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PMT17-01504 City of Menifee Permit No.: PMT17-01504 29714 HAUN RD. Type: Residential Addition <A—CCEU/ MENIFEE,CA92586 MENIFEE Date Issued: 07/11/2017 PERMIT Site Address: 31559 NORTHFIELD LN, MENIFEE, CA Parcel Number: 358-231-003 92584 Construction Cost: $13,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of ENGINEERED PATIO COVER 1100 SF W ELECTRICAL-3 FANS.AND 14 CAN LIGHTS Work: Owner Contractor LEOVE RODRIGUEZ 31559 NORTHFIELD LANE MENIFEE,CA 92584 Applicant License Number: LEOVE RODRIGUEZ 31559 NORTHFIELD LANE MENIFEE, CA 92584 Phone:9513065907 Fee Description Oty Amount l$) Receptacle, Switch, Outlet&Fixture 17 196.00 Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 Additional Plan Review Building 110 110.00 Additional Plan Review Building 165 165.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 2.00 General Plan Maintenance Fee-Building 1 6.65 General Plan Maintenance Fee-Electrical 1 9.80 $660.45 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 carded 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 perjurytha[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 /t am exempt from licensure under the Contractors State License Law for Professions Code and my license Is in full force and effect. ` the fallowing 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 Code is available upon request when compensation,issued by the Director of Industrial Relations as provided for this ap 'e ion is submittQ[ f e follow' g website: by Section 3700 of the Labor Cade,for the performance of work for which t/ this permit is issued. w I. mfo.ca. aw.ht Policy p Date RA ' ❑I have and will maintain workers compensation insurance,as required by PROPERTYOWNE HORIZEDAGENT section 3700 of the Labor Code,for the performance of the work for which ❑ey my signature be ow 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 with all applicable city and coup inances and state laws relating to building c struction,I auth a rep se ' s this city or county to Policy q Expires ente above id ifi pro f insp ion purposes. (This section need not to be completed is the permit is far one-hundred Date dollars($100)or less PROPER OWNE R AU OR NT ❑I ceri fy that in the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE JJ 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 AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant the intended use permiof thet building st the on or modificatiureon building ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction D)modification from South IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See.permitting checklist for guidelines CONSTRUCTION LENDING AGENCY o Yes ❑No 1 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 ❑No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCACJMD I hereby affirm under penalty of perjury that 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 Cade,Section 25505 and 25534 concerning 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(Chapter9(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 required practices.This includes rental property owners and property than(5500). 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.epa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800424-LEAD(5323). Code;The Contractors 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 for this project because: ❑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. PMM /Ienifee DATE J-I VJ •rL� PERMIT/PLAN CHECK NUMBERPW[ 1-0 I'M TYPE: O COMMERCIAL XRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: N ADDITION OALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES �•�� DESCRIPTION OF WORK Q W V W I�/ c ` PROJECTADDRESS J` J" /vd1tM7&7 / &w*3- `-" ` OS ASSESSOR'S PARCEL NUMBER 35/��-Z31 -//003 LOT TRACT 2GI�Or.7� OWNER NAME Z,4SWIle /C Dr'2rGa ADDRESS �/j j / /I/l} //�� Cam✓ ��r,r /r✓C�i1/ < ��y/ PHONE �S<' ((/r�7o�/�f� !!E'MIAAIIL(�GU� R S67UEZ�i�.CtJ APPLICANT NAME ADDRESS 3/53_9' A(9A11W1? Cs 10 C/I IV&V19V�`��,CR�TC'.!� PHONE �,1y'-,3PIFj �� (� / EMAIL ��crr/l96 'ZT�G5'•C//� CONTRACTOR'S NAME `OWNER BUILDER? N'ES O NO BUSINESSNAME DDC)�va �/LSTIWr.-�lIa/V _ I/1ae,,6 ADDRESS 3✓/�5-7/a G(/Vt�>9' AG ) EAwee414 � PHONE ' J/ - 3DTi-071&k — EMAIL pjlSf.�I✓D�i' S/✓� W CONTRACTOR'S STATE LIC NUMBER / 4 LICENSE CLASSIFICATION 15 VALUATION$ / 3,eJ99: ✓ SOFT I L SQ FTTr- APPLICANT'S SIGNATURE DATE 7 DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT AMOUNT I I I I OCASH OCHECK# 0CREDIT CARD VISAIMC PLAN CHECK FEES PAIDAMOUNT 0CASH OCHECK# 0CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES 0 NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee City of Menifee Building&Safety Department 29714 Hatln Rd. Menifee, CA 92586 9B1tlUhij 7Sai0ty Dc)nt. www.cityofinenifee.us Inspection Request Line 951-246-6213 MAY Rec r A �Pu ves ea � a m m raza CITY OF MENIFEE TRANSMITTAL Building Division Date: 06/27/17 Project Location: 31559 Northfield Lane Plan Check No.: PMT17-01504 BV Project#: 40017-039148.00 Project Description: Patio Addition- Rodriguez Residence Reviewer Date Hour Hourly Rate Total 1'` Plan Check- E Chock 06/01/2017 1.5 $110.00 $165.00 2nd Plan Check K. Duong 06/27/2017 1.0 $110.00 $110.00 3rd Plan Check 41h Plan Check Final Approval: K. Duong 6/27/2017 2.5 $110.00 $275.00 � e Bureau Veritas North America,Inc. \ 1665 Scenic Avenue,Suite 200 Costa Mesa,CA 92626 M:714.431.4100 F:714,625.0685