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PMT17-03057 City of Menifee Permit No.: PMT17-03057 29714 HAUN RD. (ACCEL/17. MENIFEE,CA 92586 Type: Residential Addition r.R...,.-K.:s.u.Y. MENIFEE Date Issued: 08/29/2017 PERMIT Site Address: 25774 ROUNDUP CIR, MENIFEE, CA Parcel Number: 358-510-007 92684 Construction Cost: $6,900.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 840 SF SOLID ALUMAWOOD PATIO COVER WITH 3 FANS,4 POST LIGHTS Work: Owner Contractor CARLOS FLORES KONTIKI CONSTRUCTION 25774 ROUNDUP CIRCLE 31060 HIDDEN LAKE RD MENIFEE,CA 92584 MURRIETA, CA 92563 Applicant Phone:9097172457 EPELI MAFUA License Number:782009 KONTIKI CONSTRUCTION 31060 HIDDEN LAKE RD MURRIETA, CA 92563 Fee Description ON Amount IE) Receptacle, Switch, Outlet&Fixture 7 146.00 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 7.30 $321.95 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 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 form and effect. ( the following reason: License Class i License No. -7,Nz-00�` By my signature below I acknowledge that,except for my personal residence Expires Signature 4a 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.IeRinfo_ca.Rov/caIaw.htm1.permit is issued. Policy q Date ❑I have and will maintain workers compensaton insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT 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 carder 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 ` with all applicable city and county ordinances and state laws relating to Carrier CC building construction.I authorize representatives of this city or county to Policy q 926 RJCJc� 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, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 9 workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith empty with those provisions. WIII the applicant or future building occupant handle hazardous material or a Applicant Date a' 17 mixture containing a hazardous material equal to or greater that the / amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECUR ORKER'S COMPENSATION OVERAG L5 ❑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 ❑Yes ❑No 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 DYps ❑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(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 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($500). managers who do the paint-disturbing work themselves or through their ❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.gov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code,The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible forthis project property who,through employees or personal effort,builds or improves the property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required forthisproject because: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. APPLICATION& SAFETY PERMIT/PLAN CHECK ,Menifee DATE 17 PERMIT/PLAN CHECK NUMBER W vi -U f�j TYPE: O COMMERCIAL C RESIDENTIAL O MULTI-FAMILY 0 MOBILE HOME O POOL/SPA OSIGN SUBTYPE: O ADDITION u'ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK PROJECTADDRESS 2577 of U l <�Tk M \ (2. ':fz4� ASSESSOR'S PARCEL NUMBER , �� ( � LOT TRACT OWNER NAME City of Menife Opf. ADDRESS PHONE EMAIL APPLICANT NAME Receivp ADDRESS PHONE EMAIL CONTRACTOR'S NAME ` OWNER BUILDER? 0 YES CA BUSINESS NAME v( ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER 73j2C�o� LICENSE CLASSIFICATION VALUATION$ C2 1 EGG SQ FT L-t L SQ FT APPLICANT'S SIGNATURE DATE �-' CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I - SMIP 1 INVOICE AMOUNTZQ�_ q,,�5 PAID AMOUNT 1, 15 OCASH QCHECKR OCREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT OCASH OCHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER YES ^ NO City of Menifee &Wdinc&Safety Depertment 29714 Houn Rd. Menife_=, '_4 92586 951-672-6777 www.cityofineni;ee.us Inspection Request Line 951-246-621 I I I I I City of Menitee LEDGER & TRACKED f3uiidAus 2 s 2ot�ing & Safety t. n C�ION REQUIRED � i rnn I Receiver' � C� b I � I I �r. _f JJi i e • yl Qi -I - I ti 1 � t • ��'\ 1 !- !-J—I -- I. —EtTY,-oEr-M�f NfFf!F UIC 4113F �MD� E ETY DEPARTMENT _ I I _ LA_ ' — --I - I�E�IEWE(� � ---- - - DATE I I � PPr64 fthesepidn,snr 1 be construed tobe.&permit f 4oran — III— —I----�--- pk$ul proValoff any 61adcut of an --ovlslons of the federal,state or city _ _ _ - j rationsland�rrdinances Ths , t of approved plans must be kept on the f bsrt I e until completion. — II I _ I _