PMT17-02311 City of Menifee Permit No.: PMT17-02311
29714 HAUN RD. Type: Residential Re-Roof
.ACCELA? MENIFEE, CA 92586
MENIFEE Date Issued: 07/03/2017
PERMIT
Site Address: 26282 HOHOKAM CT, MENIFEE, CA Parcel Number: 338-222-022
92586 Construction Cost: $6.500.00
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING COMPOSITION SHINGLES, INSTALL#30 FELT AND GAF TIMBERLINE HD
Work: COMP SHINGLES-COOL ROOF
CRRC: 0676-0131
COLOR:COASTAL SLATE
Owner Contractor
HOLLY DILLENBECK CBCI CONSTRUCTION INC
26282 HOHOKAM COURT 10015 MUIRLANDS BLVD
MENIFEE,CA 92586 IRVINE, CA 92618
Applicant Phone: 9495427265
EDDIE FONSECA License Number.458773
CBCI CONSTRUCTION INC
10015 MUIRLANDS BLVD
IRVINE, CA 92618
Fee Description QtV Amount l$1
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 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_eldg 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 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 Na. By my signature below I acknowledge that,except for my personal residence
Expires in which I must have resided for at least one year prior to completion of
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 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.leginfo.ca.gov/calaw.html.permit is issued.
Policy# Date
o I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Cade,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 worker's 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 I have provided is correct.I agree to comply
Carrier 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)C_ Expires /.3 / 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#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall f ply with those provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date mixture containing a hazardous material equal to or greaterthat the
amounts specs n the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes r<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 -- - --
forguidelin�-
CONSTRUCTION LENDING AGENCY ❑Yes efFJo
I hereby affirm that under the penalty of perjury there is a construction WIII 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 boun ry of a school?
(Section 3097 Civil Code) ❑Yes o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjurythat I am exempt from the permitting checklist.I understand my requirements underthe State of
California Health&Safety Code,Section 25505 and 2SS34 concerning
Contractor's License Law forthe reason(s)indicated below by the haz pus material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es ❑Business and Professions Code).Any city or county that requires a permit to Nof Date 3 j
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permitto file a signed statement
that he or she is licensed pursuant to the provisions of the Contractor's 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 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
❑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�Lov/lead/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 ❑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:
❑1,as owner of the property am exclusively contracting with licensed
contractors 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 A. . •
_Menifee
DATE � �� PERMIT/PLAN CHECK NUMBER 1" I� I � -
TYPE: []COMMERCIAL ❑d RESIDENTIAL ❑MULTI-FAMILY ❑MOBILEHOME POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION []DEMOLITION []ELECTRICAL [-]MECHANICAL
[-]NEW ❑PLUMBING ORE-ROOF-NUMBER OF SQUARES 21
DESCRIPTION OF WORK Tear off existing composition shingles at 1 &2 Story sloped roofs. Install 1-30#felt underlayment
Install GAF Timberline HD Composition shingles
PROJECT ADDRESS 26282 Hohokam Court �y
ASSESSOR'S PARCEL NUMBER *2-22*C)2-2- LOT Zz TRACT Zzo3 O
PROPERTY OWNER'S NAME Holly Dillenbeck
ADDRESS 26282 Hohokam Court,Menifee,CA 92586
PHONE (951)973-7507 EMAIL
APPLICANT NAME Eddie Fonseca
ADDRESS 10015 Muirlands Blvd.,Suite#, Irvine,CA 92618
PHONE (949)355-6173 EMAIL efonseca@cbciconstruction.com
CONTRACTOR'S NAME CBCI Construction, Inc. OWNER BUILDER? ❑YES ONO
BUSINESS NAME CBCI Construction, Inc.
ADDRESS 10015 Muirlands Blvd.,Suite E, Irvine,CA 92618
PHONE (949)542-7265 EMAIL efonseca@cbcioonstruction.com
CONTRACTOR'S STATE LIC NUMBER 458773 LICENSE CLASSIFICATION B,C39
VALUATION$ $6,500.00 SO FT 2100 L SQ FT
APPLICANT'S SIGNATURE_ DATE -;1'13 1,
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT OCASH CCHECK# OCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 95146@7) f Menifee
www.cityofinenifee.us inspection Request Line 951-246-6213 g $ Safety Dept.
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- - �' r VI
1`0C R C T CBCI Construction, Inc.
1 J 1 Serving Southern California since 1964
10015 Muirlands Blvd, Suite E
Rock Solid Dependability Irvine,CA 92618
Office Phone:(949)542-7265
Toll-Free:(877)471-2224
Fax:(949)305-4653
California State License#458773
May 16, 2017
To Whom It May Concern:
This is authorization for Eduardo Fonseca to obtain business licenses and permits for CBCI
Construction, Inc. and Crank Brothers Roofing Company in the State of California.
Thank you!
Frank Blefari
President
CBCI Construction, Inc.
Crank Brothers Roofing Company, Inc.
1
T
City of Menifee
Building & Safety Dept.
JUL 012017
Received
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MODEL INFO
INWI 37. MW 3Ye+r WWI 3YM1 —
D6760131a GARTPnbedine HDaand Timberline Ultra Steep slope:Asphalt Grey n-ta Pentlin, 0.91 Vend'ng 17 ^din, +
NOS Shingles — —
Coastal Slate
COOL ROOF RATING COUNCIL 44915th Street,Suite 400 TEL(866)465-E523 EMAIL•Infolnfo )coolronfs.00 \ _
Oakland,CA 946E Fm(510)482-44,1
1
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City of Menifee
Building & Safety Dept.
JUL 0 3 2011/
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