Loading...
PMT17-03045 City of Menifee Permit No.: PMT17-03045 29714 HAUN RD. *�CCELA" MENIFEE, CA 92586 Type: Residential Re-Roof MENIFEE - Date Issued: 08/28/2017 PERMIT Site Address: 28808 W WORCESTER RD, MENIFEE, Parcel Number: 339-132-014 CA 92586 Construction Cost: $10,800.00 Existing Use: Proposed Use: Description of REMOVE EXISTING SHINGLES, REROOF W/MALARKEY COOL ROOF IN BRONZED MEZA Work: Owner Contractor CONNIE LOPEZ GO ROOF TUNE UP INC 28808 W WORCESTER RD 6809 INDIANA AVE STE 130 MENIFEE,CA 92586 RIVERSIDE, CA 92506 Applicant Phone:9517820336 JOHN STOUT License Number:933425 - GO ROOF TUNE UP INC 6809 INDIANA AVE STE 130 RIVERSIDE, CA 92506 Fee Description Oft Amount f$1 Residential Water Heater 1 83.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 4.15 $115.15 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_Pennit_Template.rpt Page 1 of 1 CITY OF MENIFEE (1phereby ENSED 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). affirm under penalty of perjury that i am under provisions ofpter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractors State License Law for fessions Code and my liceense is in full force and effect. the following reason: nse Class J q License -� By my signature below I acknowledge that,except for my personal residence ires —5O /t� Signature in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DE[IARATI improvements covered by this permit.I cannot legally sell a structure that I 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.xov/calaw.html. this permit is issued. Polity# !23 'Wr3 ')"(P/ 1�l Date ❑I 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 with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy If �.3 ,4/� O/ 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 ❑I certify that In the performance of the work for which this permit is issued, 1 shall not emolov aWalifo o as to become subject to the ITY BUSINESS LICENSE# workers co nsationagree that if I should become HAZARDOUS MATERIAL DECLARATIONsubject the workersns of Section 3700 of the LaborC ,I shall forthwitsions. Will the applicant or future building occupant handle hazardous material or a lican[ Date ry-0/7 mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:F RE O SECURE WORKER'S COMPENSATION CO ERAGE IS ❑Yes o UNLAWF ,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applican[or future building AND C FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a perm([for the ng by t e ap li modification from South ADDITI N TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management Disto tricttSC(ion or See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes Alo 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 boundary of a school? (Section 3097 Civil Code) 0 Yes IZIo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I under n my r nts under the State of Contractors License Law for the reason(s)indicated below by the California Health&Safe ode Se on 2 5 an 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material r orting Business and Professions Code).Any city or county that requires a permit to Yes '044o A Q� / Date Lt.