes D No I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility 6e 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 1 have read the Hazardous Material Information Guide and the SCAQMD permitting checklist.I understand my requirements under the State of 1 hereby affirm under penalty of perjurythat I am exempt from the California Health al Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes ❑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 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 Contractors 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 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 fora 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 ❑I,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.gov/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 D 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: o 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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE 2 PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL ^RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK n/ ,; � >: c C'v�2r < <' �T c� n.✓' _ C 'r a,v /ocA-.,cod e fle d PROJECTADDRESS 2I'Z 6- z Cu a C ASSESSOR'S PARCEL NUMBER -3S8 - t 0 . o015 LOT TRACT 3 `j OWNER NAME u/ C 6, /9 -) 2-' ADDRESS 2- ,1'2- 6-2. CP v 2 X)C✓ e - lie...,, f et c7 99 PHONE '7,f/- -P f 7 EMAIL APPLICANT NAME ,r)L, / C 2 14'n z< ADDRESS 4 f' 2 C 2- Cf rz C r Or-7 2 F v1t C 6 9 Z ry / PHONE "1 -/ EMAIL CONTRACTOR'S NAME OWNER BUILDER? ES O NO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ 5-0 o a ` SQ FT y/ L SQ FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION � CITY OF MENIFEE BUSINESS LICENSE NUMBER Wy� BUILDING PLANNING ENGINEERING FIRE GREEN SMIP , INVOICE pplD AMOUNT AMOUNT 8S. OCASH 0CHECK# >CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building & Safety Department 29714 Noun Rd. Menifee, CA 92585 951-672-6777 www.cityo fineni fee.us Inspection Request Line 951-246-6213 Jo1,-d CV✓ILr y y L X 2 (r 2 �_ /ram�„� /�-J�.�.. •F,P � C R q L �� -PY 7— PQ 9 7 C f , + of , 1 Gas' f• I �� S4 - I � Z L' Sr/v r7' CITY 0 MENIFEE BUILDI 4G AND SAFETY DEPARTMENT PLAN P PPROVAL REVIEWED BY ,/ V. ATE 'Approval of these plans shall not be construed to be a ermit for,or an , approval of,any violation of any provisions of the feder,I,state or city regulations and ordinances. This set of approved plans nust be kept on the r jobsite until completion, �� City of Menitec Building & Safety Depi FEB 0 s Rol- . i I (. I part#: PCM-400-15x24 Cu 15.875W x 23.37"H x 8.75"Deep fi (+4" Deep for Drain & Hose) City of MenifeE Building & Safety Dept. FEB 0 6 2011 Received Cj a j h [jam 0