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PMT17-01656 City of Menifee Permit No.: PMT17-01656 29714 HAUN RD. T Residential Addition � E /_>CCL MENIFEE,CA 92586 yPe- """n=K`s""""'" MENIFEE Date Issued: OS/2512017 PERMIT Site Address: 25157 SPRINGBROOK WAY, MENIFEE, Parcel Number: 339-431-001 CA 92584 Construction Cost: $28,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL PRE-FRABRICATED IAMPO PATIO ENCLOSURE 12.4'X 33'W/ELECTRICAL 8 LIGHTS,6 Work: OUTLETS,2 FANS,4 SWITCHES Owner Contractor ARCHIE&MICHELLE CLARK CALIFORNIA SUNROOM PROS 25157 SPRINGBROOK WAY 2600 MICHELSON DRIVE STE 1700 MENIFEE,CA 92584 IRVINE, CA 92612 Applicant Phone:8772951713 JOE MOORE License Number: 991258 CALIFORNIA SUNROOM PROS 2600 MICHELSON DRIVE STE 1700 IRVINE,CA 92612 Fee Description Qtv Amount f51 Receptacle, Switch, Outlet&Fixture 20 211.00 Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 GREEN FEE 1 2.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Building 1 6.65 General Plan Maintenance Fee-Electrical 1 10.55 $394.20 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 Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: License Cla99ssA CIQJ QP 3 Lice o. S 33 By my signature below I acknowledge that,except for my personal residence Expires l 31 4 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 contactors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self-insure for worker's 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.¢ov/calaw,html. this permit is.issued. Policy# Date ❑I have and will maintain workers compensaton insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the workfor which ❑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 Carrier with all applicable city and county ordinances and state laws relating to 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 certify that in the performance of the workfor which this permit is issued, shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 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 fg�bw"th comply. 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 p nfed on the Hazardous Materials Information Guide? WARNIN . AILURE TO SECURE W RKER-S COMPENSATION COVERAGE IS ❑Yes o UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ttyill th inded 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 IN SECTION 3906OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist _ ---- - - _ — --__ - - - - - -- _-- — -- for guidelines CONSTRUCTION LENDING AGENCY ❑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) ❑Yes IgRJ0 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 Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning h zardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es ❑N Business and Professions Code).Any city or county that requires a permit to Date rj construct,alter,improve,demolish or repair any structure,prior to its pERTY OWN ER ORAUI 0�2EDAGENT 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 Contractor's 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 an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified fans and comply with than($500). required practices.This includes rental property owners and property managers who do the paint-disturbing work themselves or through their in 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 orimprovement 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. J BUILDING , : SAFETY PERMIT/PLAN • 1 APPLICATION S`Z Mennee DATE :5-( 25--/ l PERMIT/PLAN CHECK NUMBER I �/ TYPE: O COMMERCIAL 'YRESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Fab ? Epc Lo u R-E L (n LI 2 .Ltx 33 PROJECTADDRESS 957/5_ I P %PrL9;>_oe7LZ WA ASSESSOR'S PARCEL NUMBER 3Si-"I-rD LOT TRACT ' I OWNER NAME RCl1LE 4- 14 lL'14C:1,L.6 CL-AlZl1 ADDRESS aS/57 1/J )W PHONE %Sg- Lj (y- EMAIL APPLICANT NAMEOo\QC. ADDRESS c7 L-ZX> �ICJIAIF L-SON PHONE EMAIL 3M06;_lC- CONTRACTOR'S NAME CkLAF ?R ALA OWNER BUILDER? O YES O BUSINESS NAME n ADDRESS b \C..l1 - 1. U'r� DR t4, 1r)0CD V r ,,, a PHONE `3)kO- '? g0- (o3LJC) EMAIL CONTRACTOR'S STATE LIC NUMBER _ q I lj'g II -- LICENSE CLASSIFICATION B CLOI Dv3 VALUATION$ d}�/©C`� SO FT OL L,�, L SQ FT / APPLICANT'S SIGNATURE /C DATE 5�a S IFSTAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE. PAIDAMOUNT AMOUNT OCASH OCHECKA 0CREDI7 CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH 0 CHECK 9 OCREDITCARD VISA/Mc OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213