PMT17-01814 City of Menifee Permit No.: PMT17-01814
29714 HAUN RD. Type: Residential Addition
<ACCELA7. MENIFEE, CA 92586
MENIFEE Date Issued: 06/08/2017
PERMIT
Site Address: 30326 CORALIUM WAY, MENIFEE, CA Parcel Number: 360-810-010
92584 Construction Cost: $3,650.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 11'x 30'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS,2 LIGHTS
Work:
Owner Contractor
BERRY TURNER PSLQ INC
30326 CORALIUM WAY 28910 RANCHO CALIFORNIA RD
MENIFEE, CA 92584 #206
Applicant phone:9517954260
JOSH HERRICK License Number:919885
PSLQ INC DBA GREENBEE
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description Qtt t Amount 1$1
Receptacle, Switch, Outlet&Fixture 4 131.00
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
General Plan Maintenance Fee-Electrical 1 6.55
$306.20
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 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_Bldg_Pernit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
with a licensed contractor(s)pursuant to the Contactors State License Law).
I hereby affirm under penalty of perjurythat I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure underthe Contractor's State License Lawfor
Professions Code and y license is in full force and effect. the following reason:
License Class License f By my signature below I acknowledge that,except for my personal residence
Expires -����A Signature in which l must have resided for at least one year pdorto completion of
improvements covered by this permit.I cannot Iegallysell a structure that I
WORKER'S COMPENSATION DECLARATIO
have built as an owner-builder if it has not been constructed in its entirety by
in I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that 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 webslte:
by Section 3700 of the Labor Code,for the performance of work for which
www.legin fo.ca.gov/calaw.htm I.
this permit is issued.
Policy# Date
Pi'fiave 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 o By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carder 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
Carrier CN e— with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# Y SQ'5 o 7-5 Z 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
of certify that in the performance of the work for which this permit is issued, rq,/1rr ie-2
1 shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# l Z 1'-t(J�J
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compens on provisions of Section 3700 of the Labor
Code,Ishall fort i ompl�thos� Will the applicant or future building occupant handle hazardous material or
Ib. l mixture containing a hazardous material equal to or greater that the
Applicant Date amounts specified an the Hazardous Materials Information Guide?
WARNING:FAIL RE O SECURE WORKER'S COMPENSATION COVERAGE IS 0 Yes o�
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 require a 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 CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY oYes VWo
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 bounda of school?
(Section 3097 Civil Cade) o Yes w .
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
California Health&Safety Code,Section 25505 and25534 concerning
Contractor's License Law for the reason(s)indicated below by the hazar ous material r ortin .
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es o No
Business and Professions Code).Any city or county that requires a permit to Date ? 1 _
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNifffAA 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 Contractor's 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( )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 Contractor's State License Law does not apply to an owner of a o 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. o No EPA Lead-Safe Certified Firm is required for this project because:
o I,as owner of the property am exclusively contracting with licensed
contactors to construct the project(Section 7044,Business and Professions
Code:The Contractor's 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
Menifee
DATE PERMIT/PLAN CHECK NUMBER em
TYPE: O COMMERCIAL V ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: 0 DDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
4 NEW OPLUI (VGA
MBING CRE-ROOF-NUMBEROF SQUARES
DESCRIPTION OF WORK j d — CA
\iokNJ
11
PROJECT ADDRESS 3 a32ba,�� !U�►.1 1�Iry
ASSESSOR'S PARCEL NUMBER LOT TRACT Cit o
OWNER NAME r S C. U Id ng& Safety Dept.
ADDRESS i7AWW- UN O 8 2017
PHONE — 9�311' ��ql EMAIL
APPLICANT NAME -::So n d-f i c
ADDRESS /,
PHONE "i 5��y 7 b—q 0'9 EMAIL
CONTRACTOR'S NAME OWNERBUILDER? O YES NO
BUSINESS NAMES 1 Q
ADDRESS Q`z q to nclz � �'Af
I 1 P e ` R5 Q Q
PHONE 151-23Y-035b EMAIL
CONTRACTOR'S STATE LLIIC NUMBER 1 lgp � y LICENSE CLASSIFICATION
VALUATION$ b5a LSO FT 3 APPLICANT'S SIGNATU / DATE —J//' / 7
7DEPARTMENTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
ING ENGINEERING FIRE GREEN SMIP
^^����. PAIDAMOUNT
�(T♦;JCCASH OCHECKN OCREDITCARD VISA/MC
CK FEES PAIDAMOUNT OCASH OCHECK# OCREDITCARD VISAIMC
R VERIFIED C YES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO
City of Menifee Building&Safety Department 29714 HOLin Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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