PMT18-00883 City of Menifee Permit No.: PMT18-00883
29714 HAUN RD.
�A_CCF1/�. MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued:
02/28/2018
PERMIT
Site Address: 27805 SPRING MEADOW CT, MENIFEE, Parcel Number: 333-263-050
CA 92585 Construction Cost: $3,100.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 10'X 23'SOLID ALUMAWOOD PATIO COVER SIDE YARD W/ELECTRICAL 1 FAN
Work:
Owner Contractor
BEATRICE COTA T F MEADOR CONSTRUCTION
27805 SPRING MEADOW CT PO BOX 713
MENIFEE,CA 92585 WILDOMAR, CA 92595
Applicant Phone: 9518376180
TOM MEADOR License Number:639087
T F MEADOR CONSTRUCTION
PO BOX 713
WILDOMAR, CA 92595
Fee Description Qtv Amount($1
Receptacle, Switch, Outlet&Fixture 1 116.00
Building Permit Issuance 1 27.00
Deck/Patio, non-standard 1 133.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 1.00
Document Reproduction Reimbursement 5 4.50
General Plan Maintenance Fee-Building 1 6.65
General Plan Maintenance Fee-Electrical 1 5.80
$294.95
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_aldg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from Iicensure under the Contractor's State License Law for
Professions Code and my license Is in full force and effecL�]p the following reason:
License Class Lice se No. ( 0$J
—7
//'' By my signature below 1 acknowledge that,except formy personal residence
Expims`L 3U Signature in which l must have resided for at least one year pdarto completion of
improvements covered by this permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECLARATION
have hail[as an owner-builder if it has not been constructed in Its entirety by
o l 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 www.leRf1nfc,.ca.goy1mIaw.html.permit is issued.
Policy# Date
d•l 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 l 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: 11 application and the information I have provided is correct.I agree to comply
s''fga'�U y�.da 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#q (IF 353`-f—( (O Expires J 0 J1 01 13
enter the above identified property for inspection purposes.
(This section need not to he completed is the permit is for one-hundred r.
dollars($100)or less Date
PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued, n �q
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 9
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forth (th co p tJh thos ravisions. —'7 Will the applicant or future building occupant handle hazardous material or
Applicant /010 / mixture containing a hazardous material equal to or greater that the
Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oYes �{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 FIN ES UP TO ONE HUNDRED THOUSAND DOLLARS($100,00D),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 District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guideInes
CONSTRUCTION LENDING AGENCY oYes 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 bou Plary of a school?
(Section 3097 Civil Cade) ❑Yes or o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
1 hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
California Health al Safety[ode,Section and 25534 concerning
Contractor's License Law for the reason(s)indicated below by the ct
�i�es ins material repo i g.
chsiness and
I have placed next to the applicable item(s)(Section permit dyes o No� / i(7
Business and Professions Code).Any city or county that requires apermitto Dater (�
construct,after,improve,demolish or repair any structure,prior to its 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRPj
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.S 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
o 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.eoa.eav/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 aAn 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:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct 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.
i • • Will 1 • • l L'• ...
Menifee
DATE: PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA --SIGN
SUBTYPE: /ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK 'TA VA 6� 10 X 2 3 r(j vAllrjQW\
a Gutt7 O w ( Ar
PROJECTADDRESS Z / , 05 5 rInc) If-t ZIP 9�85
ASSESSOR'S PARCEL NUMBER a✓J'O0Jv0WLOT 1 v _ TRACT
OWNER NAME 13eF-rrrCe Co-M
ADDRESS Sr1y✓�2.
PHONE 3731 EMAIL
APPLICANT NAME 1��� ecdap�l I
ADDRESS Po �X 7'Z l3 Wf 1don,&Y— CA- ai�,5�5
PHONE IT5/-F>37-(al30 EMAIL
CONTRACTOR'S NAME l � ME(e Jc,�'_ CG K-l't OWNER BUILDER? O YES AO
BUSINESS NAME Sa mC
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER (o3/q OS 7 LICENSE CLASSIFICATION
VALUATION$ J G SO FT <3 L SQ FT
APPLICANT'S SIGNATURE DATE 2 /�
CITYSTAFF USEONLY
DEPARTMENT DISTRIBUTION ACCEPTED CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
PERMIT FEE aq SMIP 1 GREEN I
PLAN CHECKFEE INVOICETOTAL
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
K. i ,iy DoperYR7� -i 21071.=i.C,6li !,i 'Ill.. I) e. -_�.. l=._ �tii7
u✓;y'el.f'I i,Q%irR+7lj 2v'.U'
I �
.�-DGER & TRACK
ASPECTION REOUiRED
City of Menifee
Building Dept.
tj S��, r FEB 2 8 2018
• U
Receiu ^,
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.4 c' 373�
i
CITY OF ME NIFEE
BUILDING ND SAF �DEPARTMENT
PLAN APP VAL
REVIEWE Y
DATE
ii to
'Approval of these p ans shall not be 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.
s r v eaJ.-ow_ - G