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PMT17-02471 City of Menifee Permit No.: PMT17-02471 29714 HAUN RD. <A-CCEL:A—> MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 07/17/2017 PERMIT Site Address: 28918 GOLDEN DAWN DR, MENIFEE, Parcel Number: 372-352-020 CA 92584 Construction Cost: $12,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 14'X 50'SOLID ALUMAWOOD PATIO COVER WITH ELECTRICAL 3 FANS Work: Owner Contractor RASHARD SCOTT PSLQ INC 28918 GOLDEN DAWN DR 28910 RANCHO CALIFORNIA RD MENIFEE,CA 92584 #206 Applicant Phone:9517954260 JOSH HERRICK License Number:919885 PSLQ INC 28910 RANCHO CALIFORNIA RD #206 TEMECULA, CA 92590 Fee Description Qtv Amount($1 Receptacle, Switch,Outlet&Fixture 3 126.00 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 6.30 $301.95 The issuance of this permit shall not prevent the building official fmm 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_Bidg_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 D 1 am exempt from licensure under the Contractor's State License Law for Professions Cade and y license is in ll force and effect. the following reason: License Class Q Licenseh 9 S By my signature below l acknowledge that,except formy personal residence Expires Signature in which I must have resided for at least one year pdmto completion of improvements covered by this permit.I cannot legallysell a structure that I WORKER'S COMPENSATION DECLARATIO have built as an owner-builder if It has not been constructed in Its entirety by o 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 ofself-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 ,A,,, w.le-info.ca.gov/calaw.html. this permit is Issued. - Policy ft Date p4'faave and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 ofthe Labor Code,for the performance of the work for which D By my signature below I certify to each ofthe 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.1 have read this number are: application and the Information I have provided is correct.I agree to comply Carrier CNc with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy It y 5Q 3 2 5 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 O I certify that in the performance of the work for which this permit is issued, /� I shall not emoloV any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If OZ0 4 workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers ompens "on provisions of Section 3700 ofthe Labor Code,Ishall fort 4 mply with those I Will the applicant or future building occupant handle hazardous material or mixture containing a hazardous material equal to orgreater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAIL RE O SECURE WORKER'S COMPENSATION COVERAGE IS o Yes 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 for guidelines CONSTRUCTION LENDING AGENCY 0Yes Own 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 bounda-M of a school? (Section 3097 Civil Code) o Yes wrio OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and theSCAQMD permitting checklist.I understand my requirements underthe State of I hereby affirm under penalty of perjury that 1 am exempt from the California Health&Safety Cade,Section 25505 and25534 concerning Contractors License Law for the reasons)indicated below by the haza0ous material r ortin checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es D No Business and Professions Code).Any city or county that requires a permit to — Date ?A. construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWL E /d AUTHORIZEDAGENT 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 IRRPI License Law(Chapter9(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 of5ection 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 ofthe 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.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(S323). Code,The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responuble 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 because: ❑I,as owner ofthe 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 tom: Y. Menifee DATE t — �I' PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL 4,HtJIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: 6 ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 1 i�. a o , l. eove f PROJECTADDRESS ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAM�E/ l� hLC 0 ADDRESS n1a1Qr, PHONE 5r 5 EMAIL APPLICANT NAME ADDRESS PHONE IrJ�- -QQpY EMAIL CONTRACTOR'S NAME C4 r-e n OWNER BUILDER? O YESXNO BUSINESS NAME ADDRESS /� O PHONE R5l,olw�5L EMAIL Q� CONTRACTOR'S STATE LIC NUMBER yIIIYX�5 LICENSE CLASSIFICATION VALUATION $ SOFT 700 L SO FT 51,+ APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION w CITY OF MENIF E BUS] ESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN '•� SMIP 2•� � � INVOICE /�� PAID AMOUNT AMOUNT ,; k- I OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKII OCREDITCARD VISA/MC OWNER BUILDERVERIFIED O YES O NO DL NUMBER NOTARIZED LETTER 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 z cn GOLDEN DAWN OR= � z :0 CD o 0 m o m m "o x C � Oo Z m O ; 0 O Q m D m C3 " Z o O O p a n u s D .n G c i g V :Z CD 3 0. m G1 7y w O s O Z Z w o' c A p T N O a p' tj fA n C .No a , ^ T m L N O o c .m{ m G7 O- N oh am g m rn 0 m LAT a °-' CL D Z D -70-� n m to scr D CL m Q- o m N N i M N �a Z �z N -- ------------- - ---------- a --- - Gl c D D 0 m = m c) Ln Z D 00 n 7 A D p w N 1D A m N n Z 0 wN � oa 00a A 7 �MT- I I - o aLt ol i �FUUPY