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PMT17-03591 City of Menifee Permit No.: PMT17-03691 29714 HAUN RD. <ACCEL/4> MENIFEE,CA 92586 Type: Residential Addition MENIFEE Date Issued: 10/10/2017 PERMIT Site Address: 28736 ARGO DR, MENIFEE, CA 92586 Parcel Number: 339-482-020 Construction Cost: $3,000.00 Existing use: 1 &2 Family Residence Proposed Use: Description of INSTALL IT x 29 SOLID ALUMAWOOD PATIO COVER, NO ELECTRICAL Work: Owner Contractor ROBERT MCQUIDDY CEBALLOS AWNINGS 28736 ARGO DRIVE 31151 SUNNY LANE MENIFEE, CA 92586 HOMELAND, CA 92548 Applicant Phone: 7143219411 ALBERT CEBALLOS License Number:949791 CEBALLOS AWNINGS 31151 SUNNY LANE HOMELAND, CA 92548 Fee Description ,Qtv Amount ISI 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_Per ill 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 1 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 Iicensure under the Contractors State License Law for Professions Code and my license is in full force and effect. the following reason: License Class_! 6 - D(2 3 Uc n No. By my signature below I acknowledge that,except for my personal residence Expires C)7-I(^ g Signature in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION 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 this permit is issued. www.leginfo.ca.gov/calaw.htmi. Policy# Date o 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# 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 certify that in the performance of the work for which this permit is Issued, I hall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 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 f wit�h) co I with those provisions. �9 �z Will the applicant or future building occupant handle hazardous material or a Applicant "0 Lr.Ly 5 Date_10-10—t - mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes o 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($300,00(1),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)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY ❑Yes ❑No I 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 I hereby affirm under penalty of perjury that 1 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 Health&Safety Cade,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 hazardous material reporting. Business and Professions Code).Any city or county that requires a permit to °Yes o No construct,alter,Improve,demolish or repair any structure,prior to its Date issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER OR AUTHORIZED AGENT that he or she Is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRPI 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 Iicensure that disturbs paint in apre-1978 tt and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be receiving compensation for most work rk hertified firms 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.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 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 DATE: \o PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL ' ESIDENTIAL O MULTI-FAMILY 0 MOBILE HOME C%POOL/SPA OSIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL EW " PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK 1 t PROJECiADDRE55 4f_41 UL rncL. , CC ZIP C S ASSESSOR'S PARCEL NUMBER _(„� /I LOT TRACT OWNER NAME 2 Let 1 d ADDRESS lc C( G uiltlln9 & SafetY pe PHONE s 6 L{ gggq EMAIL APPLICANT NAME ADDRESS In P' PHONE 7i4 3i i c(y ll EMAIL CONTRACTOR'S NAME _ 64S 4w I, i c OWNER BUILDER? O YESkRIO BUSINESS NAME ADDRESS I L PHONE 7(4 321 qq it EMAIL CONTRACTOR'S STATE LIC NUMBER 9 q q Zq LICENSE CLASSIFICATION 003 VALUATION$ �pdo SO 1FT L SQ FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER ACCEPTED BY: BUILDING PLANNING ENGINEERING FIRE iUS PERMIT FEE U5 SMIP 1 _ GREEN I- PPLA N CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED 0 YES O. NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO