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PMT17-02725
City of Menifee Permit No.: PMT17-02725 29714 HAUN RD. �A-CCEL/? MENIFEE, CA 92586 Type: Residential Re-Roof MENIFEE Date Issued: 08/03/2017 PERMIT Site Address: 28230 COTTONTAIL, MENIFEE, CA Parcel Number: 350-094-002 92587 Construction Cost: $4,000.00 Existing Use: Proposed Use: Description of REROOF 10 SQUARES, REMOVE EXISTING LAYERS AND REPLACE. Work: CRRC:0890-0014 OR 0890-0009 COLOR:ORANGE Owner Contractor JOSE SILLAS 360 MANAGEMENT GROUP INC 28230 COTTONTAIL 6727 ODESSA AVENUE MENIFEE,CA 92587 VAN NUYS, CA 91406 Applicant Phone:81 B3968070 VIC LUNA License Number: 992379 360 MANAGEMENT GROUP INC 6727 ODESSA AVENUE VAN NUYS, CA 91406 Fee Description gyt Amount ISI Building Permit Issuance 1 27.00 Inspections not specified 98 98.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 4.90 $130.90 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 pried 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_PernA_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects 1 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 Contractors State License Law for Professions Code and my license is in full force and effect. 7 the following reason: License Class 13 Lice se No.�qZ ` y By my signature below I acknowledge that,except for my personal residence Expires�Signature in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION 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 ❑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.lexinfo.ca.gov/caIaw.htmI.permit is issued. Policy# Date LXI 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 ❑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: �t�L;� -�- ,,/. application and the information I have provided is correct.I agree to comply Carrier 6-FA f OkV l) with all applicable city and county ordinances and state laws relating to building construction.Iauthorize representatives of this city or county to Policy# T(GDSD 7 Expires �'�!8 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 ❑I certify that in the performance of the work for which this permit is issued, I shall 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 coT pensation provisions of Section 3700 of the Labor Code,I shall forth I' rfiply with tho a provisions. (/ Will the applicant or future building occupant handle hazardous material or a Applicant Date d 3 mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAIL E TO S ORKER'S COMPENSATION COVERAGE 15 ❑Yes VNo 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($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist - .ANSECfION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES- - --'-for guidelines --- - -- - - -CONSTRUCTION LENDING AGENCY ❑Yes ❑ 40 I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feetof the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Code) ❑Yes 74 No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of permitting checklist.I understand my requirements under the State of y p ty perjury that I am exempt from the California Health ty Code,Section 25505 and 25534 concerning Contractors License Law for the reasons)indicated below by the hazardous at porting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ,E o N Business and Professions Code).Any city or county that requires aA3erffiit to Date construct,alter,improve,demolish or repair any structure,p' eOl issuance,also requires the applicant for the permit to fl��anhils atement PROPERTY WNE� HORIZED AGENT that he or she is licensed pursuant to the provlsif ' ctorlltate EPA RENOVATION,REPAIR AND PAINTING IRRPJ License Law(Chapter 9(commencing with Sectiopp�@�)of Divii{'�rf he Business and Professions Code)or that he orvis exemp frV,%ensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors and the basis for the alleged exemption.Any violation i;ion 7031.5 b receiving compensation far most work that disturbs paint in a ply with an Applicant for a permit subjects the applicant to a ciX$enalty of residencera or cices. his Includy toes rental property ownersms and property than than($500). /A�� required practices.This Includes rental property owners and property O managers who do the paint-disturbing work themselves orthrough their ❑I,as owner of the property,or my employee with wa eir sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the workll�do�d the structure is www.eoa.eov/lead or contactthe National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-900-424-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. or 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. APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK I/lenifee DATE g 3 PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL X RESIDENTIAL C MULTI-FAMILY O MOBILE HOME 0 POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING <RE-ROOF-NUMBEROFSQUARES DESCRIPTION OF WORK PROJECTADDRESS 25-030 CC"MIL47 I` ASSESSOR'S PARCEL NUMBER '3 O LOT J TRACT OWNER NAME ��'� �jl -L4_5 ADDRESS (,} _030 60rfe� %,-/ L PHONE C y Tj ' S! EMAIL APPLICANT NAME c (f ADDRESS 5011n /T s f3osl/VCSS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? ',,"YES><N0 BUSINESS NAME ADDRESS 4� 72 PHONE Y/�V �� Z� �7y EMAIL CONTRACTOR'S STATE LIC NUMBER gg0377 LICENSE CLASSIFICATION N/G- a Ve, VALUATION $ 41 JC SQ FT f� L SO FT APPLICANT'S SIGNATURE ` ',DATE V CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION. OV CITY OF MENIFEE YSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP v INVOICE I -RD PAIDAMOUNT O AMOUNT CASH O.CHECKA OCREDITCARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECKq OCREDITCARD VISA/MC OWNER BUILDER VERIFIED 0 YES O NO DL NUMBER NOTARIZED LETTER O YES O NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-6 72-6777 www.cityofinenifee.us Inspection Request Line_951-0jw-6f mnlfee Building & Safety Dept. AUG 0 3 201, m s s a � a0 n z •2 m 'm m ORID w ti N n 3 m 0 � p � �, m 3 m O b ? N °� Cl)m � 7 O n m u+ A 3 N 3 0 2E m m a' o A N 1 n m m V T A m 3 n^ o o m a m n Z m min ° s ^. °, m n '° m '° m 3 T ui O .� z 3 o v 3 N m N c ~ o < . 'A N » o 0 0 r3„ ( AA m lT'1 s D-➢ S N n S !Di o f O OT m m rdf. C N S ° (1 SL J z M D r7T O S. r m m m o o N w ¢ !�`c�. 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