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PMT17-02365 City of Menifee Permit No.: PMT17-02365 29714 HAUN RD. �CCEL/-> MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 07/1012017 PERMIT Site Address: 29241 SHIPWRIGHT DR, MENIFEE, CA Parcel Number: 333430-006 92585 Construction Cost: $5,800.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 9'X 44'ALUMAWOOD PATIO COVER,W/ELECTRICAL 4 FANS, REQUIRES 4 FOOTINGS Work: Owner Contractor VINNY GOUNDAR T F MEADOR CONSTRUCTION 29241 SHIPWRIGHT DR PO BOX 713 MENIFEE,CA 92585 WILDOMAR, CA 92595 Applicant Phone:9518376180 TOM MEADOR License Number:639087 T F MEADOR CONSTRUCTION PO BOX 713 WILDOMAR,CA 92595 Fee Description Oft Amount f51 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_Bidg Pemiit_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 Contractors State License Law for Professions Code andmy license is in full farce and effect. the following reason: License Class License o. By my signature below I acknowledge that,except for my personal residence Expires Signat 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 DECLARATI have built as an owner-builder if it has not been constructed in Its entirety by ❑I hereby affirm under penalty of perj ry 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 Cade,for the performance of work for which www.leginfo.ca.gov/calaw.htmi.permit is issued. Policy# Date ❑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 ❑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 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# 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 1I��I�////' ���- Kh! ertify that in the performance of the work for which this permit is issued, all not emolov any persons in any manner so as to become subject to the CITY BU51NE55 LICENSE N �,/ 1_ kern compensation laws of California,and agree at if I should become HAZARDOUS MATERIAL DECLARATION subject to t ore compensation P1,591ons o ection 3700 of the Labor Code,I sh forth w1 co ly wit se rovisi s. Will the applicant or future building occupant handle hazardous material or a Applica t Date mixture containinga hazardous material equal to or greater that the amountsyspenfied an the Hazardous Materials Information Guide? WARNING: U TO SECURE WORKER'S COMPENSATIO COVERAGE 15 ❑Yes p�lvo F - UNLAWFU4 SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL ES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South - - IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)7 See permitting checklist for guidelines CONSTRUCTION LENDING AGENCY ❑Yes g�rvo 1 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 No OWNER BUILDER DECLARATIONS I have ad 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 California H ction 25505 d 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardo materia e?pV checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Dyes 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 O OR AUTHORIZE 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 RENO ION 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-certlfied 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.epa.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 Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovatorwill 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 forthe purpose of sale. ❑No EPA Lead-Safe Certified Firm is required forthis project because: ❑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 Menifee DATE U 11-7 PERMIT/PLAN CHECK NUMBER 1 'O TYPE: O COMMERCIAL 4RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES - DESCRIPTION OF WORK =tt9tol ( y 1 t ctth a eU /PV` W aN 5 & 1i -9009-fv\ S PROJEcTADDRESS 212- �0\hIc D1� ASSESSOR'S PARCEL NUMBER 3 / — �1' '0140T TRACT OWNERNAME �/1Y�Y� I,SOVv.O�Y ADDRESS Sav°�e PHONE a 51 --^37 9 -(oO-3 11 1 EMAIL APPLICANT NAME 1 ('V6A / le �b" ej`� I f ADDRESS Po �� �� WI/ l ot,-LC- ee+ g25rQ 5 PHONE EMAIL CONTRACTOR'S NAME t--�e��-O''- 6' K OWNER BUILDER? O YES 60 BUSINESS NAME ADDRESS S 4m PHONE q EMAIL CONTRACTOR'S STATE LIC NUMBER C'3 1 0 7 "' LICENSE CLASSIFICATION ov VALUATION$ f15 Sao SQ FT 3 /to L SQ FT ^7 APPLICANT'S SIGNATURE DATE /a 1 DEPARTMENT DISTRIBUTION �' CITY OF�F�US LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAIDAMOUNT AMOUNT � O CASH O CHECK# OCREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZEDLETTER O YES O NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 sht wf - 038ln03H NQIAa dSNI A9VH1 'P N39033 CITY OF MENIFEE y..� BUILDING AND SAFETY D ARTMENT 07 �REVIEWED BY-,,_. _ - DA E 'Approval of these plans sh,dli nut he cv..; naeo to oe a ermit for,or an Lad rq L W y\e_r' approval of,any violation of any prowsion of the federa state or city \ regulations and ordinances. This set of apl roved plans m t be kept on the 6­0`,tea z� jobsite until completion, a5 i - 379 - Goa City of nifee f 2CLZ�( 5 kj, vj(,lgh V pr Building & I .ty Dept. S s Sew` ct-+y GA qzs g� JUL 10 01' > Recei d 5 �tlJ 9 5 9 0 O o AI c{ y r►