PMT18-00148 City of Menifee Permit No.: PMT18-00148
29714 HAUN RD. Type: Residential Addition
!\CCELA- MENIFEE, CA 92586
MENIFEE Date Issued:
0111 2/2 01 8
PERMIT
Site Address: 26739 OPALESCENT DR, MENIFEE, CA Parcel Number: 360-810-017
Construction Cost: $3,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL ONE 12'X 26'SOLID ALUMAWOOD PATIO COVER-NO ELECTRICAL
Work:
Owner Contractor
RON AND CYNTHIA BECKWITH PATIO GUY ALUMAWOOD CONTRACTOR
26739 OPALESCENT DR 41197 GOLDEN GATE CIR STE 108
MURRIETA,CA 92562
Applicant Phone:9513330056
LOIS MONTI License Number:872839
PATIO GUY ALUMAWOOD CONTRACTOR
41197 GOLDEN GATE CIR STE 108
MURRIETA, CA 92562
Fee Description Qtv Amount I51
Building Permit Issuance 1 27.00
Deck/Patio, non-standard 1 133.00
Additional Plan Review Plumbing 1 1.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 6.65
$168.65
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 slated,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
1 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 D 1 am exempt from licensure under the Contractors State License Law for
Professions Code aqs(my license is in full force and effec. the following reason:
License Class 99 JGJL Lice se �. `6' '.,.I By my signature below l acknowledge that,except for my personal residence
Expires •sJ /r_Signature / ,v vt fn whichlmust have resided for at least one year prior to completion of
v improvements covered by this permit.l cannot legally sell a structure that
WORKER'S COMPENSATION DECLARATION 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:) licensed contractors.I understand that a copy of the applicable law,Section
have and wfll 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
this permit is issued. www.leeenfo.ca.eov/calaw.htmL
Policy# Date
0I 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 ❑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 an the property owners behalf.I have read this
numberare•�� ) / application and the information I have provided is correct.I agree to comply
Carrier ! // &/!haa / a�� 1 / with all applicable city and county ordinances and state laws relating to
1 , building construction.I authorize representatives of this city or county to
Policy# �,(,7C$3j Expires ''"1 ( 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
01 certify that in the performance of the work for which this permit is issued, O �
Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall fo�rU6tw�f h comply with th se provisions. Will the applicant or future building occupant handle hazardous material or
Applicants \ ��Date mixture containing a hazardous material equal to or greater thatthe
amounts spec' Ed on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS Dyes m o
UNLAWFUL,AND SHALL SUB1ECfAN 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 requires permit for theconstroRion or modification from South
ADDITON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Aft Quality Management heconDistrict(SCtionor See permitting fro checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines
Qua
CONSTRUCTION LENDING AGENCY DYes o
I herebyaffirm that underthe penaltyofperjurythere Ise 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 boundaryof -school?
(Section 3097 ChM Code) o Yes D
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that l 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 Rem(s)(Section 7031.5 hazardous mat�e+-a reForUng.
Business and Professions Code).Any city or county that requires a permit to Dyes 0 tdo0
construct,alter,improve,demolish or repair any structure,prior to its tr Date
issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNER OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(ARP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most Painting
that disturbs paint in a preracto
and the basis for the alleged exemption.Any violation of5ection 7031.5 by receiving compor ensation
re for
mosty to eork that disturbs
ified paint
ico pre-19ply th
than
Applicant fora permit subjects the applicant taacivil 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
D 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.ena.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 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 ofsale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
0 I,as owner of the property,am exclusively contracting with licensed
contractors to construct the project(Section 7044,Buslness 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 Oil out the RRP
Acknowledgement.
PA-10 Gay
`may
DATE: PERMIT/PLAN CHECK NUMBER
TYPE: O COMMER�C�IAL +1ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA C SIGN
SUBTYPE: G"ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES T
DEPIPTIONOIWOR K 13 JIC 6.OLl L.Lfm�Gl� D D.I�
M7b - G le.
PROJECTADDRESS A%o 7A9 bQ41_J�SsrjsIvT DR ZIP
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME rC
ADDRESS
PHONE q oq• '7 1,o 7- 19 g/ EMAIL
APPLICANT NAME % A-) /� f
ADDRESS 41/__
PHONES'I ^1 EMAIL
CONTRACTOR'S NAM OWNER BUILDER? O YES C'95
BUSINESS NAME U
ADDRESS L41/ q7
PHONE �+ '�}'� 3_c�D^ �jj(y EMAIL Q D D m
CONTRACTOR'S STATE LIC NUMBER g� {�ly 3� (� LICENSE CLASSIFICATION
VALUATION$ b OC/ f SQ�q L SQ FT
APPLICANT'S SIGNATURE /W / DATE / %/ ✓CJ
CTTYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
ACCEPTED B .
BUILDING PLANNING ENGINEERING FIRE
PERMIT FEE SMIP GREEN
PLAN CHECK FEE INVOICE TOTAL
OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO
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City of Menifee ,
DL Building Dept
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BAN 12 2018 Q
Received 0
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7) /0/0 .
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-' city
reg!,'auons and ordinances. This set of approved plans ust be kept on the
jobsite until completion.
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