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PMT18-01098 City of Menifee Permit No.: PMT18-01098 29714 HAUN RD. Type: Residential Addition A—> MENIFEE, CA 92586 MENIFEE Date Issued: 03/12/2018 PERMIT Site Address: 30300 CHERRY OPAL LN,MENIFEE,CA Parcel Number: 360-820-017 92584 Construction Cost: $4,582.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL ATTACHED 12'X 34'SOLID ALUMAWOOD PATIO COVER, NO ELECTRICAL Work: Owner Contractor MAN KONG CHUCK ANTHONY COCILOVA 30300 CHERRY OPAL LN 31321 PALOMAR ROAD MENIFEE, CA 92584 MENIFEE,CA 92584 Applicant Phone:9513146910 ANTHONY COCILOVA License Number.962132 ANTHONY COCILOVA 31321 PALOMAR ROAD MENIFEE, CA 92584 Fee Description -cLt Amount($1 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 $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 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_Pennh_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 a I am exempt from licensure under the Contractor's State License Law for Professions Cade and my icense is in full force and effe the following reason: License C11las _l/.r'YI License N By my signature below I acknowledge that,except for my personal residence Expires b O Signature in which I must have resided for at least one year priorto 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 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.leginfo.ca.eov/calaw.html. Policy# ��-' �� 1- 27 `( ( — v 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 ❑By my signature below I certify to each of the following:I am the property this permit is issued.My worker's compensation insurance carder and policy owner or authorized to act on the property owner's behalf.I have read this numberar�e:'"� �, application and the information I have provided is correct.I agree to comply Carrier J 4(_ e Inc r M with all applicable city and county ordinances and state laws relating to q r� ,�,r building construction.I authorize representatives of this city or county to Policy# /�— �� X�yres �'"/0 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 ❑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# 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 f hwj V comply ith tl o provisions. Will the applicant or future building occupant handle hazardous material or a Applicant ZftDate —la_ mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE? ECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes po 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($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District eonstSCtionor modee ification checklist IN SECTION 370E OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes 00 I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer bouVary of a school? (Section 3097 Civil Code) ❑Yes PfNo OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item hazardous material repo ' g.,$)(Section 7031.5 ,p-',� Business and Professions Code).Any city or county that requires a permit to 1 Date construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWNE R 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 RENOW OWNER AND PAINTING IRRPI 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 Rcensure receiving compensation for most work that disturbs paint in apre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare n for most y to beork that disturbs paint and comply with than 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 a 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 Contractor's State License Law does not apply to an owner of a D An EPA Lead-Safe Certified Renovator will he 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. o 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 Hill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: ?j" 2-l PERMIT/PLAN CHECK NUMBER PLANNING CASE NUMBER TYPE: O COMMERCIAL YRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING 0 RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK 121 hWI G, QQ ve PROJECTADDRESS So-3 on (_ geu I oPa L C-n • ZIP 9� ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME A4LI rl 2-0/1`1 C C ADDRESS ;O O O PHONE 90 176 EMAIL APPLICANT NAME QYL Gl. ADDRESS a f ovl CL I ( onne S� PHONE r` / CD EMAIL CONTRACTOR'S NAME k O A �, VK OWNER BUILDER? /OYES ONO f 1 BUSINESS NAME AZ . !Qt / e-_4, /� �y1��1 /��S ot /� C� f1L�/r5 ADDRESS �I 5 r GI nnp✓VLCi l` R . ft_v / CJrI . ^ L PHONE �j 3� ��y EMAIL �(f oe-i l p Llrt CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION L ^ p o Q- VALUATION$ SO FT o p L SQ FF C APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION ACCEPTEDBY: CITY OF MEWEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE G 3l scri 'F^� INVOICE TOTAL I(oS, (P6 GREEN SMIP 1— OWNER BUILDER VERIFIED 0 YES O NO DRIVERS LICENSE It 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 w.s. III UEpGER &N INSPECTIOIEQUiRED 0 0 b 0 1 c.001) �,o cc�� ()�LLaiw Ee+ C v I - � IT*6F MENI BUILDING AND SAFETY DEPARTMENT PLAN APPROVAL ' REVIEWE Y '" I DATE 'Approval of these plans shall not be construed to be a permn'or,or an approval of,any violation of any provisions of the federal, - cly .1 a [ O v regulations and ordinances. This set of approved plans must!,c kept on the 0 jobsite until completion. \� V� P-