PMT17-01765 City of Menifee Permit No.: PMT17-01765
29714 HAUN RD. Type: Residential Re-Roof
<AcCELh-? MENIFEE,CA 92586
MENIFEE Date Issued: 06/06/2017
PERMIT
Site Address: 27259 EL PUENTE ST,MENIFEE, CA Parcel Number: 336-214-002
92586 Construction Cost: $6,000.00
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING LAYERS, INSTALL NEW COOL ROOF
Work: "CRRC#0890-0008•`
INSTALL NEW RECESS LIGHT IN KITCHEN AND ONE HOSE BIB IN FRONT OF HOUSE
Owner Contractor
LARRY MAYER MY HOME BUILDERS&ENERGY SOLUTIONS INC
27259. EL PUENTE STREET 18375 VENTURA BLVD#437
MENIFEE,CA 92586 TARZANA, CA 91356
Applicant Phone: 8184412417
DAVID CAMACHO License Number: 1025392
MY HOME BUILDERS&ENERGY SOLUTIONS INC
18375 VENTURA BLVD 9437
TARZANA, CA 91356
Fee Description (3ht Amount 151
Receptacle, Switch,Outlet&Fixture 1 116.00
Plumbing Fixtures and Vents,fixtures 1 116.00
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
General Plan Maintenance Fee-Plumbing 1 5.80
General Plan Maintenance Fee-Electrical 1 5.80
$374.50
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 Marilee.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_Pemrit 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 o 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 Clasl �Lice^�nse NNo..,1,�, 1- J��S L By my signature below I acknowledge that,except for my personal residence
Expires �� ��� Signature vim_ in which l must have resided for at least one year prior to completion of
v improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
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 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.1eginfiO.ca.gov/caIaw.htmI.permit is issued.
Policy# i� SSG S dqn L. II e7 I Date
❑I have and will maintain workers compensa don 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 owner's behalf.I have read this
number are: - application and the information 1 have provided is correct.I agree to comply
�V('t IL�bS WQ with all applicable city and county ordinances and state laws relating to
Carrier_ building construction.I authorize representatives of this city or county to
Policy# dxpires C-' n 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
o I certify that In the performance of the work for which this permit is issued,
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE It
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 r'Z Date I. mixture containing a hazardous material equal to or greater that the
amounts spe .led on the Hazardous Materials Information Guide?
WARNING:F ILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes No
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 requires permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR[ODE,INTEREST,AND ATTORNEYS FEES for guideline
CONSTRUCTION LENDING AGENCY o Yes PAO
hereby affirm that under the penalty of perjury there is a construction Will the proposobuilding or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is Issued outer bougnodiiof a school?
(Section 3097 Civil Code) ❑Yes d 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&Safety Code,Section 25505 and 25534 concerning
he ous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es ❑No � ll
Business and Professions Cade).Any city or county that requires a permit to �Y�—L, 2_ Date \e `lio 1��
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNRIER 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 IRRP)
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 I )portion of the work,and the structure is www.eoa.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 License Law does not apply to an owner of ❑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:
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.
BUILDING ; APPLICATION
Menifee
DATE 6 PERMIT/PLAN CHECKNUMBER , ' '11D5
TYPE: O COMMERCIAL XESIDENTIAL O MULTI-FAMILY O MOBILE HOME C POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION .2:ELECTRICAL O MECHANICAL
O NEW j2-PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK W�iWr I I W CTl %3 L (3
PROJECTADDRESS Z Z5 �i7'V �T ''ICJ-✓�
ASSESSOR'S PARCEL NUMBERQ wry,(-� •LyJpr LOT TRACT
OWNERNAME (L i. MS t,ell-(L-Y 44 gFsM M1W61" Ci Of Menifee
_ BUildmg a y Dept.
ADDRESS 2'�ZS c1 V�� >f
PHONE �r' S1� Ipy l l�r?r JUN 06 2017
EMAIL
APPLICANTNAME -TU/ &v A-J )(D GAv)Arwa 13lmLgr'�b(
� p
ADDRESS G I� ��v��^'U7 S'T
PHONE C-123) ZA-1' aAt EMAIL 'DDGL7f�t�+ZS ZZ d'4' mpoo--
CONTRACTOR'S NAME MlEr f200 I t.Q611-C OWNER BUILDER? O YES W<0
BUSINESSNAME tAy vt t aIuobll-s
ADDRESS 36Ud VIMS C�T -At`;?2Z k
PHONE (il,(T) "- 9Z b EMAIL A wMr:rPxj1L(r,>vCzA `� 44 (7("wl L
CONTRACTOR'S STATE LIC NUMBER 10 073� LICENSE CLASSIFICATION
VALUATION$ [, ,000 SOFT t�']G4 LSQFT I JO
APPLICANT'S SIGNATURE DATE
DEPARTMENT DISTRIBUTION �/ CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP X
INVOICE PAIDAMOUNT O `�
AMOUNT O CASH CHECK A CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 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.Lis Inspection Request Line 951-246-6213
City of Menffee
Building & Safety Dept.
JUN 0 6 2017
Received
_r
.Ftluf.lc �.r�vrJ , t t3-us� K I t�
r
:-7Z5-� -r;L pur ar,� S
CITY OF MENIFEE
BUILDING AND SAFETY DEPARTMENT
PLAN APPROVAL
REVIEWED BY
DATE
*Approval of these plans shall not be construed to be a permit for,or an
approval of,any violation of any provisions of the federal,state or city
regulations and ordinances. This set of approved plans must be kept on the
jobsite until completion.
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