PMT18-00149 City of Menifee Permit No.: PMT18-00149
29714 HAUN RD. Type: Residential Addition
'5A—CCELA? MENIFEE, CA 92586
MENIFEE Date Issued:
0111 212 01 8
PERMIT
Site Address: 25442 LONE ACRES RD, MENIFEE, CA Parcel Number: 358-430-008
92584 Construction Cost: $2,700.00
Existing use: 1 &2 Family Residence Proposed use:
Description of INSTALL 12'X 25'SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 2 FANS
Work:
Owner Contractor
TREVOR FOLEY PATIO GUY ALUMAWOOD CONTRACTOR
25442 LONE ACRES RD 41197 GOLDEN GATE CIR STE 108
MENIFEE, CA 92584 MURRIETA,CA 92562
Applicant Phone:9513330056
LOIS MONTINI License Number.872839
PATIO GUY ALUMAWOOD CONTRACTOR
41197 GOLDEN GATE CIR STE 108
MURRIETA, CA 92562
Fee Description ON Amount
Receptacle, Switch, Outlet&Fixture 2 121.00
Building Permit Issuance 1 27.00
Deck/Patio, non-standard 1 133.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 1.00
General Plan Maintenance Fee-Building 1 6.65
General Plan Maintenance Fee-Electrical 1 6.05
$295.70
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_Permd_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts forthe projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State License Law).
Chapter!)(commencing with section 7000)of Division 3 of the Business and 01 am exempt from Rcensure under the Contractor's State License Law for
Professions Code an my license is in full force and effect the following reason:
License Class Lice se \�
Imo, By my signature below I acknowledge that,except for my personal residence
Expires •3 /_Signature I Y / / ZIX in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION v improvements covered by this permit.l cannot legally sell a structure that l
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 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
this permit is issued. www.leeinfo.ca.eovhalaw.html.
Policy# Date
01 have and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 ofthe Labor Code,for the performance of the work for which O By my signature below l certify to each ofthe 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 owners behalf.I have read this
number are: f application and the information I have provided is correct.I agree to comply
Carrier / �i'/ �� 1 with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy �3 Expires I 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,
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 ofthe Labor
Code,Ishall fo hwi h comply with those provisions. Will the applicant or future building occupant handle hazardous material or
A mixture containing a hazardous material equal to or greater that the
Applicant /r�r Date amounts spec' ad on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE Is Dyes r9igo
UNLAWFUL,AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES Will the intended use ofthe 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 Coast Air Quality Management hecoDistrict(SCtionor modification
permitting checklist
IN SECTION 3706 OFTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airllnu
Qua
CONSTRUCTION LENDING AGENCY Ayes ";
I hereby affirm that under the penalty ofperjury there is a construction Will the proposed building or modified facility be within 1000 feet ofthe
lending agency for the performance ofthe work which this permit is issued outer boundary of school?
(Section 3097 Civil Code) o Yes 0 Plow
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD
I hereby affirm under penalty of perjury that l am exempt from the permitting checklist.l 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 hazardous matoaI,re orting.
Business and Professions Code).Any city or county that requires a permitto oyes o 0
construct,alter,improve,demolish or repair any structure,prior to its �1lLL 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 ofthe Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 ofthe The EPA air and Painting Renovation,Re
Business and Professions Code)or that he or she is exempt from licensure P g(RRP)Rule requires contractors
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978
residence or childcare facility to be RRP-certified firms and comply with
than
Applicant fora permit subjects the applicant too civil penalty of not more required practices.This includes rental property ownersand property
than($500). managers who do the paint-disturbing work themselves or through their
o 1,as owner ofthe 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 ofthe 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 1-800-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a o 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 offeredfor 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:
01,as owner ofthe 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.
APPLICATIONBUILDING & SAFETY PERMIT/PLAN CHECK
DATE: PERMIT/PLAN CHECK NUMBER tF'WI
TYPE: O COMMERCIAL 41tESIDENTIAL O MULTI-FAMILY 0' MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O� ADDITION O ALTERATION O DEMOLITION �CTRICAL O MECHANICAL
c3'NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK
Co vgaA . A Fg-lq /J
PROJECT ADDRESS a 'g*uz !R LtItoE .4d-4gas Rd_ ZIP
ASSESSOR'S PARCEL NUMBER 2;- 'WS LOT TRACT ✓E
OWNER NAME A d -'"
ADDRESS d
PHONE 4? EMAIL
APPLICANT NAME //g n ADD—/
ADDRESS G
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES U*6'
BUSINESS NAME Tl L) l> n /
ADDRESS Lill 97 �' Gf� , D c f J16
PHONE �S�_ `��-�Q �(J 9a5�p
EMAIL
CONTRACTOR'S STATE LIC NUMBER �'rj a�3 LICENSE CLASSIFICATION
VALUATION$ D U SQ FT 3 D D L SQ FT
APPLICANT'S SIGNATURE DATE ^
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIFE
PERMIT FEE r70 SMIP GREEN
PLAN CHECK FEE INVOICE TOTAL
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O. YES 0 NO
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