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PMT18-01008 City of Menifee Permit No.: PMT18-01008 29714 HAUN RD. Type: Residential Plumbing '5ACCELA-�. MENIFEE, CA 92586 MENIFEE Date Issued: 03106/2018 PERMIT Site Address: 29609 TWO HARBOR LN,MENIFEE, CA Parcel Number: 333-560-077 92585 Construction Cost: $875.00 Existing Use: Proposed Use: Description of INSTALL 30 L FT GAS LINE FOR FIRE PIT Work: Owner Contractor BYRON MANGIS J R CONCRETE&LANDSCAPE 29609 TWO HARBOR LANE 24992 SPRINGBROOK WY MENIFEE, CA 92585 MENIFEE, CA92584 Applicant Phone: 9517770459 JOSE BRIONES License Number:840495 J R CONCRETE&LANDSCAPE 24992 SPRINGBROOK WY MENIFEE, CA 92584 Fee Description Qtv Amount($I Building Permit Issuance 1 27.00 Inspections not specified 116 116.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 5.80 $149.80 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_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 ❑I am exempt from licensure under the Contractors State License Law for Professions Cade and my license is in(full force and effect. _ the following reason: License Class -2> ti (-7-g License o. By my signature below l acknowledge that,except for my personal residence Expires 6 O 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 perj one of the foll wing declarations:I licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of�onsent of self-in re 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 w,ww.leginfo.ca.gov/calaw.html. this permit is issued. Policy# Date r 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 on the property owners behalf.I have read this number are: application and the information I have provided is correct.I agree to comply SYIG�t�� U .v 1T> with all applicable city and county ordinances and state laws relating to Carrier ll �� I / building construction.I authorize representatives of this city or county to Policy# JD1 7 1 I Expires enter the above identified property for inspection purposes. (This section need not to tie completed is the permit s for on -hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, I shall not emolov 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 3700 of the Labor Code,I shall forthwith co�jmplyL�with those prow ions. /` �j Will the applicant or future building occupant handle hazardous material or a Applicant�CIF.x I�-'SJC='eS Date 3^10—%6 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 SHALLSUBIECTAN EMPLOYERTO CRIMINAL PENALTIES Will the intended use of the building bythe 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 District(SCAQMD)7 See permitting checklist IN SECTION-3706 OFTHEiABOR CODE,INTEREST;AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY ❑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) ❑Yes ❑No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that am exempt from the permitting checklist.I understand my requirements under the State of California Health&Safety Cade,Section 25505 and 25534 concerning Contractors License Law forthe reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 DYes ❑No Business and Professions Code).Any city or county that requires a permitto Date construct,alter,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 Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt from licensure The EPA Renovation,Repair and Painting(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 ply w78 an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility a be rental property firms and comply with than($500). required practices.This includes rental property owners and property 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 Contractors 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. in No EPA Lead-Safe Certified.Firm is required for this project because: in 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 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. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: 3 , PERMIT/PLAN CHECK NUMBER i PLANNING CASE NUMBER TYPE: O COMMERCIAL kR_ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA C SIGN SUBTYPE: O ADDITION t>ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW LUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK � L`� ��✓LS? ' 2 PROJECTADDRESS vG ZIP cyr men wee ASSESSOR'S PARCEL NUMBER Building Dept. ��JI.007—O�'1 LOT TRACT OWNER NAME U MAR 0 6 j 018 ADDRESS 22 0U G o Z ,W, ,.. _: , ' v^d PHONE 3�j a��'Op D / EMAIL r +C I� APPLICANT NAME (� ADDRESS PHONE ��Vl� EMAIL l (c3v✓i, CONTRACTOR'S NAME r t)WNER B DER? O YES (I-NO BUSINESS NAME 5 0 S �— ADDRESS2�Ajq 2- PHONE 7 6�� O (( EMAIL 66 CONTRACTOR'S STATE LIC NUMBER O�[ �J LICENSE CLASSIFICATION VALUATION$ ? 5 SOFT �94 , L SQ FT 3 APPLICANT'S SIGNATURE DATE OTYSTAFFUSEONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEE G FIRE INVOICE TOTAL ' GREEN 1 SMIP OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofmenifee.us NI City of Menifee Building Dept, MAR 0 6 2018 DP, wft r -- -- . � Ved LAM Cl Y OF MENIFEE B ILDING AND SAF TY DEPARTMENT AN APPROVAL l9 'l� ram04 - EVIEWED BY k DATE fl - 36 �V Approval of these plans shall not be construed to be a penP! or,or an mom approval of,any violation of any provisions of the federal,scat:or city _ ^ Q regulations and ordinances, This set of approved plans musi be kept on the \ jobsite until completion. 1 r f fD,t