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PMT17-02751 City of Menifee Permit No.: PMT17-02751 29714 HAUN RD. Type: Residential Addition <A-CC11i MENIFEE, CA 92586 MENIFEE Date Issued: 0 810 412 01 7 PERMIT Site Address: 29931 TWIN LAKES RD, MENIFEE, CA Parcel Number: 333591-013 92585 Construction Cost: $3,500.00 Existing use: 1 &2 Family Residence Proposed use: Description of INSTALL ATTACHED SOLVALLIMWOOD PATIO COVER 336 SO FT.WITH 2 FANS Work: Owner Contractor JOSH HERRICK PSLQ INC 29931 TWIN LAKES ROAD 28910 RANCHO CALIFORNIA RD MENIFEE, CA 92585 #206 Applicant Phone:9517954260 MENIFEE, CA License Number.919885 Fee Description (�yl Amount($) 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 carded on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise stated,a peril 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 with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractors State License Law for Professions Code and y license is in full force and effect. the following reason: License Claasss Y License �/ -7 /1 �7 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 pdorto completion of improvements covered bythis permit.I cannot legallysell a structure that I WORKER'S COMPENSATION DECLARATIO 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.leeinfo.ca.eov/calaw.html. this permit is issued. Policy# Date p4'6ave 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 1 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 C A/ 1� with all applicable city and county ordinances and state laws relating to Carrier /V building construction.l authorize representatives ofthhcity orcountyto Policy# Y50 3 o'L 5'L Expires -� �_ 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 o I certify that In the performance of the work for which this permit is issued, z v�L I shall not am Ploy 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 workerskompensation provisions of Section 3700 of the Labor Code,l shall fort zi mply with those Will the applicant or future building occupant handle hazardous material ora -' 6. ` mixture containing a hazardous material equal to orgreater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAIL RE O SECURE WORKER'S COMPENSATION COVERAGE IS o Yes J;I10__ 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 IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelihes CONSTRUCTION LENDING AGENCY oYes p74o 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 bound�a of a school? (Section 3097 Civil Code) o Yes aa14"o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD permitting checklist I understand my requirements under the State of I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazar us material r ortin checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es o No Business and Professions Code).Any city or county that requires a permitto Date construct,alter,Improve,demolish or repair any structure,priorto its PROPERTY OWP(fffilk 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 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($500). managers who do the paint-disturbing work themselves or through their ❑1,as owner of the property,or my employee with wages as their sole employees.For more Information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eoy/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-900-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or Improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required for this prolect because: o 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE PERMIT/PLAN CHECK NUMBERFmTn—o--r1 D 1 TYPE: O COMMERCIAL jKRESIDENTIAL C MULTI-FAMILY O MOBILE HOME -- POOL/SPA O SIGN SUBTYPE: O ADDITION ""ALTERATION O DEMOLITION :% ELECTRICAL O MECHANICAL O NEW OPLUMBING )^ RE-ROOF-NUMBER OF SQUARES 7 DESCRIPTION OF WORK n i a , v PROJECTADDRESS a9 7Gwn', ASSESSOR'S PARCEL NUMBER ?33-'5 11 11 'o 13 LOT �� TRACT OWNER NAME AM 6 d f ADDRESS at ini CA 2S PHONE qS�•2;$-S9go EMAIL APPLICANT NAME p ADDRESS ((]]rr p PHONE '{7�����lO�y EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES KENO BUSINESS NAME ADDRESS JO r.e�.. , ,� 97,50 PHONE 95�-a3yo3sb EMAIL CONTRACTOR'S STATE LIC NUMBER 7/q$ZS LICENSE CLASSIFICATION VALUATION$ 3500. SQ FT 3 3 & L SO FT a2 , APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN " SMIP 1 INVOICE /aC PAID AMOUNT �. AMOUNT � lJ OCASH 'CHECK# CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT C;CASH :.'CHECK# C CREDIT CARD 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 951-672-6.777 Menifee www.cityofin denifee.us Inspection Request Line 951-246-6213 BUIl ng&t Safety Dept. AUG 0 4 2017 RArci„ot,11 N N � V 1_ 01, 7 ____ 7 7 _ _ __ __ _ ____1 I I (D T iN .D O I I O m W an m -0 07 n r o _ w c n rn _ H =_ M d m Z r- 0 O m n a ^ D T z - Z n O IO d O m o W O Z Z ,,AA y. C) !Z N C v fn V � O) C a o D m Z 3 s � � m m C. :E a' Vf r ° o O v v m a a a a m n O) O it O_ 9 v m m _ o � z � m m a m a r M D m m z m a m to CD m w C7 m 9-0 -O rr, (D r CO w CD X Crn"7 G s N Z � mm o u+ m 00 ro m cn M K � � LA o z ;a D � C-� N v z rn o C111 S3MVl N I MJL 00 - OFFICE COP