PMT17-03588 City of Menifee Permit No.: . PMT17-03688
29714 HAUN RD.
47\CCELAk7 MENIFEE, CA 92586 Type: Residential Re-Roof
MENIFEE Date Issued: 1 0/1 012 01 7
PERMIT
Site Address: 29270 THORNHILL DR, MENIFEE, CA Parcel Number: 338-061-012
92586 Construction Cost: $8,000.00
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING LAYERS, INSTALL NEW COOL ROOF SHINGLES
Work: TM CRRC#0890-0009"
Owner Contractor
ED RUHMAN BAKER ROOFING CORPORATION
29270 THORNHILL DRIVE 29515 DUNKIRK STREET
MENIFEE,CA 92586 MENIFEE,CA 92586
Applicant Phone: 9512557237
LARRY BAKER License Number:884731
BAKER ROOFING CORPORATION
29515 DUNKIRK STREET
MENIFEE, CA 92586
Fee Description City Amount 1El
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
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_Pemiit_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ 1 am exempt from licensure under the Contractors State License Law for the
I hereby affirm under penalty or perjury that I 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 my license is in full force and effect which I must have resided for at least one year prior to completion of
License Class r7-7 1 License No. 7`i r I improvements covered by this permit, I cannot legally sell a structure that I have
Expires '^Ii Signature built as an owner-building if it has not been constructed in its entirety by licensed
contractors. 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:
ElI hereby affirm under penalty of perjury one the following declarations: htto://www.leoinfo ca.cov/calaw.html.
I have and will maintain a certificate of consentt of se fansure 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 or Authorized Agent
Policy# ❑ By my Signature below, I certify to each of the following: I am the property
I 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
ection 3700 of the Labor Code, for the performance of the work for which this application and the information I have pmvided is correct. I agree to comply
•permit 1s iss ad.My workers'com ensation insurance carder and policy number are: with all applicable city and county ordinances and state laws relating to building
construction.I authorize representatives of this city or county to enter the above-
Carder `�"� T-0"7 Identified property for the Inspection purposes.
Policy# 32 Expires Date
Property Owner or Authorized Agent(This section need not be completed if the permit is for Ci Business License# Oa� L 1 5y
one-hundred dollars($100)or less) h'
-
❑ I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIAL DECLARATION
shall not employ 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'compensation laws of California, and agree that if I should become mixture containing a hazardous material equal to or greater that the
subject to the workers'compensation provisions of Section 3700 of the Labor amoun specified on the Hazardous Materials Information Guide?
Code,I shall forthwith comply with those provisions. DYES NO
Applicant ram. Date; Will the Intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quality Management District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL for guidelines -
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND El YES (1Vb
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building or modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary of a school?
LABOR CODE, INTEREST,AND ATTORNEYS FEES ❑YES�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 understand my requirements under the State of
agency for the performance of the work which this permit is issued (Section California Health&Safety Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardopusjpaterial reporting.
OWNER BUILDER DECLARATIONS ❑YES t Date
ar-(A`l /nJ�`�0
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AUTHORIZED AGENT
next to the applicable item(s)(Section 7031.5. Business and Pmfesstons Code:
Any city or county,that requires a permit to construct, alter, improve, demolish, EPA RENOVATION,REPAIR AND PAINTING(RRP)
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(S500).) employees.For more information about EPA's Renovation Program visit:
El 1, as owner of the roe www.epa.govAead or contact the National Lead Information Center at
property,rty, 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
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State 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 safe.If,however, Certified Finn 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 purpose of sale). Finn Certification No
❑ 1, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Fimr 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
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
DATE p - PERMIT/PLAN CHECK NUMBER vi -
TYPE: ❑COMMERCIAL JORESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION. ❑ELECTRICAL QMECHANICAL
❑NEW ❑PLUMBING [XRE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK---�>v�' T" �. l y1 e$ {
PROJECT ADDRESS
ASSESSOR'S PARCEL NUMBER ' ^QO\-aa LOT TRACT
City Of Menifee
PROPERTY OWNER'S NAME c t f Building & Safety De
ADDRESS 0 6I_n OCT 0
PHONE Cf^ .S_b (`" d EMAIL
APPLICANT NAME ecelved
ADDRESS t
o, +r
PHONE q,5`�55 - 7 Q V 7 EMAIL I
CONTRACTOR'S NAME I-aL� DWNERBUILDER? ❑YES10
BUSINESS NAME � + �
ADDRESS 51 Ll h I(
PHONE Jr� ^ _5-5-M3"? EMAIL
CONTRACTOR'S STATE LIC NUMBERS LICENSE CLASSIFICATION
VALUATION$ ? re-0 SQ FT D- ) L SO FT
APPLICANT'S SIGNATURE DATE - -
CITY STAFF USE e
DEPARTMENT U15TRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE I GREEN SMIP
INVOICE PAID AMOUNT
AMOUNT -- CASH 0 CHECK# !.)CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT <%CASH C.%CHECK# OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED "YES U NO DLNUMBER NOTARIZED LETTER YES NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6 77 7
www.cityofrnenifee.us Inspection Request Line 951-246-6213
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