PMT17-02851 City of Menifee Permit No.: PMT17-02851
29714 HAUN RD.
"!ACCE L%!7 MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 08114/2017
PERMIT
Site Address: 30213 NIGHT PASSAGE PL, MENIFEE, Parcel Number: 358-501-002
CA 92584 Construction Cost: $5,640.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 11'x 15'AND 15'x 36'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS,2 LIGHTS
Work:
Owner Contractor
SUMMER ASTOEFORD TODD'S PATIO COVERS
30213 NIGHT PASSAGE PLACE 30905 GREENSBORO DR
MENIFEE, CA 92584 TEMECULA, CA 92592
Applicant Phone: 9516608665
TODD SKARIN License Number:834251
TODD'S PATIO COVERS
30905 GREENSBORO DR
TEMECULA, CA 92592
Fee Description 01t rr Amount IEl
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_Templatespt 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 perjurythat 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 licensure under the Contractors State License Law for
Professions Code and my license is in full force and effe the following reason:
License Class; Ure Selo. By my signature below I acknowledge that,except formy personal residence
Expires<3' Signatur in which I must have resided for at least one year prior to wmpletion 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
❑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.IegInfo.ca.aov/caIaw.htmI.permit is issued.
Policy R Date
O I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Cade,for the performance of the work for which `OBy 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
buildinction. authorize representatives of this city or county to
Policy If Expires Z5�
(den ad property for inspection purposes.
(This section need not to be completed is the permit Is for one-hundred
dollars($100)or less Date
R OW RAUTHORIZEDAGEM
-*;RQ certify that in the performance of the work for which this permit is issued,
Ishallnotemolov 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 coin ensation provisions of Section 3700 of the Labor
Cade,I shall If hw Is ywith those provisions. Will the applicant or future building occupant handle hazardous material or a
Applica Date mixture containing a hazardous material equal to or greater that the
amount specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes ❑No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Willthe ntended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ocoupa require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coaster Quality Management hecoDistrict(SCtionor See icatio from
ing checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forCoast
Aguldi lines
CONSTRUCTION LENDING AGENCY ❑Yes 3No
I hereby affirm that under the penalty of perjury there is a construction Will the ;roposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer b ndary of a school?
(Section 3097 Civil Code) ❑Yes No
OWNER BUILDER DECLARATIONS I have re lid the Hazardous Material Information Guide and the SCAQMD
hereby affirm under penalty of perjury that exempt from the permittin checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)Indicated below by the California ealth&Safety Code tion 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes ❑
o mate' I r
Business and Professions Code).Any city or county that requires a permit to Yes 1 7� `
construct,alter,improve,demolish or repair any structure,prior to its Date (�
R ER
issuance,also requires the applicant for the permit to file a signed statement PROPE RHORIZED AGENT
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 Ilcensure 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
o 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.epagm/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 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. ❑No EPA Lead-Safe Certified Firm Is required for this project because:
❑I,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
r�
BUILDING PP •
I
Menifee
DATE 11 PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY ^ MOBILE HOME O POOL/SPA C%SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING '0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK �/r X�� 1 4
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ASSESSOR'S PARCEL NUMBER "" � '� LOT TRACTIts
OWNER NAME //� S _e 7T ty De
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PHONE / Q — EMAIL
Received
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APPLICANT NAME v-/ �"'�'7
ADDRESST�I ►l/ / J U �J 7
PHONE Q '' S -� EMAIL
CONTRACTOR'S NAME Imo/ ✓L OWNER BUILDER? OYES
BUSINESS NAME p Ol ✓,.3
ADDRESS SO EMAIL
PHONE
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CONTRACTOR'S STATE LIC NUMBER �S 7 Y 2� LICENSE CLASSIFICATION
VALUATION S CC`J� FT -7 LSO FT
APPLICANT'S SIGNATURE DATE tJ I r
CITY STAFF USE ONLY 1mw_
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP
INVOICE PAID AMOUNT 0
AMOUNT 0CASH OCHEGK# CREDITCARD VISA/MC
PLAN CHECK FEES PAIDAMOUNT OCASH "CHECK# %CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED Q YES O NO DL NUMBER NOTARIZED LETTER YES O NO
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