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PMT17-02665 City of Menifee Permit No.: PMT17-02665 29714 HAUN RD. Type: Residential Addition 'CACCEL^_ MENIFEE,CA 92586 MENIFEE Date Issued: 08/15/2017 PERMIT Site Address: 25870 GARBANI RD, MENIFEE,CA Parcel Number: 358-240-038 92584 Construction Cost: $25,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of 1 DETACHED PRE-FABRICATED METAL BUILDING 40 FT X 60 FT X 14 FT H.2 ROLL UP DOORS. Work: 'NO ELECTRICAL, MECHANICAL,PLUMBING* Owner Contractor JAMES WATTS 25870 GARBANI RD MENIFEE,CA 92584 Applicant License Number: JAMES WATTS 25870 GARBANI RD MENIFEE, CA 92584 Phone: 7143647320 Fee Description gty Amount($I Building Permit Issuance 1 27.00 Reinspections/Additional Inspections 258 258.14 Additional Plan Review Building 165 165.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 4.00 New Construction Permit Fee 1 401.86 General Plan Maintenance Fee-New 1 20.09 Construction $877.09 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 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 in I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: License Class License No. By my signature below I acknowledge that,except for my personal residence Expires Signature in which I must haver sided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements cove by this permit.I cannot legally sell a structure that I have built as an o ne builder' it has not been constructed in its entirety by ❑I hereby affirm under penalty of perjury one of the following declarations:I licens contra N. uncle an that opy of the applicable law,Section have and will maintain a certificate of consent of self-insure for worker's 70 o the Bus es and fes ons ,is available upon request when compensation,issued by the Director of Industrial Relations as provided for thi a plicatio is s bmi e h owing website: by Section 3700 of the Labor Code,for the performance of work for which ,h, t ,leginfo, a. 'c aw.ht this permit is issued. Policy# Date ❑I have and will maintain worker's compensation insurance,as required by PR O R R IZ GENT section 3700 of the Labor Code,for the performance of the work for which in y my signature o ow 1 certify to each of the following:I am the property this permit is issued.My worker's compensation insurance carrier and policy o ner or authoriz to act on the property owner's behalf.I have read this number are: pli i n and it in or ati have ovided is correct.I agree to comply Carrier i all pplicah city a d un ord' nces and state laws relating to b ildin constr ctio'. aut,ori a ematives of this city or county to Policy# Expires mer a a 1 n fi d pr spection purposes. (This section need not to be completed is the permit is for one-hundred Date Z�Z dollars($300)or less / R N RI 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 ITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date mixture containing a hazardous material equal to or greater 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 COSTOF 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 CONSTRUCTION LENDING AGENCY ❑Yes ❑No I hereby affirm that under the penalty of perjury there is a construction WIII 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 ❑No 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.1 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 hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ❑yes ❑No Business and Professions Code).Any city or county that requires a permit to Date construct,alter,Improve,demolish or repair any structure,prior to its PROPERTY OWNER 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 Contractor's 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)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 an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with than($500). required practices.This includes rental property owners and property 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.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 Contractor's 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: *as owner of the property am exclusively contracting with licensed Contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's 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. DATE - 2,6 I PERMIT/PLAN CHECK NUMBER 'N1T C% TYPE: O COMMERCIAL 94RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME ^POOL/SPA O SIGN 1, SUBTYPE: &ADDITION O ALTERATION : DEMOLITION ;D ELECTRICAL C: MECHANICAL L� O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK jy 1„y D Jt PROJECT ADDRESS ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME jry�,,,l�,> 9 ADDRESS J) ' - �QvL:4p Cal" PHONE /!t ?�/�l{ �.?,,;�j`, EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? /lf`YES NO BUSINESS NAME ADDRESS PHONE MAIL CONTRACTOR'S STATE LIC NUMBER' /// / LICENSE CLASSIFICATION VALUATION$ „ SQ L SQ FT APPLICANT'S SIGNATURE r % �% � DATE DEPARTMENT DISTRIBUTION / CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERINW FIRE GREEN ' - SMIP '1 INVOICE L PAIDAMOUNT AMOUNT �t 0CASH CCHECKk C)CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT `. CASH 0 CHECK N 'O CREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES G' NO DL NUMBER NOTARIZED LETTER C YES NO City of Menifee Building'&Safetv Depi, JUL 3 1 201 �er'+e,i�oar� 0 m I I n pgoEp i�i_gj( v :ves s , _ ss x�go � I _a��oEe a w wmg 5§2 o J -_ft^Aoe p Z Ls a 0� 3 FR Er C I ro„as9�� Q � I ��fiq�At� d a.. m ---- --� t mg2:s5aa REVIETED DATE juate until completion.