PMT18-00004 City of Menifee Permit No.: PMT18-00004
29714 HAUN RD. Type: Residential Re-Roof
<-�CCELJ� MENIFEE,CA 92586
o"""""wt" MENIFEE Date Issued: 01/02/2018
PERMIT
Site Address: 29790 AVIDA DR, MENIFEE, CA 92584 Parcel Number: 339-282-005
Construction Cost: $13,800.00
Existing Use: Proposed Use:
Description of LIFT 100 PERCENT&RELAY EXISTING CONCRETE TILE.
Work:
Owner Contractor
TED CASLER ARMOUR ROOFING
29790 AVIDA DRIVE 24372 KENTUCKY DERBY WAY
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone: 9517608029
ARMOUR ROOFING License Number: 984307
24372 KENTUCKY DERBY WAY
MURRIETA,CA 92562
Phone:9517608029
Fee Description ON Amount ISI
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_Bldg_Permit_Template.rpl Page 1 of 1
CITY OF MENIFEE
ICENSED 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 ❑I am exempt from licensure under the Contractors State License Law for
Professions Code aarnd my license is in full force and effect. the following reason:
L License Class - 13 ( License No. 3(2 By my signature below I acknowledge that,except for my personal residence
Expires 'U�O' Signature in which I 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 DECLARA1100rN 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 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.leginfo.ca.gov/calaw.htm).
this permit is issued.
7Poli dt Date
I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 37DO of the Labor Code,for the performance of the work for which ❑By 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 owner or authorized to act on the property owners behalf.I have read this
number area �, application and the information I have provided is correct.I agree to comply
Carrier `, �yli dt with all applicable city and county ordinances and state laws relating to
t'
building construction-I authorize representatives of this city or county to
Poliryg R65795sr Expires 5 -17-/r- 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,
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE p
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subjectto the workers compensation provisions of Section 3700 of the Labor
Code,lshall forthw' mply wi those provisions. Will the applicant or future building occupant handle hazardous material or
mixture containing a hazardous material equal to or greater that the
Applicant Date �O' '�� amounts sp e,peMd on the Hazardous Materials Information Guide?
WARNI AILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oyes
UNLAWFUL,AND SHALL SUBJECT AN 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 permitfor 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
- - - — - ------— - - - � for guideli
CONSTRUCTION LENDING AGENCY o Yes No
I hereby affirm that under the penalty of perjury there is a construction Will the propos d building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer bou ry of a school?
(Section 3097 Civil Code) ❑Yes o
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
Califor 'a Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the haz dous material reporting.
checkmark(s)I have placed nextto the applicable item(s)(Section 7031.5 es ❑
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 gR OWNER OR AdfHORIZED 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 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( I 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).
Cade;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovatorwill 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:
❑I,as owner of the property am exclusively contracting with IicenC�l����O{�f Mefllfee
contractors to construct the project(Section 70",Business and Prbfjl4�tlp9 Dept.
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
JAN U ZUli;Acknowledgement.
�An/1^11 /A 94
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
DATE: PERMIT/PLAN CHECK NUMBERFm-ni—coc- ]L4
TYPE: O COMMERCIAL RESIDENTIAL C MULTI-FAMILY O MOBILE HOME O POOL/SPA OSIGN
SUBTYPE: O ADDITION C ALTERATIO O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING RE-ROOF NUMBER OF SQUARES_
DESCRIPTION OF WORK CpAGJe-. `Le-- 1. aAj
PROJECT ADDRESS r)'L to w•{"'I/^ r _ ZIP 01-
ASSESSOR'S PARCEL NUMBER 3 l3 • ;Z LOT TRACT
OWNER NAME
ADDRESS �"(/ 71
PHONE (q6 ) ?R- -b EMAIL
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME asa ri l�('�1.In,- OWNER BUILDER? O YES tNO
BUSINESS NAME T
ADDRESS �+ // �T �vje t, Q
PHONE "l'S� 2 Lad"�O EMAIL c.Svvl ,Iv1..pyl,( R� .n4
CONTRACTOR' TATE LIC NUMBER 9 O 7r � ' 1 LICENSE CLASSIFICATION
VALUATION$ ��, SOFT v LSO FT
APPLICANT'S SIGNATURE DATE
CITYSTAFF USE ONLY _
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
PERMIT FEE 'BCD SMIP GREEN
PLAN CHECK FEE INVOICETOTAL
OWNER BUILDER VERIFIED 0 YES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES O NO
Laity of Manifee
Building Dept.
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