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PMT17-04000 City of Menefee Permit No. PMT17-04000 _ 29714 HAUN RD. �J- Type: Residential Addition ccEL/-> MENIFEE, CA 92586 MENIFEE Date Issued: 11/07/2017 PERMIT Site Address: 30329 COBURN CIR, MENIFEE, CA Parcel Number: 368-720-030 92584 Construction Cost: $23,500.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 14'X 35'SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 2 FANS, 30 L FT OF 3/4" Work: GAS LINE,30 L FT ELECTRICAL LINE FOR FUTURE USE Owner Contractor JOHN &MAUREEN CLINGINGSMITH 30329 COBURN CIR MENIFEE, CA 92584 Applicant License Number. JOHN&MAUREEN CLINGINGSMITH 30329 COBURN CIR MENIFEE,CA 92584 Phone:9516728442 Fee Description Qtv Amount($1 Receptacle, Switch, Outlet&Fixture 3 126.00 Plumbing Fixtures and Vents,fixtures 1 116.00 Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 4.00 General Plan Maintenance Fee-Building 1 6.65 General Plan Maintenance Fee-Electrical 1 6.30 $419.95 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_Permit Templalexpt 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(commencingwith section 7000)of Division 3 of the Business and ❑I am exempt from liconsure under the Cgntrpactr,ors.State License Law for Professions Code and my license is in full force and effect the following reason: (�T h `�,(.t i.C/R3.71, License Class License No. By my signature below I acknowledge that,except for my personal residence Expires Signature I 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 COMPENSATION DECLARATION 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 far which this permit is issued. w .Ie info.ca. ov c aw.htmL Policy# to //-7-1 7 o I have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTH I 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:1 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 ant theahove identifi ropgrty far inspection p rposes. (This section need not to be completed is the permit is for one-hundred dollars($SOD)or less PROPERTY OWNER OR AUTHOR119D AGtNT 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 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,sPecified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes r)(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($1DO,ODD),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 for guidell�l'es CONSTRUCTION LENDING AGENCY ❑Yes V0 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 b ndary 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 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 HeaRh 8r So C n 25505 and 25534 concerning checkmark(s)I have placed nextto the applicable items)(Section 7031.5 hazardous material p i g. Business and Professions Code).Any city or county that requires a permit to 0 Dale -7— �, construct,alter,improve,demolish or repair any structure,prior to Its PROPERTY OWNER OR AUTHORIZED AGE 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 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 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 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( I portion of the work,and the structure Is www.e0a.eov/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 ❑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: ❑1,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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION City of Menifee Building Dept. , °Menifee Lill I _ O DATE: PERMIT/PLAN CHECK NUMBER TY RESIDENTIAL C MULTI-FAMILY C MOBILE HOME O POOL/SPA C SIGN SUBTYPE: ADDITION O ALTERATION C DEMOLITION X ELECTRICAL O MECHANICAL NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK PROJECTADDRESS __30 a4 CobLU(-n CI(-CjC ZIP q 8 ASSESSOR'S PARCEL NUMBER LOT TRACT 3 ' OWNERNAME I S y� f-eerl ADDRESS 30� orn I rCl e- m 2n l Ca qa PHONE 951 -LPU- FjLM� EMAIL ft Oct YYl d, czm APPLICANT NAME C ADDRESS 7 C Cif i C a PHONE 95i'(p7a- Ma EMAIL 7 L--l' O 5 I I- CDryI CONTRACTOR'S NAM QW OWNER BUILDER? YES NO BUSINESS NAME H I e Q eS ADDRESS I I i J eIj ave. # n Ca. cl 13W PHONE 9QQ - gt te —70&A EMAIL l�qe e M CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION C VALUATION$ 3 SO FT n L SO FT APPLICANT'S SIGNATURE XG4 ' ry 9 DATE //- 7-/7 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: PERMITFEE L- cS SMIP GREEN PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED O YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO City of Menifee Building&Safety Department 29714 Houn Rd. 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