PMT17-01033 City of Menifee Permit No.: PMT17-01033
29714 HAUN RD. Type: Residential Addition
'[;kCCELA? MENIFEE,CA 92586
MENIFEE Date Issued:
04/10/2017
PERMIT
Site Address: 31212 PALOMAR RD, MENIFEE, CA Parcel Number: 372-270-006
92584 Construction Cost $2,955.00
Existing use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 200 SO FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 1 FAN,2 POSTLIGHTS
Work:
Owner Contractor
RUS TOLENTINO SOUTHERN CALIFORNIA PATIOS
31212 PALOMAR RD 1787 PAMONA DR#B
MENIFEE, CA 92584 CORONA,CA 92880
Applicant Phone:9098161288
LOIS MONTINI License Number.948536
SOUTHERN CALIFORNIA PATIOS
1787 PAMONA DR#B
CORONA,CA 92880
Fee Description 01t r Amount t$1
Receptacle, Switch,Outlet&Fixture 3 126.00
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 6.30
$300.96
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 Menifse.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 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 D I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect�j ! , the following reason:
License Class Lice e By my signature below I acknowledge that,except for my personal residence
Expires f ^�U ' 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 1 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 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 webslte:
by Section 3700 of the Labor Code,for the performance of work for which
this permit is issued. www.leginfo.ca.gov/calaw.litmi.
Policy# Date
o 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 D 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.1 agree to comply
/y� �/'•� with all applicable city and county ordinances and state laws relating to
Carrier r - "�,L7 build! construction.l authorize representatives of this city or county to
Policy#"nv]n
� �O .r,� 9 Expires a th ho a identified ro rty for inspection purposes.(This section need not to be completed is the permit is for one-hundred Date /T�"' ^/2
dollars($100)or less RO ERTY OWNER OR AUTHORIZEDAGENT
o I certify that in the performance of the work for which this permit is issued, js��1/
I shall not emulov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# CO �J P
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worke}sst ompensation provisions of Section 3700 of the Labor
Code,I shall forth N Rh rbmPl r w'th those pr isions. /rn Will the applicant or future building occupant handle hazardous material are
!J mixture conta g a hazardous material equal to or greater that the
Applicant \ te— 7 i 'amounts s afied on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o 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
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quali anagemerd District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguldelin
CONSTRUCTION LENDING AGENCY 0 Yes 0 0
I hereby affirm that under the penalty of perjurythere 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}.school?
(Section 3097 Civil Code) o Yes mxoe/
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 afety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardou m a reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes ? �7
Business and Professions Code).Any city or county that requires a permit to Date .�7^ �� ^�/
construct,alter,improve,demolish or repair any structure,prior to its PROP O ER OR AUTH IZEDAGENT
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(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
o 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.epa.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 0 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:
❑1,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
Wenifee
AZ
DATE �- �' 7 PERMIT/PLAN CHECK NUMBER
TYPE: 0 COMMERCIAL <-RESIDENTIAL C MULTI-FAMILY C` MOBILE HOME O POOL/SPA SIGN
SUBTYPE: `>ADDITION C ALTERATION C DEMOLITION ') ELECTRICAL `> MECHANICAL
C�--NEW OPLUMBING ORE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK /<% X //a • LL1/✓)/�LUDD.�
Le D G-4� • DS /9S
PROJECTADDRESS / !a L D�/1n^ qR. D�
ASSESSOR'S PARCEL NUMBER ZflA - A70-00LO LOT L. TRACT
OWNER NAME S
ADDRESS
PHONE LPl - 95C4 EMAIL p
APPLICANT NAME � �A \/
ADDRESS
PHONE 1- 3 -I EMAIL
CONTRACTOR'S NAME E E�LLn r^ �I-O�W/NER BUILDER? O YES C440�
BUSINESS NAtME (��jD /V C LI/' A +{ �_�1 n (y
ADDRESS 17 a ( -I n-) /^� �- /v!`�!�-1 CA 9a b
PHONE G & Lo- q j5 �p( EMAIL �, vZ� �Q• l�
CONTRACTOR'S STATE LIC NUMBER 9�g �)b LICENSE CLASSIFICATION
VALUATION $ CA SQ FT Z D L SO FT L� Q� ''7
APPLICANT'S SIGNATURE DATE / U - / /
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN Ito SMIP to
INVOICE �5 PAID AMOUNT
AMOUNT CASH �CHECK# !✓CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT OCASH OCHECK# 'CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES '-' NO DL NUMBER NOTARIZED LETTER YES 0 NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
O a8 ' �LD a8'
(__. I b M ` .
N R E
t ",
c
('� � City of Menifee
Building & Safety Dop
APR 1 0 2011
' D
L 6n eLecraw, L r-' a2m-TLIg4Ts OceiVea
CITY F MENIFEE _
BUIL {{>J
PLAN PPROVAL
REVIEWED Y
A
'Approval of these p ns shall not be construed to be a permit for,or an 1
approval of,any viola io" a�oi�lovisions of the federal,state or city
regulations and ordi n set of approved plans must be kept on the 35'
jobsite until completi n.
IL
>_ A
arnr6owHSO, =NRD -TAP; ,��/r r(!
ND �eiT'
US I d E/�1Tt 17�� `Po>wo
3124 a 14 Lb m A-12. Pb . S "rTF �5
C ,DRbA.) Pr ) C'4 ' ga99a
yYlL 1� 1 I� �, pia w0 N �nrr s-t-p-