PMT17-02476 City of Menifee Permit No.: PMT17-02476
29714 HAUN RD. T Residential Re-Roof
�AAE A?CCL MENIFEE, CA 92586 Type:
li_".114111" MENIFEE Date Issued:
D7/17/2017
PERMIT
Site Address: 28804 WOODCREST LAKE DR, Parcel Number: 364-181-003
MENIFEE,CA 92594 Construction Cost: $15,000.00
Existing Use: Proposed Use:
Description of REMOVE EXISTING TILE AND INSTALL NEW FELT, METAL AND TILE
Work:
CRRC:0918-0015
EAGLE ROOFING
ORANGE TERRACOTTA
Owner Contractor
MELANIE BLUNCK FREEMAN AND SONS ROOFING
28804 WOODCREST LAKE DRIVE 28320 AGAVE WAY
MENIFEE, CA 92584 MURRIETA, CA 92563
Applicant Phone:9516727500
VINCENT FREEMAN License Number:965749
FREEMAN AND SONS ROOFING
28320 AGAVE WAY
MURRIETA, CA 92563
Fee Description O0t Amount($1
Building Permit Issuance 1 27.00
Inspections not specified 9B 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_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 perjurythat I am under provisions of with a licensed contractors)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. j the following reason:
License Class C—�J'I U ens No. 9(eE;1/'tc(_ By my signature below I acknowledge that,except for my personal residence
Expires_Signature l /.!w .— /�� — 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 DECLARATION 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 far 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 www.leginfo.ca.gov/calaw.htnil.permit Is issued.
Policy# Date
s'fGve and will maintain workers compensation insurance;as required by PROPERTY OWNER ORAUTHORIZED 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 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 with all applicable city an and state laws relating to
S'TP— i `9�1"J Q 1�f94fHfib
//�� '1—r T '^ / building cons[ructio&I 'z�r2a�4f this city or county to
Policy q`-L17�""t 12 c47 za l Expires W 1 1� enter the above ideflf��e pr erty for inspection purposes.
(This section need not to be completed is the permit is for one-hundred 11 1L 17 2017Date
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 R V�i\ e rd
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the ork s compensation provisions of Section 3700 of the Labor
Code,I ;ha :hiw' comply th thos provisions. � — Will the applicant or future building occupant handle hazardous material or a
Applicant'` Date r/� t�-f II 17 mixture containing a hazardous material equal to or greater that the-�
Tf amounts spe 'ied on the Hazardous Materials Information Guide?
WARNING:FAILUR E ORKER'S COMPENSATION COVERAGE IS ❑yi M40
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the intended use of the building by the applicant or future building
ADDITION 70 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(SCAQMO)7 See permitting checklist
forguideline�s '
CONSTRUCTION LENDING AGENCY ❑Yes B'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 o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the Permitting checklist.I understand my requirements underthe State of
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable items)(Section 7031.5 ` hazardous mna rial-report ing:
Business and Professions Code).Any city or county that requires a permit to ` � ❑-No -�
construct,alter,improve,demolish or repair any structure,prior to its Date _
PROP RTY OWNER OR AU THO 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 REND ATION,REPAIR
AND PAINTING(RRPI
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. Roy/lead or contact the National Lead Information Center at
not Intended oroffered 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 Renovator will be responsible forthis 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:
❑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 outthe RRP
Acknowledgement.
ABUILDING & SAFETY PERMIT/PLAN CHECK
PPLICATION
Menifee
DATE // PERMIT/PLAN CHECK NUM 1BERTv n-624 1 te
TYPE: O COMMERCIAL '`"RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION , O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING ROOF-NUMBER OF SQUARES Zc4�
DESCRIPTION OF WORK
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER v�Q�' I�1 ' O�� LOT L4 C1_ TRACT '2-2I LP
OWNER NAME
ADDRESS
PHONE Q51i--AA6r4 - :J` 2A EMAIL
APPLICANT NAME (L.
ADDRESS L- � _ ( C�� C'(•�• •,j
PHONE 21 > a�2-A-Z EMAIL
CONTRACTOR'S NAME ( OWNER BUILDER? O YES IW O
BUSINESS NAME
ADDRESS 2
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER qC671z� LICENSE CLASSIFICATION (�—
VALUATION$ SO FT 2 L SQ FT
APPLICANT'S SIGNATURE i DATE 1-7
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I• SMIP �/
INVOICE I�O a� PAID AMOUNT
AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT -- CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee
City of Menifee Building & Safety Department 29714 Houn Rd. Menifee, CA 925B5if fig 5&-6WM Dept.
www.cityofinenifee.us Inspection Request Line 951-246-6213 JUL 17 20V
Received
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MCPROMIP M WACRMERBRRN0 PRODUCTWPE COLOR 501-MRER£CLANC£ THERMILLEMIiTNICE 5R1 MORE
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0918u015 EAGLE RooOng Produces:Weathered Steep Slope: Orange 0.23 0.25 0.87 0.88 21 24 +
Temcona Range Concrete/Oay The —
BelAlr4615,Malibu 2615,Capistrano 3615 and Slates
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