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PMT17-01755 City of Menifee Permit No.: PMT17-01755 29714 HAUN RD. Type: Residential Addition <ACCEL/� MENIFEE,CA 92586 MENIFEE Date Issued: 0 610 6/2 01 7 PERMIT Site Address: 29467 WINDING BROOK DR, MENIFEE, Parcel Number: 340-240-081 CA 92584 Construction Cost: $980.00 Existing use: 1 &2 Family Residence Proposed use: Description of INSTALL 50 SF LATTICE PATIO COVER IN ATRIUM AREA, NO ELECTRICAL Work: Owner Contractor RICHARD&MARGARET FOREMAN C&S PATIO COVERS 29467 WINDING BROOK DRIVE 65269 ELAINE CIRCLE MENIFEE,CA 92584 MECCA, CA 92254 Applicant Phone:7606254225 RICHARD&MARGARET FOREMAN License Number. 1004320 29467 WINDING BROOK DRIVE MENIFEE, CA 92584 Phone:9516798682 Fee Description Oty Amount($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 builiding operations being pried 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 contractors)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exemptfrom licensure under the Contractors State License Law for Professions Code and my license is in full force and effect. the following 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 application is submitted or at the following websiter by Section 3700 of the Labor Code,for the performance of work for which sy�y ica. ov calaw.html. this permit is issued. ` Policy# // o&iZ� 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 ❑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 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. Q (This section need not to be completed is the permit is for one-hundred 0 f��'-+rt� Date dollars($100)or less 7 PROPERTY OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, I shall not employ any persons in any mannerso as to become subject to the CITY BUSINESS LICENSE If 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 occupll eintended a ermitf of the building st the applicantor antorfutionure building ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction D)modifpermit from South IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES- - - - -for oguide Quality ManagementDistrict(SCAQMD)?See,permi[tlng checklist. - far guidelines CONSTRUCTION LENDING AGENCY ❑Yes ❑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 underthe State of California Contractors License Law for the reason h s)Indicated below by the Health al Safety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable items)(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(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 fora permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and propertythan($500). 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.eov/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 Ucense Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovatorwill 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: PI,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 & SAFETY PERMIT/PLAN CHECK APPLICATION 4 r: Menifee DATE C,- -6- 7 PERMIT/PLAN CHECK NUMBER PvfT TYPE: O COMMERCIAL !RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: 2l'ADDITION OALTERATION :.'DEMOLITION O ELECTRICAL O MEC�gNl9fty of Menlfe Bull O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES ding& Safety apt. DESCRIPTION OF WORK % JUN 0 6 201 Jl PROJECTADDRESS -1- '0 47 "-r/i✓a 1 A1,t ASSESSOR'S PARCEL NUMBER� O � LOT TRACF OWNER NAME 4!/r, ADDRESS PHONE 'y 9 -iv-- �Cg2- EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? YES ibNO BUSINESS NAME ADDRESS A 77- Z G P 0 PHONE �7 C e� G Zif'- SG�Z S EMAIL ✓+�. G.F'" Z c d'Yes/� . o CONTRACTOR'S STATE LIC NUMBER t b d YVA 2.is LICENSE CLASSIFICATION VALUATIONS ej S f3 SO FT S p L SO,FT APPLICANT'S SIGNATURE DATE e- 6 - �7 DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE Q ' ^ PAIDAMOUNT ` AMOUNT (J-U5 �� . �i�'J OCASH OCHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED O YES 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.cityofinenifee.us Inspection Request Line 951-246-6213 U -�-z29 �79 City of Menifee d Building &Safety Dept. LEDGER & TRACK JUN o 6 2017 p INSPECTION REQUIRED U :C'A.0 ) Q ®lAri� Received w N _ f}�CaN 3HoRJ� WA�6 i i; " AND SAFETY DEPARTMENT eZ$4 4D/-- AFv'r WLAN A PR VAL New REV B1 ED%Y 1 Imo 'DATE GHr7,"— , �p _ V and cay.>~X 'Appr al o*ese plans shall not be construed to be a permit for,or an approv of,my viola ion of any provisions of the federal,state or city 5 ti 9 e © — (� —� regulat ns d ordinlInces. This set of approved plans must be kept on the )o si e n � etibn. 13- kn 9 �H