PMT17-02530 City of Menifee Permit No.: PMT17-02530
29714 HAUN RD. Type: Residential Addition
<A_CCELA? MENIFEE, CA 92586
MENIFEE Date Issued:
07119/2017
PERMIT
Site Address: 25880 BALTRUSTROL DR, MENIFEE, CA Parcel Number: 339-122-024
92586 Construction Cost: $5,400.00
Existing use: 1 &2 Family Residence Proposed use:
Description of INSTALL 14'X 20'SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 1 FAN., 1 OUTLET
Work:
Owner Contractor
TAMMY&ALAIN BIANCO CALIFORNIA SHOWCASE CONSTRUCTION INC
25880 BALTRUSTROL DR 1507 MARLBOROUGH AVENUE
MENIFEE, CA 92586 RIVERSIDE, CA 92507
Applicant Phone:9516820208
ANGELA GOODMAN License Number:912352
CALIFORNIA SHOWCASE CONSTRUCTION INC
1507 MARLBOROUGH AVENUE
RIVERSIDE,CA 92507
Fee Description ON Amount(SI
Receptacle, Switch,Outlet&Fixture 2 121.00
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 6.05
$295.70
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_Oldg_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 I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and efkct. the following reason:
tense ii aI ss— 9A ense o.J By my signature below I acknowledge that,except for my personal residence
Expires L 1 r ( Signatw n in which I must have resided for at least one year priorto 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 for worker's 7044 of the Business and Professions Cade,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.Ieginfo.ca.Rov/caIa%v.htmI.permit is issued.
Policy# Date
YJ,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 1�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
numberare: application and the information I have provided is correct.I agree to comply
Carriers T pp I-IT E COMP with all applicable city and county ordinances and state laws relating to
•�rq,'�77 bu'ding nstruction.l authorize representatives of this city or county to
Policy# �17L�JZ i Expires 1 (� enter h a ove identified property for In
purposes.
(This section need not to be completed is the permit is for one-hundred s t
dollars($100)or less _ 3• - '"� Date
W P R OWNER OR AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued, O ]SOI iy
1 shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# O
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subjecttgal,
orkers comp nsation provisions of Section 3700 of the Labor
Code,I s th cc ith t Qse provisions. , &/_ Will the applicant or future building occupant handle hazardous material or a
Applican — Date'n/T,�'�/I--� mixture containing a hazardous material equal to or greater that the
amounts p cifred on the Hazardous Materials Information Guide?
WARNING:FAIL RE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes RIo
UNLAWFUL,AND SHALLSUBIECTAN EMPLOYERTO 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 guide in s
CONSTRUCTION LENDING AGENCY ❑Yes
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) Oyes olo
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 under the State of
Contractors License Law for the reason(s)indicated below by the California Health&Safety l!..G�o Section 25505 and 25534 concerning
hazer u aterialrepogtip .
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to Date I l 1
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OW R OR AUT RIZED 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 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
O 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 ownerof a ❑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:
in 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 RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE PERMIT/PLAN CHECK NUMBER T 1 —V2row
TYPE: ❑COMMERCIAL &SIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑POOL/SPA _]SIGN
SUBTYPE: ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL ❑MECHANICAL
NEW ]PLUMBING ❑RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK (C7 E r X 26 , 2-00 G I Ukm( )
I'i fib Cc�e� eeY I, (I & -Can a .-1 uF Itf
PROJECTADDRESS 2 15` r
ASSESSOR'S PARCEL NUMBER ✓ram l ' �ac�." LOT TRACT a �
PROPERTY OWNER'S NAME p !
ADDRESS 25(")8D (4t,v4.10 I
PHONE G `a I ._ I (0 EMAIL
APPLICANT NAME (1rJ
ADDRESS �},
PHONE
l V9 'S�C' ,7 - l 7J 1 EMAIL U
CONTRACTOR'S NAME I ( sY 1 p OWNERBUILDER? ❑YES❑NO
BUSINESS NAME
ADDRESS /'661 (VA{..l.i
PHONEY LO()Z - EMAIL
CONTRACTOR'S STATE LIC NUMBER "( Z JS flZ LICENSE CLASSIFICATION � �A
VALUATION$ 1 S-pFT �Lq `8 y L SQ FT (P _)
APPLICANT'S SIGNATUTE � l l`_�-.ZK.) 1i ' DATE 1
CITY STAFF USE ONLY dw
DEPARTMENT DISTRIBUTION CITY OF MENIFEEBUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
)Cob 12-
INVOICE I ^q� -7 PAID AMOUNT
AMOUNT p(., , l OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DLNUMBER 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
1507 Marlborough Ave.
�'• Riverside, CA 92507
C�of� PROPERTY PLOT PLAN Office (951) 682-0208
Showcase Construction Fax(951) 686-2769
Customer: &�f�4AC0 measure date: T 77
11
7 AA 6%50 L-MUML. lot size: G9G9
'511AI J?N CA LS�lG house size: /7 U
S7 7 garage size: 42,1
P/C size: Z
lot coverage: o_
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BUI DING D SAFETY DEPARTINEOT O
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'ApproYal of these plans shall not be construed to be a permit for,Oran
approval of,any violation of anyp�visions of the federal,state or city O
regulations and ordinances. This 11 of approved plans must be kept on the
jobsite ntil completion.
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