PMT17-01577 City of Menifee Permit No.: PMT17-01677
29714 HAUN RD.
�A_CCEL:A�' MENIFEE, CA 92586 Type: Residential Re-Roof
MENIFEE Date Issued:
05/19/2017
PERMIT
Site Address: 25715 WARWICK RD, MENIFEE, CA Parcel Number: 339081009
92586 Construction Cost: $9,800.00
Existing Use: Proposed Use:
Description of REROOF-REMOVE 2 LAYERS AND REPLACE WITH A 30 YEAR COMP SHINGLE.
Work: TIMBERLINE HD-BIRCHWOOD COLOR
Owner Contractor
JACK MILLER COMMERCIAL ROOFING CONCEPTS
25715 WARWIK RD 26100 NEWPORT ROAD At #170
MENIFEE,CA 92586 MENIFEE, CA 92584
Applicant Phone:9512442365
MATT ORTIZ License Number:936177
COMMERCIAL ROOFING CONCEPTS
26100 NEWPORT ROAD Al2#170
MENIFEE,CA 92584
Fee Description 01t rr Amount 15)
Building Permit Issuance 1 27.00
Inspections not specified 98 9&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_Pennit Templale.rpl 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 contractors)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 Ucense Law for
Professions Code and 7m7y license is in full force and effect. —i the following reason:
License Class C�J CI License f /J� f By my signature below I acknowledge that,except for my personal residence
Expires Signature / I/i in which Imust have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WO KER'S COMPENSATION DECLARATION 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 application is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which www leeinfo.ca.Rov/calaw.html.
this permit is issued. -1
Policy# _1mu J' —7w] Date
❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,forthe 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.I agree to comply
Carrier 12 with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#_ M\5YQ —2-Okl Expires \0 1 \ enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
Date
d Ilars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
certify 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 subjectto the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compens���ion provisions of Section 3700 of the Labor
Code,I shall forty�`y{ry��`cJ n�bly I[h t ose provisions. C- /' Will the applicant or future building occupant handle hazardous material or a
Applicant /v /' l% Date mixture containing hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WO CER'S COMPENSATION COVERAGE IS ❑Yes d No
UNLAWFUL,AND SHALL SUBIECTAN 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($300,000),IN
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a e for the construction or 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 ❑Yes A 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 ®No
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
Contractors License Law for the reason(s)indicated below by the California Health&Safetyy de,Se ion 25505 and 25534 concerning
hazardous material rep in
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 eyes ❑No �r
Business and Professions Code).Any city or county that requires a permit to / I Date // —tl
construct,alter,Improve,demolish or repair any structure,prior to its PROPERTY OWN 'OR AUTHORIZE ENT
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(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 orthrough 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 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 ❑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-guilder 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 PERMIT/PLAN CHECK APPLICATION
Menifee
DATE �- PERMIT/PLAN CHECK NUMBER l�mT t'1 - 015-1
TYPE: O COMMERCIAL • RESIDENTIAL O MULTI-FAMILY 0 MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES Sd
DESCRIPTION OF WORK
a D 'A 9�n;a ` , ( / A
PROJECTADDRESS — `\y - QGl-fw C(K 0. VYl l.1 l.J(• ' �
ASSESSOR'S PARCEL NUMBER( J3��n,� Ob. I- 001 LOT _ TRACT ZM
OWNER NAME �\
ADDRESS 1.S
PHONE (�l y) d 7 R —yl '}S EMAIL
APPLICANT NAME y'6 Lr v\C
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME h(, `!OWNER BUILDER? O YES O NO
BUSINESS NAME \1�\OVwv ' `AL` `-�rC. (� Q
ADDRESS
PHONE �� Z,L{L.{-`Z3IDS EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION C_Z
VALUATION$ 00 L SO FT
< J
APPLICANT'S SIGNATURE DATE ✓ _J���
DEPARTMENT DISTRIBUTION 1 CITY OFF M�EENNIFFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GLEN �
INVOICE At `2D PAIDAMOUNT
AMOUNT t 7 _lLi'� OCASH v CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT I OCASH 0CHECK# 0 CREDIT 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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Home Energy Renovation Opportunity
Cool Roofing
HERO Program Overview:
HERO is an energy-efficiency financing program available in California. HERO partners with local governments to make energy-
efficient,water-efficient,and renewable energy products more affordable for homeowners.Specifically, HERO supports cool
roof products that may help to reduce cooling energy costs.'Eligibility requirements apply.'
HERO Program Product Requirements:
• Roofingi t j! Of M
product must meet the following specifications: e n I fe,.
o Low-Slope Roofs(5 2:12):Z 0.5 Aged Solar Reflectance MAY �
o Steep-Slope Roofs(>2:12):>_0.15 Aged Solar Reflectance 9 4,01
• Roofing product must also meet California Title 24 requirements.
• Roofing product must be installed per manufacturer's specifications. Rece(vecr
HERO Program Eligible Steep-Slope GAF Products:
Initial Initial Aged CRRC
Shingle Product Shingle Color Reflectivity Emissivity Reflectivity Aged SRI Product ID#
Glenwood® Golden Prairie 0.17 0.92 0.18* 17 0676-0103
Timberline* Cool SIM
Series* Cool Weathered Wood 0.26 0.92 0.26 28 0676-0042
Timberline*Cool
Series* Cool Antique Slate 0.28 0.92 0.26 28 0676-0043a
Timberline* Cool
Series* Cool Barkwood 0.27 0.90 0.26 27 0676-0041a
Timberline Ultra HD* Birchwood 0.20 0.92 0.20* 20 0676-0096
Timberline HD*
Reflector Series'" Sagewood 0.17 0.90 0.183 16 0676-0132
Timberline HD*
Reflector Series'"' Sandalwood 0.17 0.90 0.18* 16 0676-0133
Timberline HD*
Ref lectorSeriesT" Aged Chestnut 0.17 0.90 0.18* 16 0676-0130
Timberline HD*
Reflector Series'm Coastal Slate 0.17 0.90 0.18* 16 0676-0131
Timberline HD®
Reflector SeriesTM Birchwood 0.20 0.92 0.20* 20 0676-0096
Timberline HD*
Reflector SerieSM Golden Amber 0.20 0.92 0.20* 20 0676-0098
Timberline HD*
ReflectorSeriesT" Copper Canyon 0.17 0.92 0.18* 17 0676-0097
Timberline®
American Harvest* Amber Wheat 0.18 0.92 0.19* 19 0676-0099
Timberline* Natural
Shadow® Arctic White 0.26 0.85 0.29 28 0676-0089
Royal Sovereign* Desert Sand 0.19 0.92 0.19* 19 0676-0100
Royal Sovereign* White 0.27 0.91 0.27 28 0676-0033
'Savings depend on various factors including,but not limited to,climate zone,utility rates,location,and HVAC equipment efficiency.
2To learn more about the HERO program,please visit www.heroorogram.com.To learn more about eligible GAF products,please visit www.paf.com.
*Calculated value per Title 24 requirements.
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