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PMT17-04341 City of Menifee Permit No.: PMT17-04341 29714 HAUN RD. �A_CCEL/ MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 12/08/2017 PERMIT Site Address: 30640 LONE PINE DR, MENIFEE, CA Parcel Number: 358-691-004 92584 Construction Cost: $2,700.00 Existing use: 1 &2 Family Residence Proposed use: Description of INSTALL 12'X 27'SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 1 FAN, 5 LIGHTS Work: Owner Contractor JARED BRYSON TODD'S PATIO COVERS 30640 LONE PINE DR 30905 GREENSBORO DR MENIFEE, CA 92584 TEMECULA,CA 92592 Applicant Phone:9516608665 TODD SKARIN License Number:834251 TODD'S PATIO COVERS 30905 GREENSBORO DR TEMECULA,CA 92592 Fee Description 01t rr Amount ISI Receptacle, Switch, Outlet&Fixture 6 141.00 Building Permit Issuance 1 27.00 Deck/Patio, non-standard 1 133.00 GREEN FEE 1 1.00 SMIP RESIDENTIAL 1 1.00 General Plan Maintenance Fee-Building 1 6.65 General Plan Maintenance Fee-Electrical 1 7.05 $316.70 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_Perrnit_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 force and effe the following reason: License Class . L Uce se lo. LJ By my signature below l acknowledge that,except for my personal residence Expires Stgnatur 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 ❑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.IeRInfo.ca.Rov/caIaw.htmL this permit is issued. Policy# Date o 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 '*OBy 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 numberare: application and the information I have provided is correct.I agree to comply With all applicable city and county ordinances and state laws relating to Carrier building construction.Lauthorilze representatives of this city or county to Policy# Expires ente Z iden ed property for Inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($100)or less Date RAUTHORIZEDAGENT �I certify that in the performance of the work for which this permit is issued, Ishallnotemoloy 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 com ensation provisions of Section 3700 of the Labor Code,Ishall to hw'h y with those provisions. Will the applicant or future building occupant handle hazardous material or Applica Date ZS mixture containing a hazardous material equal to or greater that the -mount specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes o No UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the ntended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupa require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast At Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guich lines CONSTRUCTION LENDING AGENCY ❑Yes iNo I hereby affirm that under the penalty of perjury there is a construction Will the roposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer ndary of a school? (Section 3097 Civil Code) o Yes No OWNER BUILDER DECLARATIONS I have re d the Hazardous Material Information Guide and the SCAQMD l hereby affirm under penalty of perjury that l am exempt from the permittin checklist.I understand my requirements under the State of Contractor's License Law for the reason(s)indicated below by the California ealth&Safety Code lion 25505 and 25534 concerning hazacheckmark(s)I have placed next to the applicable item(s)(Section 70315 Dyes 0 mate' I oyes o Business and Professions Code).Any city or county that requires permit to � Date G(� construct,alter,improve,demolish or repair any structure,prior to its PROPER ER R ORIZED 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(RRPI License Law(Chapter9(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 ❑1,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 1-800-424-LEAD(5323). Code,The Contractor's State License Law does not apply to an owner of a oAn 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: D 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 ON Menifee DATE: iZZO PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL % RESIDENTIAL O MULTI-FAMILY i> MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION C ALTERATION O DEMOLITION C) ELECTRICAL O MECHANICAL O NEW O P- /L►UMBING RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK IZ1 r ( ( 11 (,(, LCaW owo f OJECiADDRESS D ND L4 ivis__ r. ZIP ASSESSOR'S PARCE NUMBER ?619- (c2l FOCI LOT TRACT' 52Q2B OWNERNAIM�E �Q ✓ V tS'Ov1 ADDRESS n cll�oIy Liu 1✓�- �C.. PHONE % 9 7o _ wAp )�EM�AIL APPLICANT NAME -radd S ft(,l q9�9 ADDRESS p3V r 26" /A- / z- I z— PHONE I'Q (040`- t,(,4C' EMAIL d01Cj dL jk7 KJ k00. C0*11 CONTRACTOR'S NAME f rn•\ `OWNER BUILDER. O YES NO BUSINESS NAME 1d S QL O W ADDRESS 3G Q Sl�JO ✓0 Y IIF S PHONE -/5I `0 — �j (0� ] EMAIL +0 syArl ll 00.CQ CONTRACTOR'S STATELIIC NUMBER 31 CA N Z LICENSE CLASSIFI LI VALUATION $ 100 SO L SO FT APPLICANT'S SIGNATURE p DATE . .1�vr DEPARTMENT DISTRIBUTION ACCEPTE B �. CITY OF MENIFEE BUSINESS LICENSE NUMBER D Y'- - BUILDING PLANNING ENGINEERING FIRE PERMIT FEE �� SKIP GREEN PLAN CHECK FEE INVOICE TOTAL 51(0.--70 OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE H NOTARIZED LETTER 0 YES O NO ",1 e "714 Haur Rd. Me^riee. C4 92586 951-672-6777 i a 1- *� o CU ( � v m vv x Rh EL D T Er m � z _ �_ -_ 7 Mil I �