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PMT17-02055 City of Menifee Permit No.: PMT17-02055 29714 HAUN RD. Type: Residential Addition CCEL/A> MENIFEE,CA 92586 MENIFEE Date Issued: O6/22/2017 PERMIT Site Address: 28768 WOODCREST LAKE DR, Parcel Number: 364-181-001 MENIFEE, CA 92584 construction cost: $10.000.00 Existing use: 1 &2 Family Residence Proposed use: Description of INSTALL 16 x IV AND 16'x 14'SOLID AND 14'x 15' LATTICE ALLIMAWOOD PATIO COVERS WITH 2 Work: FANS, 8 LIGHTS Owner Contractor JIM DIAZ SOCAL HOME IMPROVEMENT 28768 WOODCREST LAKE DRIVE 16331 LAKESHORE DR#G161 MENIFEE, CA 92584 LAKE ELSINORE,CA 92530 Applicant Phone:9512364282 TROY CRISWELL License Number:930540 SOCAL HOME IMPROVEMENT 16331 LAKESHORE DR#G161 LAKE ELSINORE,CA 92530 Fee Description OQt Amount($1 Receptacle, Switch, Outlet&Fixture 10 161.00 Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 2.00 General Plan Maintenance Fee-Building 1 6.65 General Plan Maintenance Fee-Electrical 1 8.05 $338.70 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_Pennit Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects 1 hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Levi). 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 Class � License N By my signature below I acknowledge that,except for my personal residence Expires Signatur — 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 DEC RATION _ have built as an owner-builder if it has not been constructed in its entirety by ❑I hereby affirm under penalty of p ry one ofth lowing declaration:) licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificat�o"f 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 f9J9 website: by Section 3700 of the Labor Code,for the performance of work for which www.lesinfo.c . e aw.htmi. n this permit is issued. ,l po have Date I have and will maintain workers compensation insurance,as required by PROP ORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which O By m gnature below I certify to each of the following:I am the property this permit is issued.My workers comp os`ation insurance carrier and policy oww+ r or authorized to act on the property owners behalf.I have read this number are: I I application and the information I have provided is correct.I agree to comply 1� �.r—�/)►\ with all applicable city and county 9�0dinances and state laws relating to Carder building construction.I author'zeepresentatives of this city of county to Policy# U Expires enter[ 5t ?entifi roperty ' spection purposes. (This section need not to be completed is the permit is for one-hundred Date /V! /J dollars($100)or less PROP THORIZED AG ENT o I certify that in the performance of the work for which his permit is issued, I shall not employ any persons in any manner sqasrfo besphe subject to the CITY BUSINESS LICENSE It workers compensation laws of California, rfd if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers coo pensation �sfons f- ection 3700 of the Labor Code,Ishall fo ithW h riiiply wit osep v'ions. Will the applicant or future building occupant handle hazardous material ora Applisa �� Date mixture containing a hazardous material equal to or greater that the amounts ecified on the Hazardous Materials Information Guide? WA NG:FAILUR TE O S E WORKER'S COMPENSATION COVERAGE IS O Yes pr o UNLAW�LAND 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 forguidelii es CONSTRUCTION LENDING AGENCY O Yes [fNo 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 bou9�dary of a school? (Section 3097 Civil Code) Dyes oMo OWNER BUILDER DECLARATIONS I have re d the Hazardous Material Information Guide and the SCAQMD permitting checklist I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the reason(s)indicated below by the California Health al Safety Code,Section 2 and 534 concerning hazard s material repo checkmark(s)I have placed next to the applicable items)(Section 7031.5 Oyes Business and Professions Code).Any city or county that requires a permit to reporting. / Date construct,alter,Improve,demolish or repair any structure,prior to Its PROPERTY E O AUTHO IZED 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 OVATION REPAIR AND PAINTING fRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the he 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 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.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 D 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 bemuse: 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. APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK r;. Menifee DATE Z PERMIT/PLAN CHECK NUMBER TYPE: 000MMERCIAL (VRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW 11O PLUMBING� O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK b ILIc�-► II(� �' SG v Lo(/-VS c D Go— PROIECTADDRESS ASSESSOR'S PARCEL NUMBER 7QLi - IC6111 - (�O\ LOT TRACT Building $ Safety )ept. OWNER NAME�[ S` Vv— h Ca-L-- JUN 2 2 2017 ADDRESS v0 VV 2 C vim, PHONE 109 312 7 IL EMAIL i W� t4Z +L' yh-q�� �-�ti APPLICANT NAME ADDRESS PHONE (` EMAIL " CONTRACTOR'S NAME S `(� �^1 -7� OWNER BUILDER? OYES O BUSINESS NAME A ADDRESS lL 1 L4 0 (� 51L,o qz-5.3b [^' PHONE 'PCID Z2( 4'(< EMAIL CONTRACTOR'S STATE LIC NUMBER 530 '(? LICENSE CLASSIFICATION 0/ VALUATION$ /fl ,D O0 SQ FT L SQ FT APPLICANT'S SIGNATURE �� DATE DEPARTMENT DISTRIBUTION C. CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT O AMOUNT ' CASH O CHECK# 0CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT 0CASH 0 CHECK 4 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES 0 NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department29714 Noun Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 LEDGER '& TRACK MPECTIQN REQUIRED U j'` w U. Est ro��, o P — �)I�XIy Uf'I-ice 'S 16 Pa4tb GAS ALL (q5'3 8 �F-Kv �r Fvw^e� City of Menlfee CI Y OF MENIFEE Building & Safety Dept. B ILDING AND SAFETY DEPARTMENT JUN 2 2 2017 p ROVAL Received r REVIEWE 1 ~ DATE *Approval of these plans shall not be const ued to be a permit for,or an approval of,any violation of any provisions �ioe federal,state or city regulations and ordinances. This set of DEPARTMENT r ed plans must be kept on the jobsite until completion.