PMT17-04305 City of Menifee Permit No. PMT17-04305
29714 HAUN RD. Type: Residential Re-Roof
'CACCEUA MENIFEE, CA 92586
MENIFEE Date Issued:
12/05/2017
PERMIT
Site Address: 27165 DAHLIA CT, MENIFEE,CA 92586 Parcel Number: 335-362-001
Construction Cost: $18,400.00
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING COMP SHINGLES, REROOF W/OWENS CORNING COOL ROOF IN AMBER
Work: CRRC#0890-.0014
Owner Contractor
NANCY LETHER ARCADE CURVES ROOFING
27165 DAHLIA CT P 0 BOX 9442
MENIFEE, CA 92586 ALTA LOMA, CA 91701
Applicant Phone:9493382869
DOMINIC VASQUEZ License Number:797664
ARCADE CURVES ROOFING
P 0 BOX 9442
ALTA LOMA, CA 91701
Fee Description 01t r Amount IS)
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 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_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).
Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full fo and effect, the following reason:
License Class By my signature below lacknowledge that,except for my personal residence
Expires r31_1 Signature is a 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 DECIARAT
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 Cade,for the performance of work for which w,,,sw.leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
41 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 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.l authorize representatives of this city or county to
Policy# 'Z �y 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
a I certify that in the performance of the work for which this permit is issued, 0
e7 /_
I shall not emoloy any persons in any manner so as to become subject to the CITY BU51NESS LICENSE#
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to ��the w s p p t com n provisions of Section 3700 of the Labor
Code,I sha :hwith comp) vith hose provisions. /�-� Will the applicant or future building occupant handle hazardous material or a
Applicant Date `Z ' / mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAIL E WORKER'S COMPENSATION COVERAGE IS o Yes &-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($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(SCAQM D)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY oYes 00
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 "o
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 m requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health afe coon 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazard rting.ous ate epo /^
Business and Professions Code).Any city or county that requires a permit to oYes o o — ! -/
Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNE1R0—RAUThUdIZED 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 Contractors State EPA RENOVATION,REPAIR AND PAINTING fRRP)
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 owners and property
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.eovAead 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 D 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:
ct 1,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
,®- ,Menifee
DATE: PERMIT/PLAN CHECK NUMBER ' —O
TYPE: O COMMERCIAL *'RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION C ELECTRICAL O MECHANICAL
O NEW O PLUMBING $ RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK ✓� � �9s"�f_351 ,� �r�%S�IyGC c.u2S�
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER
JJ�PQ LOT TRACT
OWNERNAME G'��6
ADDRESS S'¢ --� E
PHONE 07T7— —� EMAIL
APPLICANTNAME
ADDRESS fS
PHONE EMAIL
EMAIL
CONTRACTOR'S NAME ��ac�d E c`�f2t/ES OWNER BUILDER? OYES 6NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE L`IC,NUMBER� � LICENSE CLASSIFICATION e
VALUATION$ L SO FT
APPLICANT'S SIGNATURE DATE 1"7
CITY STAFF USE.ONLY-. -
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY
PERMIT FEE SMIP GREEN _
PLAN CHECK FEE INVOICETOTAL
OWNER BUILDER VERIFIED ()YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29719 Noun Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.us
N ° e °, £ ' z
D
77]
M nm DO = om o 3 O
amu cn
O
_ mwo y n o a 1D °' °- m 0 s o fD ;u '. Pf > m n
a o 0 3 o, °c 5 m o m ° ' f° N D C D z r
c a z N m o m m S _r m m oT
3 o n m N m' - ."a R7
s 0, ^ o n mm � � m Z �D �^ z
m (1 m c o ^+ n n 9 'rl R O A D z_
n 3 o, x o m 'o a $ < Nis z o ❑ 9 (� O O- n r D
p m - D
O ago m n 01
z o °o a m o 2. 3 m
3, >
eT r v
z o, M i+ n o o V n m m 0
D m D y
O N p p, N w w D O w ^ Z
3 y T c _. i� 3 " o ♦ O = f1
O T O
3 = m N 2 ^ x s N m o a 0 E a y Z
`. CO)
m a T y a 3 m w o c a o ' » = a ao C_ sT1
O �• C M N < N R m m of n R N O
m s i » O "o N - p '-� = w m 'n' n ❑ \ z m
m. Q N 3 '. o n n n c m o .�-, ri o N' O
3, c n w a o v� °' 3 0 o rN.� 3 n °° i > > .c-. O
m m n o �' °� m £ om, 3 £ i+ ° a N 2 N n a T mZl
3 n y a s N a N n C o• m m m _.
