PMT17-04417 City of Menifee Permit No.: PMT17-0"17
29714 HAUN RD.
�/--_CCEL/-? MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 1 211 31201 7
PERMIT
Site Address: 31590 NORTHFIELD LN,MENIFEE,CA Parcel Number: 358-234-023
92584 Construction Cost: $1,800.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL ONE PRE-FAB GAS FIREPLACE, GAS BBC, INSTALL GAS LINE, ELECTRIC LINE.
Work: *NO SINK ALLOWED IN THE OUTDOOR KITCHEN*
Owner Contractor
WARREN GRIFFIN JAMIE AVILA LANDSCAPE
31590 NORTHFIELD LN 27171 WICKERD RD
MENIFEE, CA 92584
Applicant Phone:9517575964
27171 WICKERD RD License Number: 836428
MENIFEE,CA 92584
Fee Description gtv Amount f81
Receptacle, Switch, Outlet&Fixture 5 136.00
Gas System 1 116.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 1.00
General Plan Maintenance Fee-Plumbing 1 5.80
General Plan Maintenance Fee-Electrical 1 6.80
$293.60
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 building operations being carded 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
with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjurythat I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from Iicensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. t7 the following reason:
License Class�'Lq Lice se- . _p 3? l 2 0 B m signature below I acknowledge that,except for m y y g g p y personal residence
Expires Signatu in which I must have resided for at least one year prior to completion of
improvements covered bythis permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION Eperjurvy
have built as an owner-builder if it has not been constructed in its entirety by
D I hereby affirm under penalty 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 workers 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.gov/calaw.htmI.permit is issued. k
Policy# Date
D I have and will maintain workers compensation Insurance,as required by
PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which okay my signature below I certify to each of the following:I am the property
this permit is Issued.My workers compensation insurance carrier and policy 6wner 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
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy# �r� Expires ab tified property for inspection purposes.
(This section need not to be completed is the permit Is for one-hundred Dater
dollars($100)or less 2OP 7tUTHORIZED AGENT
certify
❑I rtify 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#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worke c p�Icy rovisions of Section 3700 of the Labor
Code,I shall a wit ompl tC f se provisions. Will the applicant or future building occupant handle hazardous material or a
Ap Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
ARN Nd I O CURE WORKER'S COMPENSATIO COVE GE IS ❑Yes XNo
UNIA L,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
A IVIL 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(SCAOMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes tdo
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 boupdary of a school?
(Section 3097 Civil Code) ❑Yes a
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjurythat I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors 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 7031.5 ha ardous a eporting.
Business and Professions Code).Any city or county that requires i permit to s�N
construct,alter,improve,demolish or repair any structure,prior tp its Date
issuance,also requires the applicant for the permit to file a signed statement UTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION.REPAIR AND PAINTING IRRPI
Ucense 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 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
❑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.epa.gov/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 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:
o I,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.
r � ffrY 3 IF�J''YY SSFj� �. . •
1 _
DATE: PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL AESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA OSIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING ORE-ROOF NUMBER OF SQUARES I
DESCRIPTION OF WORK } C 1 h
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER LOT TRACT'
OWNER NAME
ADDRESS $ 99/�// r I P
PHONE QyCJ 16A_ oz :3 EMAIL
APPLICANT NAME r /
ADDRESS JC y � H { (. 9g5,751
PHONE �S� S S �� EMAIL N InOD D
CONTRACTOR'S NAME imil,0014 d OWNER BUILDER? O YES KO
BUSINESSNAME
ADDRESS 4CZ / dje2I ,
7 r
PHONE ��Js7 ^s , �/ EMAIL
CONTRACTOR'S STATE LIC NUMBER 3? LICENSE CLASSIFICATION
VALUATION $ f Q SQ FT L SQ FT
7
APPLICANT'S SIGNATUR DATE 2
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSENUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED B 1 ci 05,
PERMIT FEE .ePO SMIP GREEN ,
PLAN CHECK FEE INVOICE TOTAL
OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE if NOTARIZED LETTER 0 YES 0 NO
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`Approval of these plans shall not be construed to be a permit for,or an `
approval of,any violation of any provisions of the federal,state or city
regulations aniWinGnces. This set of approved plans must be kept on the
jobsite until completion.
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ISOMETRIC VIEW
58 3/4
30 3/4 I~ 26 3/4
74 1/2
40
10 1/2
h731/4 ►� �— 31 1/
76 33
FRONT VIEW LEFT SIDE VIEW
73 1/4
12 3/4
3 1/2
3 1/2
24 1/4 31 1/4
NOTES: i
1.6"MAX HEIGHT ON All 5MAIPS.
2.vtc:1/2"=1'-0" STUB-UP DIAGRAM UTL STUB-UP AREA
3 MIVON:04/2012 (SEE NOTE#1)