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PMT17-02505 City of Menifee Permit No.: PMT17-02505 29714 HAUN RD. <—ACCEL/-> MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 0 910 8/2 01 7 PERMIT Site Address: 25851 PROSPECTOR CT, MENIFEE,CA Parcel Number: 358-522-053 92584 Construction Cost: $16,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 692 SF ENGINEERED INSULTAED PATIO COVER WITH 1 FAN Work: Owner Contractor FRANK JOVE OMEGA BUILDERS 25851 PROSPECTOR COURT 28087 SUNWOOD PL MENIFEE,CA 92584 MENIFEE, CA 92584 Applicant Phone: 7142635575 SHANE TULLOS License Number: 963275 28087 SUNWOOD PL MENIFEE,CA 92584 Fee Description Owl Amount IEI Receptacle, Switch, Outlet& Fixture 1 116.00 Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 Additional Plan Review Building 165 165.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 3.00 General Plan Maintenance Fee-Building 1 6.65 General Plan Maintenance Fee-Electrical 1 5.80 $467,45 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_Pennit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe 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 Co and my license is in full force and effect. the following reason: License Clas ��" C-� LI ns.(e No. (Q^�3 22 �' 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[OMPENSATION 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 in 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 this permit is issued. www.leginfo.ca.gov/calaw.html. Policy# Date ❑I have and will maintain worker's 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 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 If 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 certJIf that in performance of the work for which this permit is Issued, /�►►//�� n hall not em a y persons in any in so as to become subject to the CITY BUSINESS LICENSE# workers com n ion laws of California,and agree that if I should became HAZARDOUS MATERIAL DECLARATION subjectto the o ers compensation provisions of Section 3700 f the Labor Code,I shall f rt with cc ly with those provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to or greater that the Applican Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes 0 UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will th mtended 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 permltfor 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 gold CONSTRUCTION LENDING AGENCY ❑Yes I hereby affirm that under the penalty of perjury there is a construction Will t e 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 r d the Hazardous Material Information Guide and the SCAQMO permitti c ecklist.I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the Californi He Ith&Safety Code,Section 25505 and 25534 concern' g Contractors License Law for the reason(s)indicated below by the hazard s m erial reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 roc No Business and Professions Code).Any city or county that requires a permit to (/' _ Date ( J construct,alter,Improve,demolish or repair any structure,priorto its PROPE1dTYOfyNER ORAUTHORIZEDAGENT 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[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)orthat 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 a 1,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 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 forthis 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 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 RAP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL ` ESIDENTIAL O MULTI-FAMILY O MOBILE HOME POOL/SPA O SIGN SUBTYPE: WADDITION O ALTERATION 'O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBINGy. O RE-ROOF-NUMBER OFSQUARES DESCRIPTION OF WORK PROJECTADDRESS Z ,_/ Of OG95&A ASSESSOR'S PARCEL NUMBER "7 yj' -�� LOT city Of M CT � ntY D OWNER NAME © f/4nl4 p�.Q ash'Deft. ADDRESS 2/ S�v S I roS P41� el 8 2017 PHONE 11''__,^,EMAIL F3� QPjjjprj APPLICANT NAME Jl Its ADDRESS 2-000 P7 SVz,woo d101 PHONE q5-/- (7q- .SS/S`{ EMAIL 0 fA A $'r QQ '. q 9^ CONTRACTOR'S NAME © 1 Atr-g OWNER BUILDER? : YES/e!QNO BUSINESS NAME 0- u I. «w- ADDRESS Z(B C> 8 U Wot:cl PHONE 1 t Ll ) Z(0 3- j S 7 y- EMAIL 0. ST& 5c f- ` (i CONTRACTOR'S STATE LIC NUMBER - I (o3,�277 , LICENSE CLASSIFICATION f) 3 VALUATION$ 0 V /U cry SO FT `Q q,2 L SO FT APPLICANT'S SIGNATURE DATE S - DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE I GREEN 1 SMIP ON0152Jo INVOICE pglD AMOUNT AMOUNT .�� Qa• u OCASH OCHECK# OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH O CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES NO AAPrifee Building&Safety Department 29774 Hawn Rd. 1V oniipe, CA 92595 951-672-077' !nSpeCiiD7 ReQUPSt Line 951-246-6213