PMT17-03806 City of Menifee Permit No.: PMT17-03806
29714 HAUN RD.
<-AC MENIFEE,CA 92586 Type: Residential Re-Roof
MENIFEE Date Issued:
10125/2017
PERMIT
Site Address: 29514 OAKBRIDGE DR,MENIFEE, CA Parcel Number: 338-214-001
92586 Construction Cost: $10,000.00
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING ROOF, REROOF W/OWENS CORNING COOL ROOF IN ANTIQUE SILVER
Work: CRRC#0890-0011
Owner Contractor
JAMES BISHOP PROJECT ECO
29514 OAKBRIDGE DR 3309 KENNELWORTH LN
MENIFEE,CA 92586 BONITA, CA 91902
Applicant Phone:8584650626
JANE RECKTENWALD License Number:998875
PROJECT ECO
3309 KENNELWORTH LN
BONITA,CA 91902
Fee Description City Amount($)
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 carded 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 61dg_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).
Chapter!)(commencing with section 7000)of Division 3 of the Business and O I am exempt from Iicensure under the Contractor's State License law for
Professions Code and my license is in full farce and effect. the following reason:
License Class License No.ggss-IS By my signature below I acknowledge that except far my personal residence
Expires ��-?�t1-lam Signatures in which l must have resided for at least one year prior to completion of
Improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION
have built as an owner-builder if it has not been constructed in its entirety by
o 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 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.Ieeinfo.ca.goy1caIaw.html.permit is issued. a
Policy# Date
W have and will maintain worker's compensation 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 worker's compensation Insurance carder and policy owner or authorized to act on the property owner's behalf.I have read this
number are: application and the information I have provided is correct I agree to comply
Carrier �?_FH+fVy� C�fV521f"4' with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# �O�rk 1�� _Expires ��-oZ�� �� enter the above identffie rop rty ar inspection purposes. ^1
(This section need not to be completed is the permit is for one-hundred Date �U
dollars($SOD)ar less PROPERTY OWNER OR A HORIZED AGENT
o I certify that In the performance of the work for which this permit Is Issued, /
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
worker's.compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply
w flt�iose provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
APPlicant Date\6 -�V amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SEC RE WORKER'S COMPENSATION COVERAGE IS in Yes FNo
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the in/tended use of the building by the applicant arfuture 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)75ee permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines
Qua
CONSTRUCTION LENDING AGENCY j ❑Yes C.�lo
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) I o Yes 1,2cNo
OWNER BUILDER DECLARATIONS f I have read the Hazardous Material Information Guide and the SCAOMD
I hereby affirm under penalty of perjury that I am exempt from the I permitting checklist.I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the ` California Health&Safety code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable Items)(Section 7031.5 f hazardous material reporti
Business and Professions Code).Any city or county that requires a permit to 1 DYes �-7
Date
construct alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER O RIZED 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING JRRP)
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 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 work
firms and comply with
thanApplicant for a permit subjects the applicant to a civil penalty of not more required practices.This Includes rental property owners andproperty
than($500).
managers who do the paint-disturbing work themselves or through their
o 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-BOD-424-LEAD(5323).
Code,The Contractor's State License Law does not apply to an owner of a o 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. o No EPA Lead-Safe Certified Firm is required for this project because:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's 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.
c
_ T
DATE 10-25-17 PERMIT/PLAN CHECK NUMBER
TYPE: COMMERCIAL ✓RESIDENTIAL MULTI-FAMILY _ MOBILE HOME POOL/SPA SIGN
SUBTYPE: ADDITION .ALTERATION DEMOLITION C ELECTRICAL MECHANICAL
NEW - PLUMBING ARE-ROOF-NUMBEROF SQUARES-24--
DESCR: ';QN OF WORK -4/12. tear o existing material 25 year comp, 1 layer, new material j
50 y-e—arcomp, class A 24 squares, CRRC #0890-0011, Owens Corning
PRO, ADDRESS 2a5_t4_Qakbridge Dr Menifee, CA 92586
ASSESS,IR'S PARCEL NUMBER ..338-214-001 LOT TRACT D✓D�
I OWNER NAME James Bishop
ADDP- ,: 29514 Oakbridge Dr Menifee, CA 92586
PHOUL 661-965-9812 EMAIL
APPLICANT NAME Jane Re�lc enwald
ADDRE:r
PHONE 714-336-6159 EMAIL
CONTRACTOR'S NAME Protect Eco OWNER BUILDER? YES VINO
BUSIN!>;NANIE Pro'ect Eco
ADDRES`- 3,309 Ken Ln Bonita CA 91902
PHONE $58-465-0626 EMAIL
CONTRACTOR'S STATE LIC NUMBER 998875 LICENSE CLASSIFICATION B C39
VALUA` C'NS t0j006 .CSC r _ LSO FT
APPLICANT'S SIGNATURE DATE
i
DEPi.4 1 DISTR'BUTICN I CITY OF MENIFEE BUSINESS LICENSE NUMBER
eU"O' vIaNG E}:GINEE.RNG FIRE I GREEN I SHIP
IMu._: PAID AMCIUNT I
AI10l ✓ O' CASH - CHECK- :CREDITCARD VISA/MC
CHECK FEES PAIDAMOUNT CASH 0 CHECK- "CREDITCARD VISA/MC
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•, pyt;N: __R VERIFIED YES NO DL NUMBER NOTARIZED LETTER = YES G NO
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