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PMT17-02752 City of Menifee Permit No.: PMT17-02752 29714 HAUN RD. Type: Residential Addition <A-CCELA7. MENIFEE, CA 92586 MENIFEE Date Issued: 0 810 412 01 7 PERMIT Site Address: 30176 RIO BRAVO CT, MENIFEE, CA Parcel Number: 358-530-031 92584 Construction Cost: $5,975.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL SOLID 650 SQ FTALUMAWOOD PATIO COVER W/ELECTRICAL 2 FANS,2 LIGHTS Work: Owner Contractor PETER OLVERA PSLQ INC 30176 RIO BRAVO CT 28910 RANCHO CALIFORNIA RD MENIFEE, CA 92584 #206 Applicant Phone: 9517954260 JOSH HERRICK License Number:919885 PSLQ INC 28910 RANCHO CALIFORNIA RD #206 TEMECULA, CA 92590 Fee Description , Oft Amount IS) Receptacle, Switch, Outlet&Fixture 4 131.00 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 6.55 $306.20 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 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 ClaasssQ _License! _ By my signature below l 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 by this permit.I cannot legallysell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by u 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 wwwAe-info.ca.gov/caIaw.I1tnnI. this permit is issued. Date Policy N PROPERTY OWNER OR AUTHORIZED AGENT p4have and will maintain workers compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which o 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 1 have provided is coned.I agree to comply CN C with all applicable city and county ordinances and state laws relating to Carrier building construction.I authorize representatives of this city or county to Policy p t/5D 3 c 2 5 Z Expires i-A-1$ 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, rr��/��� y'� I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE N n�7 c workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers ompens ion provisions of Section 3700 of the Labor Code,I shall fort i mply with those Will the applicant or future building occupant handle hazardous material or a Applicant Date 3 `16 I!� mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILCRAD SECURE WORKER'S COMPENSATION COVERAGE IS a Yes 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 for guidelines CONSTRUCTION LENDING AGENCY ❑Yes pWo I hereby affirm that under the penalty of perjurythere 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 boundaa of a school? (Section 3097 Civil Code) o Yes wflo 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 perjurythat I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below bythe hazardous material r ortin checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 es o No I Business and Professions Code).Any city or county that requires a permit to Date 7' 6' construct,alter,Improve,demolish or repair any structure,prior to its PROPERTYOWIE ,O AUTHORIZEDAGENT 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(RRPI 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 applimnt 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 ❑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.eov/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 applyto an owner of a D 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 D No EPA Lead-Safe Certified Firm is required for this project because: not built or improved for the purpose of sale. a 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. c BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ' 4 ,Menifee DATE /Y PERMIT/PLAN CHECK NUMBER ' I�oa15�- TYPE: Ci COMMERCIAL QKRESIDENTIAL C MULTI-FAMILY O MOBILE HOME C% POOL/SPA SIGN SUBTYPE: C>ADDITION 0 ALTERATION C;DEMOLITION 0 ELECTRICAL 0 MECHANICAL ONEW OPLUIMB11NG 0, RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK �Q 011 a- IUyndw� �T•^ U-� t� Z �n Z �yi It}5 PROJECTADDRESS 9-zjD � f22��� 100 �v� Q4 ASSESSOR'S PARCEL NUMBER 49-510'ON LOT ✓1 TRACT �' J OWNER NAME Re-.(- 11SI,erk ADDRESS )J b �t vm' * l PHONE b 7- (1 � EMAIL APPLICANT NAME q S/7 {r-,c ADDRESS PHONE 5i- 5 / " 1"D7 EMAIL CONTRACTOR'S NAME 07 IWO 15& OWNER BUILDER? 0 YES X-NO BUSINESS NAME /� 11 ADDRESS e ,AClO ('„1,� r` ev 07,590 PHONE 95i-;IKq 0�51 EMAIL CONTRACTOR'S STATE LIC NUMBER %/1p p / LICENSE CLASSIFICATION VALUATION $ r>g S L FT �jQ L SQ FT 5 APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP INVOICE PAID AMOUNT AMOUNT 1N1L/•� )CASH %CHECK# »CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT OCASH C%CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED 0 YES C% NO DL NUMBER NOTARIZED LETTER 0 YES G NO City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 RIO BRAVO y 2 ) � / - M > / / i $ § / \_ 0 / m C cnf It r 2 k \ E a k E 7 ET Z 0 cr n Z > \ / / 0 § \ ~ r z a § \ § LAc E @ g a) v 2 » J a) � % ° / % ° k - ` ------ -- - - - - - -- --- - ` q ; - ■ M = n \ g k Z / \ « f °m 2 0 > & tom = q m �§2 -n k \ :> m . \K2 \ . z O m » J- @ f. a � \ / f \\ f ( 2r © ±® k m n = _ o � » m CD _ ��Im 'mtD � � } @ Lrl all % rin � 2 ` I m o < & 2 rn q OFFICE COPY aim R \ m a co( = �����