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PMT17-03075 City of Menifee Permit No.: PMT17-03075 29714 HAUN RD. "ACCELA3' MENIFEE,CA 92586 Type: Residential Demolition MENIFEE Date Issued: 08I30/2017 PERMIT Site Address: 28041 MURRIETA RD, MENIFEE., CA Parcel Number: 339-051-020 92586 Construction Cost: $200.00 Existing Use: Proposed Use: Description of DEMO OF EXISTING PATIO COVER 10'X 12'-COUNTY PERMIT#BZ205440 Work: Owner Contractor HILDA PEREZ GRIFFITHS CONSTRUCTION&INTERIORS INC 28041 MURRIETA RD 4076 ALAMO STREET MENIFEE, CA 92586 RIVERSIDE, CA 92501 Applicant Phone:9513427913 GARY GRIFFITHS Lioense Number:643658 GRIFFITHS CONSTRUCTION&INTERIORS INC 4076 ALAMO STREET RIVERSIDE,CA 92501 Fee Description gyt Amount($) Building Permit Issuance 1 2700 Demolition Permit 1 140.00 $167.00 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 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 Contractor's State License Law for Professions Co d my license is in full force and ejfec the following reason: License Class !cerise By my signature below 1 acknowledge that,except for my personal residence Expires n in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DEC LA ON improvements covered by this permit.I cannot legally sell a structure that 1 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 well maintain a certificate of consent of self-insure for worker's 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.gov/calaw html. this permit is issued. Poliryp Date ❑I have and will maintain worker's compensapon 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 orkers compensation' surance carrier and polity owner or authorized to act on the property owners behalf.I have read this number ar application and the information I have provided is correct.I agree to comply Cam! 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 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 D I certify that in the performance of the work for which this permit is issued, !^ I —7 1 shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE q V workers ensation o California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subje work s of provisions of Section 3700 of the Labor C ,I rt ly w' fps revisions. Will the applicant or future building occupant handle hazardous material or a A Date mixture containing a hazardous material equal to or greater that the amounts specifi the Hazardous Materials Information Guide? WARN] . A RE T LIRE WORKER'S COMPENSATION COVERAGE IS ❑Yes o_ �Ig q� UNLAWFUL,AND SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant orfuture building AND CIVIL FINES UP O ONE HUNDRED THOUSAND DOLLARS($300,00D),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Alt Quality nagement District(SC construction or See permitting checklist IN SECTION 3706 0E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast AirlQua CONSTRUCTION LENDING AGENCY ❑Yes ines I hereby affirm that under the penalty of perjury there is a construction Will the propos uilding or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is Issued outer bou ry of a school? (Section 3097 Civil Code) ❑Yes � No 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 understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the California th&Safe C d€,Section 25505 and 25534 concerning haza feria) checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 e - Business and Professions Code).Any city or county that requires a permit to 0 construct,alter,improve,demolish or repair any structure,prior to its PE OR ORIZED AGENT issuance,also requires the applicantfor the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATIO AIR 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 preracto and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving or childcare n for to beork that disturbs and comply with than Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their ❑I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees or personal effort,builds or Improves the property provided that the improvements are not Intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: D I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION DA � PERMIT/PLAN CHECK NUMBER -O m s TYPE: Q COMMERCIAL SIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O%SIGN SUBTYPE: O ADDITION OeLTERATiON O DEMOLITION O ELECTRICAL O MEC ICAL^ ONM O PLUMBING ORE-ROOF- MBER OF SQUARES DESCRIPTION OF WORK- - PROJECTADDRE ASSESSOR'S PARCEL NUM , - Cj QOT 4 TRACT OWNER NAME - ADDRESS PHONE T_ �rJ 4?-l9 tS EMAIL APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NA C OWNER BUILDER? O YES 4N8� BUSINESS NAME ADDRESS Et�IAI�� CONTRACTOR'S STATE LIC NUMBE LICENSE CLASSIFICATION VALUATION$/ - �'�j S F L SO FT / APPLICANT'S SIGNAT R '-��_ /> / DATE f DEPARTMENT DISTRIBUTION / CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP / INVOICE PAID AMOUNT AMOUNT O CASH Ci CHECK N O CREDIT CARD VISA MC PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES 0 NO DL NUMBER NOTARIZED LETTER O YES 0 NO City of menif6e Bull ji-- MEMPH ding & safety Dept. AND SA-r--tTY DEPARTMENT AVG 3 0 20p Received and ordinances, Thi >;i ed plans must bekp; ri ia-mtE until comPletion. CL A'P