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PMT18-00104 City of Menifee Permit No.: PMT18-00104 29714 HAUN RD. Type: Residential Electrical <A-CCEL/k� MENIFEE, CA 92586 MENIFEE Date Issued: 01/0 812 01 8 PERMIT Site Address: 26259 LEOS TR, MENIFEE, CA 92586 Parcel Number: 335-510-039 Construction Cost: $500.00 Existing Use: Proposed Use: Description of INSTALL ELECTRIC AND GAS LINES TO FIREPIT.INSTALL BREAKER 110 FOR PREFAB FOUNTAIN. Work: Owner Contractor VERNON&VALERIE PORTER JILL LESLIE PRICE 26259 LEOS TRAIL 33142 OCEAN RIDGE MENIFEE, CA 92586 DANA POINT, CA 92629 Applicant Phone:9493104661 JILL PRICE License Number.555351 JILL LESLIE PRICE 33142 OCEAN RIDGE DANA POINT, CA 92629 Fee Description O—t Amount i$1 Receptacle,Switch, Outlet&Fixture 3 126.00 Plumbing Fixtures and Vents,fixtures 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 5.80 General Plan Maintenance Fee-Electrical 1 6.30 $282.10 The issuance of this permit shall not prevent the building official from thereafter requiring the corection 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_Sldg_Permk_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 I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter9(commencing with section 7 0 0)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License Law for Professions Coddg and my licenseis in II rce and effect. j the following reason: � License Class v� I ice e No � _. � / By my signature below I acknowledge that,except for my personal residence Expires 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 DECLARATIO have built as an owner-builder if it has not been constructed in its entirety by ❑I hereby affirm under penalty of perjury o 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 s„h,,,t,,le¢info.ca:eov/calaw.html. this permit is issued. \,h A `^ '77 Policy# -�lu4' e t ' D V� L ��a S-3— Date ❑I have and will maintain worker's 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 worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: 1 ` _ application and the information I have provided is correct.I agree to comply Carrier U' 11•"Clnv with all applicable city and county ordinances and state laws relating to �� 11 G building construction.I authorize representatives of this city or county to b W Policy# �ba�3 Expires enterthe 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 ❑1 certl that in the performance of the work for which this permit is issued, I shall n e to any persons in any manner so as to become subject to the CITY BUSINESS LICENSE It worker's mp sation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to t w kefs m ensa 'on provisions of Section 3700 of the Labor Code,I shallf h it co ywi t s rovisions. Will the applicant or future building occupant handle hazardous material or Applicant Date mixture containing a hazardous material equal to or greaterthat the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILU E TO CU ORKER'S MPENSATI N COVERAGE IS ❑Yes N-A.0 UNLAWFUL,AN S AL SUB1ECr AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FINE U TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO E OST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 37 F THE LABOR CODE,INTEREST,AND ATTORNEYS FEES ____for-guidelin CONSTRUCTION LENDING AGENCY ❑Yes 0 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 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 a list.I understand my requirements under the State of Contractor's License Law for the reason(s)indicated below by the California H alth Safety Code,Section 25505 and 25534 concerning hazar us m teria port' g. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes o 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 PROPERTY OW R A T IZ E T issuance,also requires the applicant forthe permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVAT ON EPAIR A PAINTING IRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Reno on,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( )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 Contractor's 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 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 licensed contractors to mnstmct the project(Section 7044,Business and Professions Code:The Contractor's 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. milr. 4 N I, rr a • a ...,, DATE: PERMIT/PLAN CHECK NUMBER 1TIM- I Ob -vo I a TYPE:. O COMMERCIAL PRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O.POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION /ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OFFSSQJUARES DESCRIPTION OF WORK GtQ�(A Q O 11D 6/ PROIECTADDRESS 2-(DZ� LQ.,D,j ZIP ASSESSOR'S PARCEL NUMBER �� ^V3q/ LOT � � U TRACT O OWNER NAME \k yr ov- 1 _ o- ✓tQ t)44-e ADDRESS 2,cpZ S 2 LSWS �C�rti\ 1 �U.1^ GL PHONE r41-1PA ^ ")3°,' �Z��j EMAIL �� l` APPLICANT NAME 1 ADDRESS 7l `+7i IJ L�i(.\,h V k I I PHONE ul D l L� LC EMAIL CONTRACTOR'S NAME I -) C r OWNER BUILDER? O YES NO BUSINESS NAME 1' I Cie O ADDRESS !+�j � LL2 4 ,A PHONE G L'I L(;4 EMAIL CONTRACTOR'S STATE LIC"�\\N B R j`l� ��I LICENSE CLASSIFICATION VALUATION$ V S L SQ FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY ITI _ _ DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERIN FIR ACCEPTED BY: PERMIT FEE v SMIP GREEN PLAN CHECK FEE INVOICE TOTAL OWNER BUILDER VERIFIED ";YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO L FP — �, re l l ab Fowr� 5L I } SOD ? i9v a. -- T O { P 1. RESIDENCE city of Menffee ' f 7��iSG1 l P.aS Buildfns Dept. CP s E JJ � JAN 0 F 20 Received .111 OF MENIFr.L .1 50 BUILDING AND SAFETY DEPARTMENT 010* i 1'±_AN APPROVAL �•fd REVIEWED BY Dollab DATE r- "ApprovaI of these plans shall not br construed to be a permit for,or an approval of,any violation of any provisions of the federal,state or city regulations and ordinances. This set of approved plans must be kept on the jobsite until completion.