PMT17-01133 City of Menifee Permit No. PMT17-01133
29714 HAUN RD.
S\CCELI? MENIFEE,CA 92586 Type: Residential Electrical
MENIFEE Date Issued:
04/17/2017
PERMIT
Site Address: 30247 CHANGING WIND LN, MENIFEE, Parcel Number: 358-510-012
CA 92584 Construction Cost: $800.00
Existing Use: Proposed Use:
Description of 60 L FT GAS&40 L FT ELECTRICAL LINES FOR FUTURE POOL& FIRE PIT
Work:
Owner Contractor
CHRIS MCWILLIAMS BILL&DAVE'S LANDSCAPE MAINTENANCE INC
30247 CHANGING WIND LN 1153 HARLEY KNOX BLVD
MENIFEE, CA 92584 PERRIS, CA 92571
Applicant Phone:9519436455
DAVID LEINDFROST License Number:751707
BILL&DAVE'S LANDSCAPE MAINTENANCE INC
1153 HARLEY KNOX BLVD
PERRIS, CA 92571
Fee Description ON Amount lEl
Plumbing Fixtures and Vents,fixtures 1 116.00
Building Permit Issuance 1 27.00
Inspections not specified 116 116.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 5.80
General Plan Maintenance Fee-Plumbing 1 5.80
$271.60
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 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 Contractors State License Law for
Professions Code and m license is in full force and effect. the following reason:
License Class)..— Li e S ' ()� g g p y personal residence
No.� By my signature below I acknowledge that,except for m
Expires Signature In which 1 must have resided for at least one year prior to completion of
_ improvements covered by this permit.I cannot legallysell a structure that 1
WORKER'S COMPENSATION DECLARATION have built as an owner-builder H it has not been constructed in Its entirety by
+QThereby 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 website:
by Section 3700 of the Labor Code,for the performance of work for which
this permit is Issued. ^ www.leeinfo.ca.aov/calaw.htinl.
Policy# :26 1- c� � Ll A 1 y 01 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 0 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
Carrier yr 1, � with all applicable city and county ordinances and state laws relating to
2-- \\ 7 building construction.l authorize representatives of this city or county to
Policy# Expires d � .5� 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
-aYcertify that in the performance of the work for which this permit is issued, 3C 1 "
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# •7 o
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to thy. orkers compensation provisions of Section 3700 of the labor
�Code,I shallfart\ i ompyxritK4f3e provisions. dl the applicant or future building occupant handle hazardous material or a
'711fplicant �— Date I'll,// 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 15 o Yes eSNo
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 Quality Management a cont(SC construction
or modification
permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY o Yes .Mo
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) j ❑yes 2rRo
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I understand my requirements underthe State of
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to oYe r�No
construct,alter,improve,demolish or repair any structure,prior to its = = F <
issuance,also requires the applicant for the permit to file a signed statement PERTY OWNER RIZED AGENT
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
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.eOa.gov/lead/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 aAn 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 said 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 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.
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
Menifee
DATE PERMIT/PLAN CHECK NUMBER I ` 1133
TYPE: O COMMERCIAL ,<RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION ELECTRICAL O MECHANICAL
ONEW .6PLUMBING ORE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK 6A S If- l � r G U L
p
PROJECT ADDRESS oa -J �V\ ,/V\f 1 U G I\/v /V
ASSESSOR'S PARCEL NUMBER V -'VI LOT 4"T _ TRACT
OWNERNAME V I An-
ADDRESS ;IlIIC) D- �4W
IV PHONE 5 �\��^'7/ ` a 10 A ,EMAIL
APPLICANT NAME V (�`I \ L0 1 c�/' �1� �(�/ .S 4�1
ADDRESS I 1 `�1 ' CAKIL}-� VVv CJX " �" `f `I S t `
CA
PHONE S �-CJ `7 `UJam/ �1 EMAIL C �-f�+YG1 � b} �` "J 6�AQC� L"' 0
CONTRACTOR'S NAME } 1 1 t.D A LAl OWNER BUILDER? O YES Qa'90
BUSINESS NAME CS j ` C74 ` Q. S L S L 2
ADDRESS I�'I J 1 \L_ 1� O/� �A. IFS CA-
PHONE �J 1 — EMAIL
CONTRACTOR'S STArT`ErL,IC NUMBER 7,S O7 LICENSE CLASSIFICATION
VALUATION$ SO FT L SO FT
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION i}> CITY OF MENIFEE� �S LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN V" SMIP J�, ;6
INVOICE 6 O PAIDAMOUNT O
AMOUNT CASH OCHECKq OCREDIT CARD VISP.IMC
PLAN CHECK FEES PAIDAMOUNT I OCASH OCHECK# 0CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Noun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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City of Menifee Ft 2 r-
tEJ Buildirib & Safety Dept.
L-57 APR 17 291
Received
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REVIEWED
DATE
*Approval of these plans sl� il not be construed to be a permit for,or an
C \1p 0 nyvioliti.on of arty provisions of the federal,state or ci
re ul ty
tions and ordinances. This set of approved plans must be kept on the
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