PMT18-00866 City of Menifee Permit No.: PMT18-00866
29714 HAUN RD. Type: Residential Re-Roof
�CCELA�. MENIFEE, CA 92586
MENIFEE Date Issued: 02/27/2018
PERMIT
Site Address: 39025 FRENCH VALLEY RD, MENIFEE, Parcel Number: 472-030-010
CA 92586 Construction Cost: $3,500.00
Existing Use: Proposed Use:
Description of RE-ROOF GARAGE-INSTALL COMP SHINGLES OVER 1 EXISITNG LAYER OF COMP
Work:
Owner Contractor
RICKEY AND ANDREA REYES
39025 FRENCH VALLEY RD
MENIFEE, CA 92586
Applicant License Number:
RICKEY AND ANDREA REYES
39025 FRENCH VALLEY RD
MENIFEE,CA 92586
Phone:9519900831
Fee Description f3ty Amount IS1
Building Permit Issuance 1 27.00
Inspections not specified 96 96.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.80
$128.80
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_Permil 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 7000)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class License 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 DECLARATION 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-leginfe.ca.gov/calaw.htmi.permit is Issued.
Policy# Date
❑I have and will maintain worker's 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 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: application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy# Expires entert above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred /Lti 125G ,�/ 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,
4 I shall not enrol ov any persons in any manner so as to become subject to the CITY BUSINESS UCENSE#
Ii!\worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,1 shall fort a ply with those pr visions. / Will the applicant or future building occupant handle hazardous material or a
Applicant c- Dale Z �y 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 ❑Yes ❑No
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 3 occupant require a permit for the construction or modification from South
ADDITION 7 Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 706 0E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES COST OF COMPENSATION,DAMAGES AS PROVIDED FOR for guidelines
CONSTRUCTION LENDING AGENCY o Yes ❑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) a Yes ❑No
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
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 material reporting.
Business and Professions Code).Any city or county that requires a permit to oYes ❑Na
construct,alter,improve,demolish or repair any structure,prior to its Date
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(RRP
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 Iicensure 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
❑I,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.ei)a.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible forthis 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 for this project because:
❑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 Ucense 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.
BUILDING & SAFETYPERMIT/PLAN CHECK APPLICATION
+'Aim
Menifee
DATE:2/27/18 PERMIT/PLAN CHECK NUMBER
TYPE: 0 COMMERCIAL 0 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME C POOL/SPA C SIGN
SUBTYPE: 0 ADDITION Q ALTERATION 0 DEMOLITION 0 ELECTRICAL 0 MECHANICAL
0 NEW OPLUMBING C RE-ROOF NUMBER OF SQUARES 224
DESCRIPTION OF WORK RE-ROOF install new roof on garage over one existing roof. Asphalt
shingles
PROJECTADDRESS 30925 French Valley Rd ZIP 92596
ASSESSOR'S PARCEL NUMBER 472-030-010 LOT TRACT
OWNER NAME Rickey and Andrea Reyes
ADDRESS 30925 French Valley Rd
PHONE 951-990-0831 EMAIL torickey@yahoo.com
APPLICANT NAME Rickey Reyes
ADDRESS same as above
PHONE EMAIL torickey@yahoo.com
CONTRACTOR'S NAME OWNER BUILDER? O YES ONO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER homeowner LICENSE CLASSIFICATION
VALUATION$ D ?S C) C SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE 2/27/18
'CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED B
PERMIT FEE SMIP GREEN
PLAN CHECK FEE INVOICE TOTAL
OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building&Safety Department 29714 Haun Rd. Menifee, CA 92586 951-672-6777
www.c1tyoj`menifee.us
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