-p( OC O ,�( construct,alter,improve,demolish or repair any structure,prior to Its ROPERTY OWNER 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 PA RENOVAT REPAIR AND PAINTING RRP 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 apre-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 ❑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.eoa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-SOD-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 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. APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK �r DATE A Lt PERMIT/PLAN CHECK NUMBER mn TYPE: O COMMERCIAL pc RESIDENTIAL O MULTI-FAMILY CIMOBILEHOME 0 POOL/SPA 0 SIGN SUBTYPE: "ADDITION O ALTERATION ODEMOLITION O ELECTRICAL O MECHANICAL ONEW OPLUMBI(N�G XRE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK Yee Mo i U �e PROJECTADDRESS o2 ® b" I ' two�o_*,T yFE ASSESSOR'S PARCEL NUMBER 3 - I✓`-014 LOT !Oil TRACT oZ55� OWNER NAME L't je7Z ADDRESS Q Dyz N 4e!,T4 It +2 d PHONE �I/1 J.3�f -- 02 5'O (p EMAIL APPLICANT NAME act L-F pp S`T-0 u,�- ADDRESS Ll iE- It- SS ✓A e . O K�/02z v if I PHONE /��/l./, �foZ ©-- /,ems/ EMAIL S OG{ 1 yC�tj CONTRACTOR'S NAME � ,n OWNERBUILDER? CYES1fA'NO ME BUSINESS NAME �o '(��., -rYe ADDRESS p /J �� f✓1S d' �('02S©6 PHONE CjS�> / gam^ 03 -3 4, EMAIL CONTRACTOR'SSTATE LIC NUMBER g334fc�� LICENSE CLASSIFICATION C " 3 VALUATION$�/O i �'ES O 1� L SO FT r7 �y APPLICANT'S SIGNATURE DATE a� _- DEPARTMENT DISTRIBUTION - CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP ✓` INVOICE PAID AMOUNT AMOUNT • l� C�OCASH CHECK# `,:CREDITCARD VISA/MC PLAN CHECK FEES PAIDAMOUNT OCASH O{HECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES 0 NO City of Menifee Buiiding &Safety Department 297.14 Haun Rd. Menifee, 4 9 25;5 951, 72-E7; wwI,v.citycfinenifeaus Inspection Request Line 951-_<'5-g2LL_' N O G �. �G ♦ • ♦ 2 n n M f� N D 9 n m y " "' m o m 0 a o A 3 c' m �'p m p m> 3 J ,o� 0 c o m p 3 O W mf O n O O O p 9 'o w 7 6 T < O N - < n Z O D Y a p J•Q c o 3 N m ° 3 r A , ; m m AO mm - Z1 o 1T0 m x 0 x o m a -c y n v v_ A 2 �-` ❑ 3 O A a 3 N a s O !`� O -1 m M fC (1 D .�i S u0i a F D N 9 .Os, C N S p N ? z r3? O n r S f° m 01 >• m m o o N w a O oo m 1 d 3 m 2 w n n a w D m A 3 c m S w p. ^• N O 3 D Z w > 3 n '< n .* m w fD a o o A a 3 D S d t J _ d o ; v n c o N r m o m 3 V N m m v m J £ O m 0 J W N F M. x �' m O u edi a N Z a rt °o Z O1 m N m c m m a wJ ti, N 6, 3o p' o, J O m a n c = w m n ❑ t m J. 3 �. T c T m n c m a rp a o K n o O -on r n w o a O 0 N W F G m �. o• O. m ram'• S T p ^ A = Z n 9 c N < n o » '° O x o m ° ^ 3 0 f0 A v m n O in l0 d < O d £ J J. 0 3 O O N J A h N N A 7 fD y '• C vTi H O O O P .tee O .r p 3 J o A O. , o m w J .. n C EL 0 4 £ 01 a. 0 n ao m A O O- 0, N O D O O N u D n N N y w W u+ y w m °° °F O O A w •+ 3 D• O O � N � O Do m w m m 3 �. D✓ J m � iD 01 a !? 2 a c m 3 3 Tia m sx m va c 3 R u m o. 3 J o � O N S w d 3 N o m _ 00 a m o x v A n m n .'mw ^ N oo m ouo r i0 O .. m w r� N o w � r• r y x m ? Rl m m in W Op .M] o 0 3 r m O A y p = m G) 3 �, m m m m n fD O K a ' x 0 s a n p_ n u A w N i a f, D n z O m 2 n 3 m 3 N a d C n O m m' n o d D ? 3 3 3 -• $ 0 ° 2 o c c n n m 1 ° s p o 0 3 9 3 � n n w d a n w m A .� z w w N' ,'-, n v 'v C O F N O O BE x ai d 0 w a n aD ° » n o o y v be ? a 3 m d y m m o' °o .a. z m r d d o _ n 3 m 3 A 1 3 r n n p », '^ n b o 0 0 p m GT o 2 � 0 3 w m m w as °Q m a 0. 7 R m 2 £ w 9 a _ m A w w m O y O . H N M o d d � d '^ � m j) C N T y> 3; m3 c •, m fl N ddN 0d dn o do d C.- ° w o n 3 w wo dN dy W i ^w r O o 9 d a v 4 T d o ym m a .dr �f N ❑ o -i m IF f° "-. o m O a q D 'A f m a �^ o ^ O O O 3 O ^ m A C a ° n » fd^. ° m5 O CQ d d o f f A N y O 0 m O a w 0 0 = f o A d A n D rt � �• A n m n c 2 m 3 m a o w n A m a n S N 0 o a o o m N m p D f °n' '" z 0 m o w U Z m � w a $ sYm ° m D a n a m n n o w n - ET d o G C m a O. O m 9 N o y M. o .z F o v n H « x n m m a d S 0 00 d o o O w zzSS W N N A 2 O m C. 2 ° n w w O Op ^ m e a s ' 0 �- w n 0 o d � 'o m m F�� m 3 n o m n + v n n c m m m n n 3 < S D y Q m m �'