PMT17-02995 City of Menifee Permit No.: PMT17-02996
29714 HAUN RD.
'ACCELA_7? MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 0 812 312 01 7
PERMIT
Site Address: 25419 HITCH RAIL LN, MENIFEE, CA Parcel Number: 358-540-006
92584 Construction Cost: $2,560.00
Existing use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 288 SO FT SOLID ALUMAWOOD PATIO COVER, NO ELECTRICAL
Work:
Owner Contractor
ROBERT BENNETT PSLQ INC
25419 HITCH RAIL LN 28910 RANCHO CALIFORNIA RD
MENIFEE,CA 92584 #206
Applicant Phone:9517954260
LOIS MONTINI License Number:919885
PSLQ INC
28910 RANCHO CALIFORNIA RD
#206
TEMECULA, CA 92590
Fee Description
CHy Amount I$I
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
$168.65
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 ❑ [am exempt from licensure under the Contractors'State License Law for the
I hereby affirm under penalty or perjury that 1 am licensed under provisions of following reason:
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that,except for my personal residence in
-Professions Code and"license tsin full force and eB e M
which I-must haveresided-for at least one year prior to cempleton of
License Class Lice s 0. � Improvements covered by this permit, I cannot legally sell a structure that I have
Expires — - ignature built as an owner-building if it has not been constructed in its entirely by licensed
/ ce R..MM. I understand that a copy of the applicable law,Section 7044 of the
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is
submitted or at the following Web site:
❑ I hereby affirm under penalty of perjury one the following declarations: hffc•//www.leoinfo.ca.cov/calaw.html.
i have and will maintain a certificate of consentt of self-Insure for workers' -
compensation,issued by the Director of Industrial Relations as provided for by Date
Section 3700 of the Labor Code, for the performance of work for which this
permit is issued. Property Owner orAulhorized Agent
Policy# ❑ By my Signature below, I certify to each of the fallowing: I am the property
❑ 1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owner's behalf. I have read this
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comply
permit is issued.My workers'compensation insurance carder and policy number are• with all applicable city and county ordinances and state laws relating to building
T' }� construction.I authorize representatives of this city or county to enter the above-
Carrier r identified property for the inspection purposes.
Policy# tV011QZ)DS 61 Expires / (() '/ .(� Date
L,L � Property Owner or Authorized Agent
(This section need not be compl tedgf the permit is for City Business License# '41 �j
one-hundred dollars($100)or less) lY •O`�
❑ I certify that in the performance of the work for which this permit is issued,) HAZARDOUS MATERIAL DECLARATION
shall not emolov any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers'compensat on laws of California,and agree that if 1 should become mixture containing a azardous material equal to or greater that the
subject to the wo rs'compensation provisions of Section 3700 of the Labor amounts sp5f on the Hazardous Materials Information Guide?
Code,I shall o comply tth those provisions. /) •/�7 I/_ OYES C�NO
Applic t; ete; -�G / /ICJ Will the Intended use of the building by the applicant or future building
occupant require a rnit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quali anagement District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL forguidelt
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ❑YES ❑NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed g rd g rmodifiied facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of proposed
LABOR CODE,INTEREST,AND ATTORNEYS FEES DYES NO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I unde Land my requirements under the State of
agency for the performance of the work which this permit is issued(Section California Health €ly Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous&16kial reporting.
OWNER BUILDER DECLARATIONS ❑Y ❑ �J
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's Date O2
License Law for the reason(s)Indicated below by the checkmark(s)I have placed PROPERTY OWNER ORAU O RIZED AGENT
next to the applicable Item(s)(Section 7031.5.Business and Professions Code:
Any city or county that requires a permit to construct,alter,improve,demolish, EPA RENOVATION,REPAIR AND PAINTING(RRPI
or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
provisions of the Contractor's State License Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified firms and comply with
she is exempt from licensure and the basis for the alleged exemption. Any required practices.This Includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees.For more information about EPA's Renovation Program visit:
www.epa.govfiead or contact the National Lead Information Center at
❑ I, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the work, and the structure is yy���,
not intended or offered for sale.(Section 7044,Business and Professions Code; l�l,l2?e3ee,
The Contractor's Stale License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
Who, through employees'or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however, Certified Firm Name:
the building or improvement is sold within one year of completion,the Owner-
Builder will have the burden of proving that it was not built or improved for the Finn Certification No:
purpose of sale).
❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm Is required for this project because:
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
who builds or improves.thereon, and who contracts for the projects with a
& SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE (9,1-177 PERMIT/PLAN CHECK NUMBER 11 �np�
TYPE: O COMMERCIAL Q-0SIDENTIAL O MULTI-FAMILY O MOBILE HOME (;POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION 0 DEMOLITION 0 ELECTRICAL C% MECHANICAL
C4-116EW 0' PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DE IPTION OF WORK Q �L, L.UI7I DQD
Td D D a'G
PROJECTADDRES IL, Zoq,�
ASSESSOR'S PARCEL NUMBER -W(p LOT TRACT �I
OWNER NAME E4ii6,s-/v/L)lR77
ADDRESS G
PHONE 919 - 7 ` 4P - l p 19-6 EMAIL
APPLICANT NAME D N N
ADDRESS
PHONE R �`- 3,1� 4—)7 �25 EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES C4-1�
BUSINESS NAME ot A L
ADDRESS
PHONE 1 _ ���� Djp EMAIL
CONTRACTOR'S STATE LIC NUMBER 9 LICENSE CLASSIFICATION
VALUATION$ SO FT L SO FT
APPLICANT'S SIGNATURE - DATE
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP I�
INVOICE (�j PAIDAMOUNT
AMOUNT C CASH 0 CHECK M O CREDIT CARD VISA/MC
j
PLAN CHECK FEES PAIDAMOUNT OCASH OCHECK# OCREDIT CARD VISA/MC
OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER 0 YES 0 NO
Sar` ty De0C, 'cu �i� 5 4 ,5- -E77?
Plot plan Robert Bennett
25419 Hitch Rail Ln.
Not to Scale Menifee, Ca. 92584
918-770-6196
288 sq. ft. Solid Alumawood Patio Covers. Attached to the house and to the
existing concrete slab. Set at 9.0' high
Colors to be : Mojave Tan
II
19, LEDGER & TRACK
INSPECTION REQUIRED
city of Menifee
�—� 24 10 Building & Safety Dept.
g•� o 0 0 � 9[ll 21' ►
Received
IF
G�Oa
CITY OF MENIFEE
BUILDING AND SAFETY DEPARTMENT
PLAN APPROVAL
i 4
REVIEWED BYOOJ* �
DATE- 1
approval of,any vjolation of any rSWi6 tz N)ie federal,state or city
regulations and ordinances. Thi set of approved plans must be kept on the r
jobsite until completion.
Sidewalk
Hitch Rail Ln.