PMT17-04368 City of Menifee Permit No.: PMT17-04368
_ 29714 HAUN RD. Type: Residential Re-Roof
� EL/t_rCC MENIFEE, CA 92586
r„,..�.lk4kx " MENIFEE Date Issued: 1 211 112 01 7
PERMIT
Site Address: 26826 INVAREY ST, MENIFEE, CA 92586 Parcel Number: . 335-322-016
Construction Cost: $9,400.00
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING ROOF, REROOF W/BLACK DIMENSIONAL,ADD R-1 9 INSULATION TO ATTIC
Work: OF HOUSE,NOT COOL ROOF
Owner Contractor
JUDY MCNATT HOUSETOP ROOFING
26826 INVAREY ST 31760 BRIGGS ROAD
MENIFEE, CA 92586 MENIFEE, CA 92584
Applicant Phone:9516798369
RICH CARROLL _ License Number: 371783
HOUSETOP ROOFING
31760 BRIGGS ROAD
MENIFEE,CA 92584
Fee Description 2y Amount 1$)
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_81dg_Permg_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 1 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's5tate License Law for
Professions Code and my license is in full force and effect, 7 C 2 the following reason:
License Class Cz ` License No.
By my signature below I acknowledge that,except formy personal residence
Expires )Z Signature '� in which I must have resided for at least one year pdorto completion of
WORKER'S COMPENSATION DECLARATI J improvements covered by this permit.I cannot legallysell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
D 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 ,,,,r.leeinfo.ca.¢ov/calaw.html.
this permit is Issued.
Policy# Date
W'�iave 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 ci 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 /Z 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
�ertify,that in the performance of the work for which this permit is issued,
I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# ( 31fJJT
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 provisio s. Will the applicant or future building occupant handle hazardous material or
Applicant Date Z mixture containing a hazardous material equal to orgreater thatthe
amounts specified on the Hazardous Materials Information Guide?
WARNING:FaLURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D YesKo
UNLAWFUL,AND SHALLSUB1ECfAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant orfuture 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 tionor odiee permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo guid Coast
Air
CONSTRUCOON LENDING AGENCY ayes No
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 5wo
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&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7032.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to oyes W /
construct,alter,Improve,demolish or repair any structure,prior to its Date 2�
issuance,also requires the applicant for the permit to file a signed statement PROPEg INNER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RE OVATION,REPAIR AND PAINTING(RRP)
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 Itcensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7032.5 by residence or childcare facility to be RRP-certified firms and comply with
than
Applicant fora permit subjects the applicanttoa civil penalty of not more required practices.This includes rental property owners and property
than($S00). managers who do the paint-disturbing work themselves or through their
D1,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.eva.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 Contractors State License Law does not apply to an owner of a aAn 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:
D 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.
BUILDING • FETY PERMIT/PLAN CHECK APPLICATION
DATE: /Z /Il/7 PERMIT/PLAN CHECK NUMBER T yD
TYPE: O COMMERCIAL ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
;SUBTYPE: O ADDITION O ALTERATIIONN O DEMOLITION O ELECTRICAL O MECHANICAL
ONEW //OPLUMBING kf'/iEROOFNUMBEROFSQUU'AR//ES�47
DESCRIPTIO�N,�OFnWORK /?6-- ILdYJ ,/ U-f� TI
/ /�/[�.�/SO.✓ �'
A47
PROJECTADDRESS 9Z2�i �I�N••�,U.i�IY�de ,'c ZIP
ASSESSOR'S PARCEL NUMBER ✓✓✓.;,b{pLV� LOT TS TRACT
OWNER NAME
ADDRESS
PHONE ',23"/'�,lj Z) EMAIL
APPLICANT NAME lelc e &?,eA-GeIL
ADDRESS / 7&0 734/G S Q11 •
PHONE -7 EMAIL 00r I tAf COA-7
CONTRACTOR'S NAME Q/G1� rn / OWNER BUILDER? O YES O'NO
BUSINESS NAME (/•Sg7T/jA /COL/if/�i
ADDRESS
PHONE Ff(f'S —17/I EMAIL ✓Ir� I '/L gCO��I
CONTRACTOR'S STATE LIC NUMBER 3 7/7�'� /_ LICENSE CLASSIFICATION
VALUATION$ �i 7 UC7 SO FT L SO FT
APPLICANT'S SIGNATURE C-ZA% "' DATE
CITY STAFF USE ONLY _
DEPARTMENT DISTRIBUTION CITY OF fNIFEE QyJ51N[S$LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE O
ACCEPTED BY: ";50
PERMIT FEE : 1 SMIP GREEN
PLANCHECKFEE I INVOICETOTAL .9�0
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityof,menifee.us
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