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PMT17-02579 City of Menifee Permit No.: PMT17-02579 29714 HAUN RD. Type: Residential Addition <�kCCEUh MENIFEE,CA 92586 MENIFEE Date Issued: 07/25/2017 PERMIT Site Address: 30293 RUSTLER WAY, MENIFEE, CA Parcel Number: 358-502-003 92584 Construction Cost: $3,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL ATTACHED ALUMAWOOD SOLID PATIO COVER WITH 1 FAN Work: Owner Contractor TIM MCCARTHY PSLQ INC 30293 RUSTLER WAY 28910 RANCHO CALIFORNIA RD MENIFEE,CA 92584 #206 Applicant phone: 9517954260 License Number:919885 Fee Description Oft t Amount 131 Receptacle, Switch,Outlet&Fixture 1 116.00 Building Permit Issuance 1 27.00 DecklPatio,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 5.80 $290.45 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—Permit_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 contractors)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 a my license is in full force and effect. the following reason: License Class License N RS- 8y my signature below 1 acknowledge that,except for my personal residence Expires Signature r in which I must have resided for at least one year prior to completion of rri WORKER'S COMPENSATION DECLARATION improvements covered bythis 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 ❑I hereby affirm under penalty of perjury one of the fallowing 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 this permit is issued. www.le in /calaw.htmL Policy# Date P have and will maintain workers compensation insurance,as required by PROPENER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which I�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.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# 454%30252- Expires enter th bove 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 ❑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# 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 fo omply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant_ Date T -7 5. 177 mixture containing a hazardous material equal to orgreater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes ❑No 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 ADDITION TO 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(SCAQMD)?See permitting checklist -- - -- for guidelines- - - CONSTRUCTIONLENDINGAGENLY ❑Yes ANo 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 ;KNo 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 Contractor's 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 item(s)(Section 7031.5 hazardous material r orting. Business and Professions Code).Any city or county that requires a permit to Otes in No Date 7- 75-4 construct,alter,Improve,demolish or repair any structure,priortoits PROPERTY OWNWdR AUTHORIZED AGENT issuance,also requires the applicant for the permit to file a signed statement that he orshe is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRP) 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 facility to he RRP-certified firms and comply with than($500).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 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.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 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. ❑No EPA Lead-Safe Certified Firm Is required for this 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 RRP Acknowledgement. City of Menifee • BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ly ept. '"Menifee JUL 2 5 2017 A DATE �(����� PERMIT/PLAN CHECK NUMBER 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 OeNEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 'e Cover,";4k 1z4 rN PROJECTADDRESS 3 oa q3 Rvsf(« V1 ) 4. ASSESSOR'S PARCEL NUMBER 2>% - W " 00 LOT 3 TRACT OWNER NAME ADDRESS (lhn-4 ) /v1 4 ri x;afcJl % asSy PHONE EMAIL APPLICANT NAME is ADDRESS PHONE °iS I-3�'6-�14$�/ EMAIL CONTRACTOR'S NAME c. n get OWNER BUILDER? OYES ,XNO BUSINESS NAME ADDRESS © kC v ca ,F 7.e. ,Ak, c A g 254 e PHONE g51•a3�•m3S6 EMAIL CONTRACTOR'S STATE LIC NUMBER 119 n75 LICENSE CLASSIFICATION VALUAT ION$ _� 000 SQFT 0 LSQFT 20 APPLICANT'S SIGNATURE DATE Vo)I I DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP %VV INVOICE . ],S PAIDAMOUNT v� AMOUNT q t OCASH 0CHECK# CREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH OCHECKN OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER . 0 YES O NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92556 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 RUSTLER WAY u m 7 l0 a P _ !� H Q w m o C' co d a a z tD Lu H N �_ W Q W s ~ �.7 J V `o Ol LLI U c -IJ o m > 0 IJJ o M z Z o a W Lu LY T. O Q L 6 i N J > a a z z0 � o o � u' Q cc coo � . � Q W CL lQ7 LL. z Lu Lu `a a CJ Co G.LLI ¢ u c V o 3 J J Z a ui 0 -a Z 3 f6 ro c a L LL Ocr U U in 1 O 4a COL uj N M N W o Q LN LA 4j L 0 0 a a 0 3 � v Lu Zn L u 'coo LLL' L1_.� a- FFICE COPY