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PMT17-04382 City of Menifee Permit No.: PMT17-04382 29714 HAUN RD. Type: Residential Addition <AtCCEL/-> MENIFEE,CA 92586 MENIFEE Date Issued: 1 2/1 212 01 7 PERMIT Site Address: 31922 ROUGE LN, MENIFEE,CA 92584 Parcel Number: 372-502-001 Construction Cost: $2,875.00 Existing use: 1 &2 Family Residence Proposed Use: Description of INSTALL 24'X 10'ATTACHED SOLID ALUMAWOOD PATIO COVER WITH 1 FAN AND 1 OUTLET. Work: Owner Contractor NATHAN BANUELOS PSLQ INC 31922 ROUGE LANE 28910 RANCHO CALIFORNIA RD MENIFEE, CA 92584 #206 Applicant Phone: 9517954260 PSLQ INC License Number: 919885 28910 RANCHO CALIFORNIA RD #206 TEMECULA,CA 92590 Phone:9517954260 Fee Description Oft Amount(s) Receptacle,Switch, Outlet& Fixture 2 121.00 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 6.05 $295.70 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_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who canlracts 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(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's Slate License Law for Professions Code and y license is in full force and effect. /J f the following reason: License Class, License h .. 7 By my signature below l acknowledge that,except formy personal residence Expires VM-)% Signature in which I must have resided for at least one year priorto completion of improvements covered by this permit.I cannot legallfsell a structure that I WORKER'S COMPENSATION DECLARATION7VfT have built as an owner-builder if it has not been canstmcted in its entirety by a 1 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 forworkers 7044 of the Business and Professions Code,is availabkupon request when compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following weluite: by Section 3700 of the Labor Code,for the performance of work for which w„�,w.le=info.ca.eov/calaw.latml. this permit is issued. Policy If Date jad'faave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Cade,for the performance of the work for which O By my signature below I certify to each of the follavdng:I am the property this permit is issued.My worker's compensation insurance carder and policy owner or authorized to act on the property owners behalf.I have read this number are: ,r application and the information I have provided is correct.I agree to comply Carrier CNC- with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy# 1/50 3 0 Z 5 2— Expires L) $ 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 ❑I certify that in the performance of the work for which this permit is issued, r��' l Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# \ )Z_"Y.Yt workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker'skompensation provisions of Section 3700 of the Labor Code,I shall fortl mplywiththose arovi ' 1. Will the applicant or future building occupant handle hazardous material or Applicant Date 3 ' ► b' !� mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE O SECURE WORKER'S COMPENSATION COVERAGE IS o Yes r>�r. UNLAWFUL,AND SHALLSUBJECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building bythe applicanlar 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)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidellnes CONSTRUCTION LENDING AGENCY a Yes V,14o 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 bound�s of a school? (Section 3097 Civil Code) O Yes sago OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD 1 hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardous material r oru checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 es ❑No 1 Business and Professions Code).Any city or county that requires a permit to Date construct,alter,Improve,demolish or repair any structure,prior to its PROPERTYOWtE ,G AUTHORIZEDAGENT 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(RRPI 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 themselvesor 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.epa.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 ❑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 far 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. D No EPA Lead-Safe Certified Firm is required for this project because: a 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. j BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION DATE: PERMIT/PLAN CHECK NUMBER P- 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 OF SQUARES DESCRIPTION OF WORK 7t' c1,Qc� a ) � Qy.Qc dvvH u D PROJECTADDRESS 51W il.4US� Ln ZIP L ASSESSOR'S PARCEL /NUMBER '3�a•G • O(7 LOT TRACT /V OWNER NAME 4N r�o nv 4 1oS ADDRESS c m PHONE �CQ- � �,�- O�jpj3 EMAIL I ildingDept. APPLICANT NAME o J, ADDRESS PHONE // EMAIL R.ece•ve CONTRACTOR'S NAME n& OWNER BUILDER? O YES OO BUSINESS NAME ADDRESS PHONE 9 51-;3q 0356 EMAIL �J CONTRACTOR'S STATE LIC NUMBER 5 LICENSE CLASSIFICATION �/(} VALUATION$ 5 , SQ FT L SQ FT a APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: PERMIT FEE �0 ,� SMIP GREEN PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE N NOTARIZED LETTER O YES O NO city of MenWee BUiiding pePt• - DEC' i'2 :201 : Received LEDvI.ER & 'TRACK NSPEG410N REQUIRED 141 3E) (1011 0 m x < n v �E � D O as i'di 3 0 it �NIFEE m c v i iJi ING AND SAFETY EPARTMEN M. a a LAI APPROVAL ) °g CA z D Vf N n IZ •�� z N -0 �n O P' rVI EDBY � 10 o o " DATE N N S o ' o rt °„' 3 of th a plans shall not be const ed to be a permit for,or an m 0 o a ;xoval of,any v lation of any provisions f the federal,state or city M m o r,,Lowions and or ances. This set of app oved plans must be kept on the z Y 6 " jobsite until comple n. `° m cn 0 Im (D r Q O r ' DfD � --- ----N- z z � D n w `�° w m m J N L N N D 1° O D T Cn C Z x rb > Ph City of Menifee x m Z C Building Dept. — ; m o o DCC it. 201; w N N V •* C a 3 1 1 T W 1-1�-0499 S ;�� erceive-O",