PMT18-01128 City of Menifee Permit No.: PMT18-01128
29714 HAUN RD. Type: Residential Addition
�ACCELn7 MENIFEE, CA 9258E
MENIFEE Date Issued: 03/13/2018
PERMIT
Site Address: 31895 EATON LN, MENIFEE, CA 92584 Parcel Number: 360-783-010
Construction Cost: $6,900.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL ATTACHED SOLID 13'X 50'ALUMAWOOD PATIO COVER, NO ELECTRIC
Work:
Owner Contractor
JUSTIN GIFFORD T F MEADOR CONSTRUCTION
31895 EATON LN PO BOX 713
MENIFEE, CA 92584 WILDOMAR, CA 92595
Applicant Phone:9518376180
TOM MEADOR License Number:639087
T F MEADOR CONSTRUCTION
PO BOX 713
WILDOMAR,CA 92595
Fee Description ON Amount fSl
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_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 1 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 Code and my license is in full force and effect. the following reason:
License Class cens N . 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
WORKER'S COMPENSATION DECLARATION
improvements covered by this permit.I cannot legally sell a structure that I
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 this permit is issued. www.leginfo.ca.gov/calaw.htmi.
Policy# Date
0I 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
Carrier with all applicable city and county ordinances and state laws relating to
/;
2 building construction.I authorize representatives of this city or county to
Policy# G l q3 l Expires_ 29 enter the above identified property for inspection purposes.
(This section need not to he completed is the permit is for one-hundred 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, /��
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS UCENSE# n
40
workers compensation laws of California,and a ree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the wo rer compensations t isi s of Section 3700 ofthe Labor
Cade,I shall f Qit cop wi a pr isions. `�77 22 Will the applicant or future building occupant handle hazardous material or a
Date L/ IV P) mixture containing a hazardous material equal to or greater that the
Applicant amounts specified on the Hazardous Materials Information Guide?
WARNING: (LURE SECURE WORKER'S COMPENSATION COVERAGE Is o Yes Nio
UNLAWFUL,AND P ALL 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(SC construction
or modification
permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guldeCoast
Air Qua
CONSTRUCTION LENDING AGENCY 0 Yes IT
1 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 outerb�nddaryofaschool?
(Section 3097 Civil Code) 0 Yes )itTJo
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,Sec" n 255 Sand 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Seciion 7031.5 hazardous eri repo in
Business and Professions Code).Any city or county that requires a permit to Dyes o
construct,alter,improve,demolish or repair any structure,prior to its Date
issuance,also requires the applicant for the permit to file a signed statement PROPERTY O N OR AUTHO IZ AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOV ON REPAIR 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 licensure t 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 work
RRP-certified firms 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($SOIL). managers who do the paint-disturbing work themselves or through their
0 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.epe.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 0 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. 0 No EPA Lead-Safe Certified Firm is required for this project because:
0 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.
CUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 3 q g PERMIT/PLAN CHECK NUMBER O - O'IC
TYPE: O COMMERCIAL (Y\RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: XADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING 0 RE-ROOF-NUMBER/OF SQUARES
DESCRIPTION
pOFWORK �M1`�`�(l Ok 13 -f 50 /'f'VMtYlunn Pq-t-IID ('C)
V�/ .r
O CC't%r�'C e�k
PROJECTADDRESS w` 5// S—a��� L—Y\
ASSESSOR'S PARCEL NUMBER aJlp�/� 7$3�OI O LOT TRACT
OWNER NAME
ADDRESS sot, t
PHONE 15 ( — 5 5 3— (0 Lf Z�f EMAIL
APPLICANT NAME t�Tc+ram McatlwIIf t
ADDRESS PO `J t 13 W� Oa ��� C p.- 0kZ5cl5
PHONE 9 5 1 —F 3-7— CD 9'0 EMAIL
CONTRACTOR'S NAME 7C ( —lea per— CGv-- OWNER BUILDER? O YES KNO
BUSINESS NAME S�Lv�t
e
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER (p 3 9 d 67 LICENSE CLASSIFICATION (3
VALUATION$ 00 o� SQ FT 50 L SQ FT
APPLICANT'S SIGNATURE • DATE
DEPARTMENT DISTRIBUTION fp CITY OF MENIFEE BU NESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN •' SMIP
INVOICE ��[[ OS PAID AMOUNT
AMOUNT bL6• OCASH OCHECK# OCREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT :0 CASH O CHECK# O CREDIT CARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building& Safety Department 29714 Houn Rd, Menifee, CA 92586 951-672-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
1
1"7E �067 LEDGER � �RACf�
Lrsc�6S�et
INSPECTION REQUIRED
— — r— RERR )'kopER'7y —
I I City of Menifee
Building Dept 'SNOT TOSLALE'1
32�
MAR 1 2010
�Sofeceived
I3� —Tfo GucA E--5
1 I �A
W Home owme?
J Tus o GIFFORo `�" i
3189s E14ToN LAME n
L at IIAENiFeE CA. 9Z.584CL
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a
7 ° CITY OF MENIFEE ZMtu
_A BUILDING AND SAFETY RTMEINT Nobs
w I PLAN APPROVA I
I REV ED BYE/ J I� N _•••••.11LLI
DATE 4I
Approval of these plans shall not be construed lo be a permit for,or an
I I approval of,any violation of any provisions of the federal,state r city P Vr
I mgulations and ordinances. This sat of approvad plans must be I ept on the
jobsite until completion.
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