PMT18-01366 City of Menifee Permit No.: PMT18-01366
29714 HAUN RD.
�ACCEL/� MENIFEE,CA 92586 Type: Residential Addition
Gw.«.-ert SMlwxe MENIFEE Date Issued: 03/27/2018
PERMIT
Site Address: 26720 OPALESCENT DR, MENIFEE, CA Parcel Number: 360-810-032
92584 Construction Cost: $4,475.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 14'x 34' SOLID ALLIMAWOOD PATIO COVER WITH 2 FANS
Work:
Owner Contractor
JERRY& PRECILLA BARRETTE PSLQ INC
26720 OPALESCENT DRIVE 18890 SEATON AVE
MENIFEE, CA 92584 #206
Applicant Phone: 9517954260
JOSH HERRICK License Number: 919885
PSLQ INC DBA GREENBEE
18890 SEATON AVE
PERRIS,CA 92570
Fee Description Ply Amount ISI
Receptacle, Switch, Outlet&Fixture 2 121.00
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
General Plan Maintenance Fee-Electrical 1 6.05
$295.70
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 sift
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 l 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 Contractors State License Law for
Professions Code and_M license is in full force and effect. the following reason:
License Class_ License No. By my signature below l acknowledge that,except formy personal residence
Expires `1-'I' I :;&_Signature Y�N in which l must have resided for at least one year priorto completion of
improvements covered by this permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in Its entirety by
o 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 Cade,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 ,A,ww.leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
o I 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 o 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: n ,� ' application and the information I have provided is correct I agree to comply
Carrier c-/v 6- with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# 047 Expires -I 2-1 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($10D)or less PROPERTY OWNER OR AUTHORIZED AGENT
❑I certify that in the performance of the work for which this permit is issued, Cry 6goZ
Ishallnotemoloy any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# �"ftJ'j(/
workers 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 forthwi mply with those provisions. Will the applicant or future building occupant handle hazardous material or
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILUR TO SECURE WORKER'S COMPENSATION COVERAGE IS oyes 040
UNLAWFUL,AND SHALL SUBIECF 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
IN SECTION ON TO
06 OF
LABOR CODE,INTERTION,DAMAGES
ST, A AND
FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE TABOR[ODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes zY1rr.-
I herebyaffirm that underthe penaltyof perjurythere isa 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) o Yes
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
hereby affirm under penalty of perjury that l 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
erial re orting.
checkmark(s)I have placed next to the applicable item hazardous mat
s)(Section 7D31.5 aYe£ ❑No '
Business and Professions Code).Any city or county that requires a permit to
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 OWN R 611 RUtHOKIZED AGENT
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 licensure 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
than
Applicant fora permit subjects the applicant toacivil 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.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-BOD-424-LEAD(5323).
Code,The Contractors State License Law does not apply to an owner of a oAn 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. 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 Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill aut the RRP
Acknowledgement.
r
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MEN IFEE
AI±i)�glr fit,r-0T.1= -
DATE: PERMIT/PLAN CHECK NUMBER -0
PLANNING CASE NUMBER
TYPE: O COMMERCIAL --X RESIDENTIAL O MULTI-FAMILY () 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 Ne j I( A I A •Z �
14% t 14 PROJECTADDRESSabl;t m 0y4'y5un} -S) qc. ZIP / xq
ASSESSOR'S PARCEL NUMBER `i1-�{� • �jp� LOT TRACT
OWNER NAME PC'C S ?Me : ck, f4t City of Menifee
ADDRESS /54e• Z IF Building Dept.
PHONE Kjq Fj 15 -lD2 q EMAIL MAR 2 7 2018
APPLICANT NAME o /,
ADDRESS
PHONE 7�I� Zi �i �dg�� EMAIL
CONTRACTOR'S NAME fwf16•1T_ OWNER BUILDER? O YES XNO
BUSINESS NAME ADDRESS �� (�-o ^^1 �l(� I FO-W-1 i 10 , CA7-54S i0
PHONE 95/ . ;?3-0;564 EMAIL
CONTRACTOR'S STATE LIpC NUMBER J J qj LICENSE CLASSIFICATION 7
VALUATION $ f Gt T / r SQ FT � Ij L SO FT >
APPLICANT'S SIGNATURE DATE Z
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL GREEN SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER YES NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
G TY oe
www.cityofinenifee.us �
TMENIFEE'
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OPALESCENT DR--77
PUBLIC SIUEV.'ALK
rtly of enifee
Buildir g Dept.
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rt MAR 7 2018
2LEDGER & TRACK
018PECTION REQUIRE,, Received
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BUILDINC AND SAFETY DEPARTMENT m Cr 4
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REVIEWS BY �ft K
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p 'Approval of them plans iall not be construed tobeapermitfor,oran
m approval ot,any iolation f any provisions of the federal,state or city
m D regulations and c dinances This set of approved plans must be kept on the
Q jobsite until com lesion.
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