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PMT17-01930 City of Menifee Permit No.: PMT17-01930 29714 HAUN RD. Type: Residential Re-Roof '5A_CCEL/k_>. MENIFEE, CA 92586 ""'"""z P..A ' MENIFEE Date Issued: 06/16/2017 PERMIT Site Address: 29589 PEBBLE BEACH DR,MENIFEE, Parcel Number: 338-064-001 CA 92586 Construction Cost: $9,490.00 Existing Use: Proposed Use: Description of REMOVE EXISTING COMP ROOFING AND REPLACE WITH 30#FELT AND COOL ROOF SHINGLES Work: CRRC 0890-0009 OWENS CORNING-AMBER COLOR Owner Contractor JIM BASINGER GARDNER ROOFING COMPANY 29689 PEBBLE BEACH DR 594 WEST SEVENTH STREET MENIFEE, CA 92586 SAN JACINTO, CA 92382 Applicant Phone:9516542794 LEE BLOOMER License Number: 528309 GARDNER ROOFING COMPANY 594 WEST SEVENTH STREET SAN JACINTO, CA 92382 Fee Description QtV Amount t$) 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 $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 building 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 with a licensed contractors)pursuant to the Contractors State License Law), ' I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractors State.License Law for Professions code 'and 7myy license is in full force and effect. the p' q !,(� the following reason: License Class C -_Tl License No. .) O O o By my signature below I acknowledge that,except for my personal residence -" Expires I7 2o(7 SignaturP in which I must have resided for at least one year prior to completion of 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 a 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.lezlnfo.ca.zov/calaw.html. this permit Is issued. - Policy# qp[Z 3R7 Date PROPERTY OWNER OR AUTHORIZED AGENT ❑I have and will maintain workers compensation insurance,as required by 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 clv�Uf 1, with all applicable city and county ordinances and state laws relating to _ Cartier building construction.I authorize representatives of this city or county to Policy#'?f 1// 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 ❑I 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 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 fo h corn I provisions. Will the applicant or future building occupant handle hazardous material or a �17 mixture containing a hazardous material equal to or greater that the Applicant �� � Date amounts s ec'fled 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 Will the intended use of the building by the applicant or future building f AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modifiation 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 for guid"es CONSTRUCTION LENDING AGENCY 0 Yes 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 bog of a school? (Section 3097 Civil Code) 0 Yes o 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 H alth&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the u aterial re checkmark(s)I have placed next to the applicable item(s)(Section 7031.E ciYes ❑ 1 _ 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 PROP WNER OR AUTHORIZED AGENT I 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 Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors 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($500). managers who do the paint-disturbing work themselves or through their ❑1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). }' Code;The Contractors State License Law does not apply to an owner of a property who,through employees'or personal effort,builds or improves the ❑An EPA Lead-Safe Certified Renovator will be responsible for this project ,h Property provided that the improvements are not intended or offered for . Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or Improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: O 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION w Menifee DATE �l�� ( PERMIT/PLAN CHECK NUMBE !J TYPE: ❑COMMERCIAL Vf RESIDENTIAL MULTI-FAMILY ❑MOBILEHOME ❑POOL/SPA ❑SIGN SUBTYPE: ❑ADDITION ❑ALTERATI N ❑DEMOLITION ❑ELECTRICAL [-]MECHANICAL ❑NEW ❑PLUMBING RE-ROOF-NUMBEROFSOUARES� DESCRIPTION OF WORK v� lS jkkA C01,Akp , ah PROJECT ADDRESS Z-1 l —12 rV$ILC ASSESSOR'S PARCEL NUMBER 33 0 -0�04 00I LOT 4��L TRACT 0 - PROPERTY OWNER'S/NAME ADDRESS 2c(,1/Q 5 & Le ZY PHONE (95l) O- (?7Q2 EMAIL APPLICANT NAME I 7 f �C/l ADDRESS "{/ ft[ t lV�-�,p Ca- q 3 PHONE (f,5-6 (QV-Z7 `y EMAIL CONTRACTOR'S NAME OWNER BUILDER? ❑YES NO BUSINESSNAME // pp ADDRESS 1 / .,I 'Lt� G{. RZS(� PHONE �9S1 1 /j,s"1� 7qq EMAIL CONTRACTOR'S STATE LIC NUMBER �5 S';nq LICENSE CLASSIFICATION VALUATION $ O . O- SO FT Z7o O L SO FT // APPLICANT'S SIGNATURE DATE LO-IS'-1 7 DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN ( 'OO SMIP INVOICE ��//�� C� � PAID AMOUNT �CASH '-'CHECK p �-'CREDIT CARD VISA/MC AMOUNT 1 50 PLAN CHECK FEES PAID AMOUNT CASH CHECK# CREDIT CARD VISA/MC OWNER BUILDER VERIFIED YES 0 NO DL NUMBER NOTARIZED LETTER YES C NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-67P,W9kMenitep www.cityofinenifee.us Inspection Request Line 951-246-6213 Building & Safetyept. JUN 16 2017 Received N 0 o :E Z v_! 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O " l d J m N d _Cn J O O ^ m C L d J O n s m o o to J m y a m m n u o a ^ 0 w c 3 o n 0 o n u• o a a T _ c an ^ c a n -ri rn rn j :0v 00 O J 101 0 OFFICE COPY Find rated products - Cool Roof Rating Council Page 1 of 1 1SEARCH RESULTS Selected filters Keywords: o8900009 Please note that the CRRC does not set a minimum definition for"Cool",the CRRC simply lists the measured radiative property values on our Directory.A product's placement on the Directory does not mean that the product is"cool"as defined by any particular code body or program. *CRRC Rapid Ratings:These are interim laboratoryaged values that simulate weathered values.These values will be replaced with the measured three-year aged ` values upon completion of the weathering process.SRI values calculated using Rapid Ratings may change once the aged rating replaces the interim rating. g.i. PRINT EXPORT ALL PRODUCTS O CRRCPROB.IB fMRBFACTUREn:BRANB PROBUCTTYPE COLOR SOWIREPLECTANCE THERMMLFMIrTM'lE 5RI MORE MODEL HIM W Initbl 3YAr In11Hl 3Yvr Initial )yin r l 0890aoo9 Owens coming Roofing and Asphalt, Steep SIope:Asphalt orange o.0 peding 0.92 pending n perdi"g + V LLC TruDeflnitlons Duration®, shingles — Oavidgeo,RapidEdge"Pre{utRake LL starter5hingles U. AmberO COOL ROOF RATING COUNCIL 449 15th Street,Suite 400 TEL(866)465-2523 EMI L Info@roolroofs.org Oakland,CA 94612 FAX(5To)482-4421 Cerlif[.i[c 3�96.ot 10 e http://coolroofs.org/products/results/search&keywords=0890-0009/ 6/16/2017