PMT17-02917 City of Menifee Permit No.: PMT17-02917
29714 HAUN RD.
rlNCCELA> MENIFEE,CA 92586 Type: Residential Alteration
MENIFEE Date Issued: 08/17/2017
PERMIT
Site Address: 29801 CALLE SAN MARTINE, MENIFEE, Parcel Number: 340-091-018
CA 92584 Construction Cost: $20,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of BATHROOM REMODEL, INSTALL NEW TOILET, REPLACE AND RELOCATE SHOWER VALVE,
Work: REPLACE SHOWER PAN, INSTALL 1 GFI OUTLET AND REPLACE EXISTING OUTLET, MINOR
DRYWALL REPAIR,ADDITIONAL MINOR WORK AS SPECIFIED IN SCOPE OF WORK
Owner Contractor
JONATHON SILVER J D F CONSTRUCTION INC
29801 CALLE SAN MARTINE 201 GEMINI AVE
MENIFEE,CA 92584 BREA, CA 92821
Applicant Phone:7145261120
NATHAN KELSEY License Number:956749
J D F CONSTRUCTION INC
201 GEMINI AVE
BREA, CA 92821
Fee Description gyt Amount($)
Receptacle, Switch,Outlet&Fixture 2 121.00
Plumbing Fixtures and Vents, fixtures 1 116.00
Building Permit Issuance 1 27.00
Inspections not specified 10 10.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Plumbing 1 5.80
General Plan Maintenance Fee-Electrical 1 6.05
$286.85
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_eldg Pernit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe 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 ❑I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
n
License Cla s Uce a Na. y4ny-signaturebelowlacknowledgetkatexcepfformy-personaLresidenrp
Expires Signature In which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that 1
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.leeinfo.m.aov/calaw.html.
this permit Is Issued.
Policy# Date
XI 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 owners behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier rnd I t l_, with all applicable city and county ordinances and state laws relating to
f building construction.I authorize representatives of this city or county to
Policy#TLADOO"K-UO Expire I g
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
D 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 th or rs compensation provisio ection 370 of the Labor
Code,is all orthwi hcompI '1<h hose visions. Will the applicant or future building occupant handle hazardous material or
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 WO 'S CO ENSATION OVERAGE 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 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 D Yes ❑No
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 boundary of a school?
(Section 3097 Civil Code) ❑Yes ❑No
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 hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes ❑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 Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRP)
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 Cade)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($SDO). 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.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 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 R was
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Finn is required for this project bemuse:
❑I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 70",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.
- MenifeP
DATE lb PERMIT/PLAN CHECK NUMBER -
TYPE: O COMMERCIAL )(RESIDENTIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME ::) POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION C) ELECTRICAL O MECHANICAL
O NEW O PLUMBING C:) RE-ROOF-NUMBER OF SQUARES
of
DESCRIPTION OF WORK ro o m Cog g,Sa6fety Dept.
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PROJECTADDRESS -I L
ASSESSOR'S PARCEL NUMBER �6wic -Qgl -Ql$ LOT TRARE)Co1v
ed
OWNER NAME Q c3\ Vfr
ADDRESS O'''rr qh'" �/ Y c
PHONE �- ry- l lf� !/ EMAIL
APPLICANT NAME S
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES - NO
BUSINESS NAME 1L
ADDRESS `pjt. O P I
PHONE 1-1K- 5 11 - EMAIL
CONTRACTOR'S STATE LIC NUMBER 9 S '4-q 1 LICENSE CLASSIFICATION 3
VALUATION$ 4A Q 1 W V SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE kl�v
As mffp�
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN '^ SMIP X
INVOICE PAID AMOUNT
AMOUNT C CASH O CHECK#CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 0CASH 0CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER CJ YES O NO
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BUILDIN�itAND SAFE'
PLAN AP*VAL
REVIEWED BY
'Approval of these plans shall not t
h approval of,any violation any
ri
regulations and ordinances.s. s(This sE
jobsite until completion.
Silver Final Scope: Bathroom (convert from tub/shower to shower only)
Built 1993/Second Story
City
°General Services: & Safety Dept.Building
Demo -leave existing vanity lights At)G 11 ZOII
-remove recessed TP holder ��CejVe�
Drywall Repair
Permits $700 (includes$350 retention fee)
°Finished Plumbing:
Install (2) single vanities
Install (2)framed mirrors
Install (3) accessories
-(1) new medicine cabinet-existing location, (1) 24"towel bar, (1)TP holder
Install new toilet
Install new bi-pass shower door
°Rough Plumbing: /
Install new shower valve and trim ✓
-Move valve to shower height✓
-Move shower head up approx. 9"✓ / DEPART
Move/Center back shower drain approx.... 23"for new pan location,/
May need to move cold shut off and drain pipe for left vanity- (may not need)
- s+rues to he
nns of the fede
approved play
eFlooring:
Install vinyl plank flooring in bathroom -total 53s.f.
-Install quarter round (included)
Install acrylic shower pan V
Install 12"x 12" porcelain tile on shower walls stacked-grout grouts 1/8"-total 84 s.f.
-use bullnose tiles for niche and window exposed edges
-Shluter for exposed edges of walls
Install glass mosaic as 6" band-in shower-total 12 s.f.
Install (1) niche
Install cement board in shower-total 96 s.f.
*Finish Electrical:
Install (1) GFI outlet„/
*Rough Electrical: /
New location for second outlet for left vanity
*Paint:
Client will paint
Millwork:
N/A
!ENT
r.it for,or an
" state or city
ust be kept on the