PMT18-00003 City of Menifee Permit No.: PMT18-00003
29714 HAUN RD. Type: Residential Addition
�ACCELA? MENIFEE,CA 92586
MENIFEE Date Issued: 01102/2018
PERMIT
Site Address: 30268 CHERRY OPAL LN, MENIFEE, CA Parcel Number: 360-820-013
92584 Construction Cost $3,355.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 21'X 12'SOLID ALUMAWOOD PATIO COVER AND ONE 1 TX 8'SOLID ALUMAWOOD
Work: PATIO COVER CONTINUOUS WITH 1 CEILING FAN.
Owner Contractor
LEE TATE STEVE BENDORF CONST
30268 CHERRY OPAL LN 28493 BAUVARDIA WAY
MURRIETA, CA 92563
Applicant Phone:9516791502
STEVE BENDORF License Number:610842
STEVE BENDORF CONST 28493 BAUVARDIA WAY 'j J 14
MURRIETA, CA 92563 1
Fee Description 01t r Amount IS)
Receptacle,Switch,Outlet&Fixture 1 116.00
Deck/Patio, non-standard 1 133.00
GREEN FEES- - 1 1.00
SMIP RESIDENTIAL 1 1.00
General Plan Maintenance Fee-Building 1 6.65
$257.65
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 staled,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_Bidg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contacts for the projects
I hereby affirm under penalty of perjurythat 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 o I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class 1; Ucense No..to S By my signature below l acknowledge that,except for my personal residence
Expires 2-25-I9Signature in which 1 must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
" have built as an owner-builder if it has not been constructed in its entirety by
o 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 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.Ieefnfa.ca.eov/calaw.html.
this permit is issued.
Policy# Date
o 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 o By my signature below I certify to each of the followini.l am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
numberare: 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 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
o I certify 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 workers compensation provisions of Section 370D of the Labor
Code,I shall forthw' ompl with thos provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant /6 Date g-�-2-�� mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes o No
UNLAWFUL,AND SHALL SUBIECTAN 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 occupant Quality Management District(SCtionor See permitting frgn ecklist
South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES foast Airllnes
Qua
CONSTRUCTION LENDING AGENCY - oYes ❑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) D Yes ❑No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury thatlam exempt from the permitting checklist l understand my requirements under the State of
California Health al Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 703L5
Business and Professions Code).Any city or county that requires a permit to oYes D No
Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNER OR AUTHORIZED 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(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 licemure 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-certiried 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($500). managers who do the paint-disturbing work themselves orthrough their
o 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-BOD-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a aAn EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. o No EPA Lead-Safe Certified Firm is required forthis project because:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement
PERMIT/PLANSAFETY A. . •
Menifee
DATE: PERMIT/PLAN CHECK NUMBER —
TYPE: O COMMERCIAL B RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: XADDITION O ALTERATION 0 DEMOLITION O ELECTRICAL -- MECHANICAL
O.NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK �)\kjrr
, Atp
8
PROIECTADDRE55 3m2_(,`6 ZIP
ASSESSOR'S PARCEL NUMBER �rjO-820 -(}/3 LOT TRACT
OWNER NAME —T
ADDRESS 26g t✓',-�'�. '"�
PHONE L�6� _�'�2..-.\ '��- EMAIL
APPLICANT NAME S
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME `�' /�`, OWNER BUILDER? O YES®NO
BUSINESS NAME
ADDRESS
PHONE
CONTRACTOR'S STATE LIC NUMBER 10 g 2 LICENSE CLASSIFICATION
VALUATION$ SQFr jZ��(211 - �, x111 LSQFT
APPLICANT'S SIGNATURE i DATE -Z-
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTE B CITY OF MENIFEE BUSINESS LICENSE NUMBER
D
BUILDING PLANNING ENGINEERING FIRE
PERMIT FEE Z7W SMIP /, GREEN PLAN CHECK CHECK FEE INVOICE TOTAL !/c�
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586951-672-6777
www.ci tyo finenifee.us