PMT17-03950 City of Menifee Permit No.: PMT17-03950
29714 HALIN RD. Type: Residential Re-Roof
< -\CCEL/—\. MENIFEE,CA 92586
MENIFEE Date Issued: 1 110 212 01 7
PERMIT
Site Address: 29069 THORNHILL DR,MENIFEE,CA Parcel Number: 338-044-010
92586 Construction Cost: $6.000.00
Existing Use: Proposed Use:
Description of REMOVE 2 LAYERS AND REPLACE WITH COOL ROOF
Work:
MALARKEY
COLOR: DOVE WHITE
CRRC:0850-0014
Owner Contractor
RAY MERRITT
29069 THORNHILL DRIVE
MENIFEE,CA 92586
Applicant License Number:
RAY MERRITT
29069 THORNHILL DRIVE
MENIFEE, CA 92586
Phone:9512597211
Fee Description QYt Amount f51
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
Inspections not specified 131 130.90
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 11.45
$268.35
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 staled,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_Permp_Template.rpt Page 1 of 1
fee CITY OF MENIFEE
LICENSED DECLARATIONO�'Cfter eQt. property who builds or improves thereon,and who contracts for the projects
I hereby affirm undertvzK�jOury that I am under provisions of with a licensed contrector(s)pursuant to the Contractors State License Law).
Chapter9(commencing ex.a ection 7000J`ppf Division 3 of the Business and ( I am exempt from Ilcensure under the Contractor's State License Law for
Professions Code and my license's I�f�ll fgce and effect. the following reason: Q tZJ n 4.F—
License Class \1—License N By my signature below I acknowledge that,except for my personal residence
Expires Signature 1 in which I 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 COMPENSATI J have built as an owner-builder If It has not been constructed in its entirety by
❑I hereby affirm under pen ty 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. wwwieRinfo.ca.gov/calaw.htmi.
,
Policy# OWNERO/'tGY Date
PROPERI OR AUTHORIZED AGENT
❑I have and will maintain worker's compensation Insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which Q,'gy 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
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 entert above Identified property fforrriinnnssp/e-ction purposes.
(This section need not to be completed is the permit is for one-hundred ��%" " "^ Date
dollars($100)or less PROPERTY INVNER OR AUTHORIZED AGENT
❑I certify that In the performance of the work for which this permit is issued,
1 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 with 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 pecifled on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS DYes -dNo
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 Air Quality Management District(SCAQMD)?See permitting checklist
—IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES -— forguld Imes -- - --
CONSTRUCTION LENDING AGENCY ❑Yes t/fMo
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 bo ndary of a school?
(Section 3097 Civil Code) ❑Yes Eo
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 6y the California Health&Safety Code,Section 25505 and 25534 concerning
fy�zardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to es ji N��,�`2j�vv .,yeL Date �� /777
construct,alter,improve,demolish or repair any structure,prior to Its PROPERTY OWNER OR AUTHORIZED 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(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 pre-1978
nd 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
n Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
an($500). managers who do the paint-disturbing work themselves or through their
s owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
pensation,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 1-80D-424-LEAD(5323).
Code;The Contractor's 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-Bulider 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:
❑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.
Menifee fr%lk AV"din IN
DATE: a I PERMIT/PLAN CHECK NUMBE
TYPE: O COMMERCIAL {RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OFl �
tt" SQUARES
DESCRIPTION OF WORK P—C,yyL F p I t I YL Il(1 Q6 s
-ZtJ tit 3 0 w 1+✓�I I n
PROJECTAD ?
DRESS �19�(a� 7of r�4,I/ D�"+ ZIP ��lJ
ASSESSOR'S PARCEL NUMBER � � [� Q L_` LA (Q'-IOT 1 TRACT
OWNER NAME nQ /�Q r�L Q- J
ADDRESS/ \ `dam 1 Q LG' ` ` 1 6o f h I` d rP
PHONE l 1 ) -)--r7 q -7� ZI yy�� EMAIL '.�.�� r�` O� ' rC o
APPLICANT NAME /' RA 1 � rr
ADDRESS 3,1) 111 "t 1 p o w F. soA) Cn Cw �86
PHONE �-Lb 1� 15��7�1( EMAIL 2.' ' of i GOm
CONTRACTOR'S NAME OWNER BUILDER? YES O NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ r b SOFT g 6 Da L SQ FT
APPLICANT'S SIGNATURE M14 DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUStUCENSFBERACCEPTED BY:BUILDING PLANNING ENGINEERING FIREPERMIT FEE `Q SMIP GREEN
PLAN CHECK FEE INVOICETOTAL
OWNER BUILDER VERIFIED O YES 0 NO DRIVERS LICENSE# NOTARIZED LE NO
City of Menifee Building &Safety Department 29714 Houn Rd. Menifee, CA 92586 951-67pll,cling Dept.
wwW.Cityofinenifee.LIS NOV 2G'i7
Received
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PRINT E%PORTALLPRDOUCTS rez
WIC PROp.Ip MoNUiMfURER:RMNO PRopVCit1PE COLOR SOLNRFf1ECi.W[E iNW.W.FMrrfPXLE SRI MORE
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o85p'oo9 Malarkey Roofing Pmtlur4:Duna seal SteepSlope,Asphalt Bdghl Whee, o.26 018 o.ql p.g0 xy 33 +
Dovewh0e shingle: DeFwM1lle
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COOLROOF RATING COUNCIL qq9 15th Street,Suite 4cm TEL(866)465-2523 EMAIL:infpdcoolroofs0�
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http://coolroofs.org/products/results/search&keywords=DOVE+WHITE/ 11/2/2017