PMT17-01081 City of Menifee Permit No.: PMT17-01081
29714 HAUN RD.
<ACCEL/� MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 0411212017
PERMIT
Site Address: 24117 DEPUTY WAY, MENIFEE, CA Parcel Number: 358-550-010
92584 Construction Cost: $5,000.00
Existing use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 740 SO FT SOLID ALUMAWOOD PATIO COVER, NO ELECTRICAL
Work:
Owner Contractor
BARBARA SEXTON HALLS DECK COATING INC
24117 DEPUTY WAY 31555 GRAPE STREET#3-355
MENIFEE, CA 92584 LAKE ELSINORE,CA 92532
Applicant Phone: 9512443265
MARVIN HALL License Number:987529
HALLS DECK COATING INC
31555 GRAPE STREET#3-355
LAKE ELSINORE,CA 92532
Fee Description City Amount l$1
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
$168.65
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 building 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_Bidg_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 ❑I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class C'-2i 7 C 6 f License No. W 7q B m signature below I acknowledge that,except for m y y g g p y personal residence
rh,10,e
ey'6—9,�^/7 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
KER'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
and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Cade,is available upon request when
ensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website:
ction 3700 of the Labor Code,for the performance of work for which www.leginfo.ca.gov/calaw.html.permit is issued.
Policy# Date
❑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 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 owner's 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
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
XII certify that in the performance of the work for which this permit is issued,
I shall not emolov any persons in any manner so as to became subject to the BUSINESS LICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
—subjecttothe.workers.compensation..provisions.of Section 3700 of the.Labor. _._
e,I shall forth "h comply w t�fiose provisions. Will the applicant or future building occupant handle hazardous material or a
plicany Dare
.
mixture containing a hazardous material equal to or greater that the
L/-/�-7_O�7
amounts spe ified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE Is ❑Yes 71
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
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)75ee permitting checklist
for guideli
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 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 o'fJ
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 underthe State of
Contractors License Law for the reason(s)indicated below by the alifornia Health&Safety Code,Section 25505 and 25534 concerning
checkmark(5)I have placed next to the applicable Rem(s)(Section 7031.5 zardous
Business and Professions Code).Any city or county that requires a permit to 0 aterial repo ' g.
construct,alter,improve,demolish or repair any structure,prior to Its Date�/ �-
issuance,also requires the applicant forthe permitto file a signed statement ROPERTY OWN Off AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's 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($S00). managers who do the paint-disturbing work themselves or through their
❑1,as owner of the property,or my employee with wages as their sale 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 Contractor's.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 forthis project because:
o 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's 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 PERM IT/PLAN CHECK APPLICATION
Menifee
DATE PERMIT/PLAN CHECK NUMBER I �O�D
TYPE: O COMMERCIAL e RESIDENTIAL G MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION C�LTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK
PROJECTADDRESS �7 (/tom`rem fU
i-
ASSESSOR'S PARCEL NUMBER 0- 9jD^V LOT TRACT
OWNERNAME
ADDRESS , oo �f-
PHONE 9�� S �— Z o 2S 2 EMAIL
APPLICANT NA /ME � ' = d!l`P
ADDRESS ZZ-7 7 (� I/ r
PHONE 2 - - l5- EMAIL l/LJ er
CONTRACTOR'S NAME OWNER BUILDER? G YES G NO
BUSINESS NAME / C-Q//
ADDRESS S�
PHONE gc�6 EMAIL
CONTRACTOR'S STATE LIC NUMBER 7S 2 LICENSE CLASSIFICATION
VALUATION$ ,rOD 9/,!�a SO L SQ FT
APPLICANT'S SIGNATURE %i� DATE
TYS�AFFUSEONLY
DEPARTMENT DISTRIBUTION �^ CITY OF ME�f II FEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP W 1/
INVOICE 'w��Ly PAIDAMOUNT
AMOUNT �J p� OCASH OCHECKq OCREDIT CARD VISA/MC
(05
PLAN CHECK FEES PAID AMOUNT OCASH GCHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O 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.cityofmenifee.us Inspection Request Line 951-246-6213
S/4,Pe
- — -- — —
F
/4q UL 611
city of Menlfee
Building &Safety Dept.
APR 12 2011
Received j
h
O
tPjuuER & TRA K
W- RED
St«' C CITY d
'; BUlISiIGCNC AFETY DEPARTMENT _
I
PIAN APPROVAL
now �.
k REVIEWED Br 411I� n i
I DA E D nko
'Ap[!4,val of these plans shall",•�o censtJ,jad to he a permit for,or an
jdpPr+al of,any violation of aa, ar-,m;u,ns of the federal,state or city
I regulations and ordinances. Th,s set of approved plans must be kept on the , {
jobsite until completion. ;
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