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PMT17-00357 City of Menifee Permit No.: PMT17-00357 29714 HAUN RD. Type: Residential Re-Roof "�kCCEU/ MENIFEE,CA 92586 MENIFEE Date Issued: 02/07/2017 PERMIT Site Address: 25801 WARWICK RD,MENIFEE, CA Parcel Number: 339-063-002 92586 Construction Cost: $11,000.00 Existing Use: Proposed Use: Description of TEAR OFF EXISTING LAYERS, INSTALL NEW COOL ROOF AND FELT Work: *'CRRC#0890-0009" Owner Contractor TOM STAGER FREEMAN AND SONS ROOFING 25804 WARWICK ROAD 28320 AGAVE WAY MENIFEE,CA 92586 MURRIETA, CA 92563 Applicant Phone:9516727500 VINCENT FREEMAN License Number: 965749 FREEMAN AND SONS ROOFING 28320 AGAVE WAY MURRI ETA, CA 92563 Fee Description ON Amount($) Building Permit Issuance 1 27.00 Inspections not specified 98 98.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 4.90 $130.90 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_Permit 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 1 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 ❑I am exempt from licensure under the Contractors State License Law for Professions Code and my license is in full force and efffe�ctt.�--�/��? the following reason: License Class _�'. Ucens No.`'L(0.� 1`"'Y-"l By mysignature below l acknowledge that,except for my personal residence ExpiresG/?:tD/1 Signature in which I must have resided for at least one year prior to completion of ""��TT 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 l 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 forworkers 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.m.goy/calaw.111ml.permit is issued. Policy q Date e'Frve and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Cade,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 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 GJ-T.�—�-� ��j with all applicable city and county ordinances and state laws relating to Carrier r� r/r_\,., J building construction.I authorize representatives of this city or county to Policy g"Lrj41 L�—1-7 Expires t0�� enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT n 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 g 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 fo h th comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Lr- Date mixture containing a hazardous material equal to or greater that the amounts specified an the Hazardous Materials Information Guide? WARNING:FAIL CURE WORKER'S COMPENSATION COVERAGE IS o Yes n 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 TOONE 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 guidelines CONSTRUCr1ON LENDING AGENCY oYes oNo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility he 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 Cade) o Yes o No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjurythat I am exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicahle items)(Section 7031.5 oyes ❑Na 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(RRPI 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 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 a 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 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 for this project bemuse: 01,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 PAP Acknowledgement. BUILDING SAFETY PERMIT/PLAN APPLICATION "Menifee DATE 2 —J I� PERMIT/PLAN CHECK NUMBER Q QW TYPE: O COMMERCIAL 3'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 PROJECTADDRESS ©�� r— ASSESSOR'S PARCEL NUMBER a' LOT TRACT Su( Clry°t Menitee Y Dept. OWNER NAMEyy — ADDRESS `L� , `�• �, nl 017 PHONE EMAIL 13eCE?iVed APPLICANT NAMM^E�- � —� — ADDRESS Z�J !} C A` OQAQ Vi PHONE QSI-'-F"t7"- `�"Z EMAIL CONTRACTOR'S NAME OWNER BUUIILDER? O YES "b BUSINESS NAME ADDRESS r' PHONE 1- _��(� �, EMAIL CONTRACTOR'S STATE LIC NUMBER Q(65,S74q LICENSE CLASSIFICATION. VALUATION $ ( SQ FT L SQ FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP k INVOICE /j,� PAID AMOUNT O AMOUNT �i(/• (zoOr-ASH -CHECK# CREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH -CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building& Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-5213 00 < 0 :E • . . Z n n W n to D 'a r) n A O m o O .v 0 0 3 O w d m 'n y A m 1 m 0 c °, vm -� Cl) m X^. 3 0 dv. Z fD !1 Ar Q m m 'p mo O ;u � p ^ r a 0 oo 3 n < -- OnyO A m m n O M ^ O m ¢ m m m v. 3 "ZTI tAn O m z n 3a o ? my -o^ o 'P N � 0 z 0 ❑ n ml_' a D O w m o m 5 S m m < o N J O '^ �. C S n L. C K A d o Z M r `• N 2 Q Z O i.; ¢ 3c O n n o a w 0 3 D m D D a ] w V < / N Z a N _ c O N r m o m u� v N m m -3a m J `< O m 0 a m 0 Z a m in m c m 0 O m D 3 m ¢ S. 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