m o ¢
3 m e < f1
o Jnc j m n 'o G p n •=c N ° m n £
n9 �° p„ w
y 3 0 ^ ° o 0 a o
c ° v 3 0 -' Z-
r, 0
3 N N °° z o w .m. p' 3
o N N 0 ° Oy O m a°. �. x c
o
'm iR
o ry o v 5 m N
m =j o
n � -
oo n m N m m
n _ o n F+ m
a
p ^' A m N � 3 (�j�
D < m m n D G
w ME .. ^ m n f0 c N m a m m o D o O
a
an d m 3 v o ° °• m oID
. �..J
0 ID
3
RL
3 _
m a' a c m 3 3 w c m °-'
O
o. z o
m n o N m M
w —
a n m o o- N F p
a 'm o m
m o n Uy 1A1'JI V '++
c m
n x a
ma
S ^ m (mI N N m °
3 3 m o y o o E
D
d m N o £ O
o �d m mm
�• m c 5 p m o 0 3 s 3 z
m e w u�i u�i
w 'O m n
T n d A
F+ 0922 i
o a „ O ?. u N z�1 z
x _ G)
J m
m
n a n z o lu
O. O d — O z
G N d d c O
<' •2 m
0 o N c c n n� m m
c c c m m m o >• m "' m o A z
° 3; O o 0 3 3 3 a. a d d n n o •� a n p
a •tf G z o �n v z .. to _ D �D, .tee n
T i N r 0 o o n. fl
c _ v E. S. F a ^ µ c °'. ti c m w ewe•
o_ z
O 3 5. = 1D c m 'n •�D^ �^ o O 3 '°" J• w ;o .* Z
a z c m m » w 3 T °: °' °' m A N x z z z A •*.
J »
3 n n o J n a o 0 0 p
Hp Z N rt O GV N �p 3 VO Q N 6 �.
J F J d 3 N wO N C YI
q d .Z d _ d J ^� N N w w N O d = O u vdi udi •T
c -ini 3 0- J m d m s ry n f0 x m m H » d d A O
d
T ^ d
N y o o N
n p_ y v » ° m o n J 3 m o w
3 v N °' T J- < < O
a v a O a a N J ^o m " ° m N d n w
a
:' ❑ a .c. n T m o fl c m o m
O
^ o H J F
N m
j, ❑ a .o an d J w O o A i s w H m A x `'•
m c d n ^ 0
o i � •� 0- oo O. ° n n T N
o .00, Q. o w
o o o• W o d _ ° •2 m F+
• � �^ N m u z � D F a �: z o, c o s 'm o
•N J N N U m N A = A 0 0. d »
» p n n d a
.. •A ° a d 0 M
.H n n d ^ N N N O .Z•
O O O d C _T N n m N D_ - C O
2 J J
d D 9 p < n c Ei m O n
00.
c O ^ D N Z
o a v M 0 y 3 o d m o z
O v n to N K n d a
m '^. 'Z m m »
N y C n •- d J •� N N O :O O- £ •C
p N ct w S w Q Cy w S
ry j O
i ir 3 0 a o w o
R
11j\f a o
J
�-
a
O V Ul
a
o c
o, N
W C
0
to v O 1�
T
m d p C 6 O N •"�
d ^1 d d N O
2 J N n N G I•a
N
zw_ y < m
m 3 m y m
m O
O
N N O T
o N G1
n i
d