PMT17-03841 City of Menifee Permit No.: PMT17-03841
29714 HAUN RD. Type: Residential Re-Roof
�14CCELI? MENIFEE,CA 92586
MENIFEE Date Issued: 10/27/2017
PERMIT
Site Address: 28545 AMERSFOOT WAY, MENIFEE,CA Parcel Number: 337-112-025
92586 Construction Cost: $11,500.00
Existing Use: Proposed Use:
Description of REMOVE EXISTING ROOFING AND INSTALL NEW COOL ROOF
Work:
OWENS CORNING
CRRC:0890-0013
COLOR:SIERRA GRAY
Owner Contractor
PAUL SANTIAGO RICK HART ROOFING
28545 AMERSFOOT WAY 38744 EXA ELY ROAD
MENIFEE, CA 92586 HEMET, CA 92544
Applicant Phone:9513267016
RICK HART License Number:833020
RICK HART ROOFING
38744 EXA ELY ROAD
HEMET, CA 92544
Fee Description ,O�t Amount tS)
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 building 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_Bldg_Perrnt_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 contractors)pursuant to the Contractors State License Law).
Chapter9(commencing with section 70001 of Division 3 of the Business and ❑I am exempt from licensure under the Contractors State License Law for
Professions Code and my license
a is in full force and effect. _ the following reason:
License pass - J Ucense J . � By my signature below I acknowledge that,except for my personal residence
Expires Signature in which I must have resided for at least one year priarto 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 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
this permit is issued. www.leeinfo.ca.gov/mlaw.htmi.
Policy# Date
(t I 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 ❑By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance carrier 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
Lanier C n with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy#L!G 5'j &5?—7/O (-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
O I certify that In the performance of the work o as to b this permit Is Issued, ..s/�104
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# �fYL]
worker's compensation laws V California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's coyriplinsation provisions of Section 3700 of the Labor
Code,I shall fo I A ly those provisions. :,/ /� Will the applicant or future building occupant handle hazardous material or a
Applicant Date /',; 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 t�(jJ0
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 Alt Quality Management District(SC construction
or See permitting checklist
IN SECTION 3706 of THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Airlines
Qua
CONSTRUCTION LENDING AGENCY ❑Yes 60
1 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 p�N0
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
Contractor's License Law for the reason(s)indicated below by the California Health&Saf ty Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material ortin .
Business and Professions Code).Any city or county that requires a permit to oyes O �� 1
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 PROPE1171V OWNER OR AUTHORIZED AGENT
that he or she Is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI
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 ownersand 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( I portion of the work,and the structure is www.epa.aov/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 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:
