PMT17-02252 City of Menifee Permit No.: PMT17-02252
29714 HAUN RD.
<ACCFI-A> MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued:
0 6/3 012 01 7
PERMIT
Site Address: 27751 BLUEWATER CT, MENIFEE, CA Parcel Number: 333-350-001
92585 Construction Cost: $5,000.00
Existing use: 1 &2 Family Residence Proposed use:
Description of INSTALL SOLID ALUMAWOOD 16 x29 PATIO COVER-464 SO FT WITH ELECTRICAL-TWO FANS
Work:
Owner Contractor
LISA CRUME GRIFFITH CO
27751 BLUEWATER COURT 213 W LA CADENA DRIVE
MENIFEE, CA 92585 RIVERSIDE, CA 92501
Applicant Phone:9516844800
MICHAEL ALLEN License Number:455382
GRIFFITH CO
213 W LA CADENA DRIVE
RIVERSIDE, CA 92501
Fee Description Oty Amount f$1
Receptacle, Switch, Outlet&Fixture 2 121.00
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 6.05
$295.70
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_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 contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from Iicensure 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 iJ .3!Y2 By mysignature below I acknowledge that,except for my personal residence
Expires—;?Zl Sigrialsfre in which I must have resided for at least one year prior to completion of
11 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 website:
by Section 3700 of the Labor Code,for the performance of work for which ,n,,,v,,v,lezinfo.ca.eov/calaw.html.
this permit Is issued.
Polity If Date
JJi 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 in By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's 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 �� '@ H / with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy n I/ Expires y//'LO t 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 If
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compen ovisio Section 3700 of the Labor
Code,I shall hwi in with th e p i ' S. // Will the applicant or future building occupant handle hazardous material or a
Applicant Date C7 3 a 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 7
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
IN Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require Managemepermit for nt
cons( CAQ D)?See permit ingfro c South
IN SECTION 37000F THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
for guidelines .
CONSTRUCTION LENDING AGENCY Dyes '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 ko
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements underthe State of
I hereby affirm under penalty of perjurythat I am exempt from the California Health&Safety Code,S ction 2 nd 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardou material repo 'n
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes /�
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 forthe permitto file a signed statement
that he or she Is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP)
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 Iicensure 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 than($500). required practices.This includes rental property owners and property
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.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions IN. 1-800-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner(tflae
❑An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or i he ^
property provided that the improvements are not intended or®rff for O�\ Certified Firm Name:
sale.If,however;the building or improvement is sold wit ear of c(��� Firm Certification No.:
completion,the Owner-Builder will have the burden of p\Q hat it 6Ls9.1
not built or Improved for the purpose of sale. 0J No EPA Lead-Safe Certified Firm is required for this project because:
❑1,as owner of the property am exclusively contracting with licerr�ed r�wv
contractors to construct the project(Section 7044,Business and Profess ICJ
Code:The Contractors State License Law does not apply to an own If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN APPLICATION
Menifee '
DATE 30 �� PERMIT/PLAN CHECK NUMBER I
TYPE: ❑COMMERCIAL JZ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME POOL/SPA ❑SIGN
SUBTYPE: OADDITION ❑ALTERATION [-]DEMOLITION ❑ELECTRICAL [-]MECHANICAL
❑NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES.
r
DESCRIPTION OF WORK C v
PROJECTADDRESS 76- (j /uc 1,0(v Y7 T-,k 92-ii`5g45-
ASSESSOR'S PARCEL NUMBER LOT TRACT
PROPERTY OWNER'S NAME 4 i S/,l &t �,,
ADDRESS p,� 13IKc 'cam /52f C -r
PHONE /O - -20 Z j� B s 6 S EMAIL
APPLICANT NAME �.�C 14/s'c .ill, — n
ADDRESS f G/t)c R (f/a e 4 -C/7 X /C` i,C r
PHONE pJ,� p p y r/ )/JJo C7 EMAIL
CONTRACTOR'S NAME /:�F�f �� JZ 'L / OWNERBUILDER7 ❑YES(XNO
BUSINESS NAME ADDRESS / / rr � Q •
Lo
PHONE pprl
EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION Z3
VALUATION$ -�C70 O 5Q L SQ FT
APPLICANT'S SIGNATURE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION C) CITY
/OF MENIFEE BU51NE55 LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I• SMIP �• V V���O
INVOICE 1= PAIDAMOUNT
AMOUNT . OCASH OCHECK# 0CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# O CREDIT CARD VISA/MC
OWNER BUILDERVERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-6724MV t Menifee
www.cityofinenifee.us Inspection Request Line 951-246-6213 Building & Safety Dept.
JUN 3 0 2017
Received
GRIFFITH CO. LEDGER & TRACK
213 W. La CadenaDr., Riverside, CA 92501 INSPECTION REQUIRED
Office (951) 684-4800 • Fax (909) 825-8801
www.griffzthawn ings.com
Owner's Name 4 S .4 L r Lf w e APN
Project Address 'Z 7 7, c w Tr,,- e. t Project A
�I258S
/Cit /County 04eb1 : {� 1: S.F. V 6 S'
Corner Lot_ Interior Lot 3 �u W ,} f-c,^ T
Front Property Line
i e CITY OF MENIFEE
BUILDING AND SAFETY DEPARTMENT
3i PLAN APPROVAI
REVIEWED BY ' '20
DATE
'Approval.of these plans shall not be construed to bea`permitfor,oran
approval of,any violation of any provisioris of the fed W,strte or dty
j regulations and'ord`mances. This set of approvetl phirs musthe kept on the
v jobsite until caq?*tion: I In
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AEBuilding &
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17
Rear Property Line Received