PMT17-02512 City of Menifee Permit No.: PMT17-02512
29714 HAUN RD. Type: Residential Addition
'A-CCELA—> MENIFEE, CA 92586
MENIFEE Date Issued: 0 7/1 912 01 7
PERMIT
Site Address: 29864 WINTER HAWK RD, MENIFEE, CA Parcel Number: 338-343-014
92586 Construction Cost: $10,725.00
Existing use: 1 &2 Family Residence Proposed use:
Description of INSTALL INSULATED SOLID 16'X 59 ALUMAWOOD PATIO W/ELECTRICAL 3 FANS,4 LIGHTS, 1
Work: SWITCH
Owner Contractor
DIANNE SUTTICE ALOHA CONSTRUCTION AND DEVELOPMENT
29864 WINTER HAWK RD 25324 CALLE DE TRES AMIGOS
MENIFEE, CA 92586 MURRIETA, CA 92563
Applicant Phone:9513003124
WENDY SANTOS License Number:868606
ALOHA CONSTRUCTION AND DEVELOPMENT
25324 CALLE DE TRES AMIGOS
MURRIETA,CA 92563
Fee Description Oft Amount(51
Receptacle, Switch, Outlet&Fixture 8 151.00
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 7.55
$328.20
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 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_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 contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑1 am exempt from licensure under the Contractors State License Law for
Professions Code an license is in full force and effect. the following reason:
License Class License No. V 60 By my signature below 1 acknowledge that,except for my personal residence
Expires Signature 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
D 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 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.leeinfo.ca.eov/calaw.html.
this permit is Issued.
Policy III Date
o 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 o 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.1 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
dollars($S00)or less Date
��, ��! PROPERTY OWNER OR AUTHORIZED AGENT�i certify that in the performance of the work for which this permit is issued, O
all not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with eprovis Ions. Will the applicant or future building occupant handle hazardous material or
Applicant Date7
. (� mixture containing a hazardous material equal to or greater that the
amounts so cified on the Hazardous Materials Information Guide?
WARNING:FAILUR T SECURE WORKER'S COMPENSATION COVERAGE IS o Yes No
UNLAWFUL,AND SH 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(SC lion or modification
permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidel' s
CONSTRUCTION LENDING AGENCY 0 Yes TN,
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 boo ary of a school?
(Section 3097 Civil Code) ayes YR
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I understand my requirements under the 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 material reporting.
Business and Professions Code).Any city or county that requires a permit to O es '7
Date L '
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY W R OR AUTHORIZED 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 RENOVATION,REPAIR AND PAINTING IRRPI
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 apre-1978
and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facilitytobeork that
-mirtified firms and comply with
than
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
o 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.eov/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 o 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. o 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 out the RRP
Acknowledgement.
BUILDINGAPPLICATION
r,.
DATE , 1 7 ' PERMIT/PLAN CHECK NUMBER O� I
TYPE: O COMMERCIAL XRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES //
DESCRIPTION OF WORK r I - d I /CO A/
y r
PROJECTADDRESS a9 s y W io4 P r Ain mw I t Ce Oct
G ro
ASSESSOR'S PARCEL NUMBER r�' -� f�j C.�L^'� T �_ TRACT �!)Db
Lfo
OWNERNAME A
ADDRESS 0 9 91c' g
�('
PHONE �l 3Ql 5�33 EMAIL
APPLICANT NAME
ADDRESS I r I I
PHONE �51•.58 ? 193-z. EMAIL �f 0
CONTRACTOR'S NAME h r f II r OWNER BUILDER? ES ONO
BUSINESS NAME
Ika T IQ 4T e
ADDRESS ! Cy ctlio rr- • a 9a5
PHONE l ..�QV • 31 a y / EMAIL cs
CONTRACTOR'S STATE LIC NUMBER 2 L S( 0 (0 LICENSE CLASSIFICATION Q
VALUATION$ /0. 73 5 . C)0 SO FT /(p L SQ FT
APPLICANT'S SIGNATURE DATE 7
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP ✓1�
INVOICE a,Q PAIDAMOUNT
AMOUNT I I I 1 O CASH O CHECK# O CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT I O CASH O CHECK# O CREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES C NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Sofety Deportment 29714 Houn Rd. Menifee, CA 92585 951-672-6777
wwww.cityofinenifee.us Inspection Request Line 951-246-6213
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