❑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 RAP rule please fill out the RRP
Acknowledgement.
a i �
DATE: 10/25/17 PERMIT/PLAN CHECK NUMBER M ! 1-1-0 0 u 1
TYPE: 0 COMMERCIAL WRESIDENTIAL 0 MULTI-FAMILY C; MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION 0 ELECTRICAL 0 MECHANICAL
O NEW O PLUMBING ORE-ROOF NUMBER OF SQUARES 31
DESCRIPTION OF WORK Remove existing roofing and install a Owens Corning Cool roof shingle
CRRC#0890-0013
PROJECTADDRESS 28545 Amersfoot Way ZIP 92586
ASSESSOR'S PARCEL NUMBER 15 i ia'605 LOT �� TRACT a54
OWNER NAME Paul Santiago
ADDRESS 28545 Amersfoot Way Menifee
PHONE 951-672-4715 EMAIL rooferhart@aol.com
APPLICANT NAME Rick Hart
ADDRESS 39744 Exa Ely Rd Hemet Ca 92544
PHONE 951-326-7016 EMAIL rooferhart@aol.com
CONTRACTOR'S NAME Rick Hart OWNER BUILDER? O YES s&NO
BUSINESS NAME Rick Hart Roofing
ADDRESS 28545 Amersfoot Foot way
PHONE 951-326-7016 EMAIL
CONTRACTOR'S STATE LIC NUMBER 833020 LICENSE CLASSIFICATION C 39
VALUATION$ 11500.00 SQ FT 3100 L SQ FT
APPLICANT'S SIGNATURE DATE 10/25/17
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: r, I /i
4 US
PERMIT FEE SMIP V IGYREEN
PLAN CHECK FEE INVOICE TOTAL
[OWNER BUILDER VERIFIED OYES 0 NO DRIVERS LICENSE H NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 ,ffl., f Menifea
L19t�1.. Ul*,if(f, t92586951-672-6777
www.cityofineni fee.us
w r.i n 3 D 0 3 C c c N 3 3 O w a' w 'n u0i 70 n m m
?. s ^ o r nd �� a S � Om n wv' aZ -{ � NOm
m w F 3 N 3 ro n e T N d 0 A N -� n R m V T_ ,9 0
O O ro rr N y p n m ° < O T w ^ D n
'» 0 9 0 M < O D d 0 J n 0 9 a 6 ur c V Z
m a n a < m 5 A ro r m
o m a ro m Z M m m z
3 m ^ Dz
m — r'o m n o �, n o' � CL
, 2 °' v m O ul r D
( Nso N ~ o z 3 ? n < r
ro m ti T m m o a m w' a O oa m 1 Oi 3 'm M
O 0 m m
�^ c c s on w '" c z °' Z s
o' Va 3 n po V < y Z —�
O s omd N0 ND 'ro• oc o'roao D»em 3Tf.Twp G ° o'a w wo°
\ Oy r
Rn
O m ro aw mo
Av w a z a =
0 D a 3
~O �
n N VI N O �/n yr V1 N f0 N �^ N 3C F
or
K N 3 ;T C o.p1 0 ° 3 0 o ram.•, 3 g °° e m 7 O
o' o °� m F oroi 3 -'<, i-+ 3 iv ° H (/`• v w RI
ro ° d in n w' ^ � .'°. m •+ w' a o o_ w 3 7 Z
tn' a r s T o d 2 ro c < 11
M x ro �° c p m goo
^�.. pOi F a o� m
0 t p 2. r
c m 3 H N w z o u :' 0 3 c <d m O
K 0 0 0 Q d
° ro N 0 n N F~+ W ro fD
= o
0 T o d F F d c s o a oe ro O
n °
O O J O O
n 3 �
m w D
d
rn y 3 S O. A m R L d N �♦ �l
°- c 3 m � v e l m — x -•
d
—
^I
r�-
ro n T a m c O
K]'C d j !• ro vclZ
Lx'O a m w m 3 m m
N m to V1 ro o ? 3, s3 z
w 3
Otl
T a n w 43
T T j S LU N M z
o D a d
5rA
e > zv n
N A N
N vTaaov ti T
m v' d D o S 3 3 3 0• o o Mu 00 0 � o c c a
C' >• O o 0 3 3 3 � n n � m n � n p '� n �
O byq m » A 9 N V Z N O
d �F1 .i N C 09 O a a .. A R F N OLL
aii
n A
a ° oT n °! •• O M
m
0. D D
N Z
J A m i J O R O. 0. 3 ; d N ° l m A Z A A w m
m F; 0 f J d ^� 3 N 00 3 w o N c J. >• N
m Z S = m O m +' R A a u N n
N N
d 3 m c ,�_, m n - m e -„ » h o $• d o. 0o m
a M 3 m o w
n A N aD ° = 3 a m roi" T
a �- ❑ 0 10 a' 'a° `—' o c m O o o n
O m m w 3 0 r , o o
A l c a 0 w m p " o m 'n_ m m �'
m n A n ? y
J. O mm a v c z a 3 3 d o m m
a� o a o o a o w mm o m a c e O
N O w N '
9 O O �" O N n
' � S C n M N D A la O
_ A O n w
m J m m Z
N � � m O d -°n M
V I$J o
8
T m s
» W m c d m
A d w
m 0
n n 3. Erd d o 2 �apl
N m d m o d 9 L
o v o GNC, x n n » N m ? w m f C d S
0 J T 9 0 F '
0 y
c 3 w a p e w a
o
U, S
a
N O V Of
CT ry j O O N J ry y = N
9-1
CT
d_
n d M
O
N
� o (m(�� m w 3 J O f1
Ac _
n
o'_
m
�G P -
.r,
n.>
`Z O II T D c N
J
n pi, Z
m