PMT18-01404 City of Menifee Permit No.: PMT18-01404
29714 HAUN RD. Type: Residential Addition
�1CCELAk7. MENIFEE, CA 92586
MENIFEE Date Issued: 0 312 912 01 8
PERMIT
Site Address: 29299 WHITEWATER DR, MENIFEE, CA Parcel Number: 333-481-014
92585 Construction Cost: $3,200.00
Existing use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 12'x 30'SOLID ALUMAWOOD PATIO COVER WITH 1 FAN
Work:
Owner Contractor
ALEJANDRO PANTOJA PSLQ INC
29299 WHITEWATER DRIVE 18890 SEATON AVE
MENIFEE, CA 92585 #206
Applicant Phone:9517954260
JOSH HERRICK License Number. 919885
PSLQ INC DBA GREENBEE
18890 SEATON AVE
PERRIS, CA 92570
Fee Description L�yt Amount Ibl
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
General Plan Maintenance Fee-Building 1 6.65
General Plan Maintenance Fee-Electrical 1 5.80
$290.45
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 building 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 o 1 am exempt from licensure under the Contractor's State License Law for
Professions Code and m license is in full force and effect. //tL the following reason:
License Class_License No. �t
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
D 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 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
by Section 3700 of the Labor Code,for the performance of work for which this application is submitted or at the following website:
this permit is issued. Mn .leginfo.ca.eov/calaw.html.
Policy# Date
❑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 l 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 LA) with all applicable cityand county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy 0'-1 Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for ane-hundred
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, I �
Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 5qo
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,l shall forthwi ply 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
71 amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURY TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes 040-
UNLAWFUL,AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the Intended use of the building by the applicant or future building
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air quality Management District(SCAQMD)?See permitting checklist
for guidelines
CONSTRUCTION LENDING AGENCY o Yes diro
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
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
Contactors 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(s)(Section 7031.5 hazardous material re ordng.
Business and Professions Code).Any city or county that requires a permit to oyef D No _
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 6H KtitHoKrZED AGENT
that he or she is licensed pursuant to the provisions of the Contactors State EPA RENOVATION.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 contactors
Business and Professions Code)or that he or she is exempt from licensure
and the basis for tha alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978
an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to he RRP-certified firms and comply with
than($Sao). required practices.This includes rental property owners and property
managers who do the paint-disturbing work themselves or through their
o 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.eoa.eov/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 DAn 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 1,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 ale please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION — MENIFEE
PERMIT/PLAN CHECK NUMBER
Ring) 01gog—
PLANNING CASE NUMBER
TYPE: c_ COMMERCIAL 06,RESIDENTIAL 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 O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK ce j )UMO.W o-d ry,,fC 1 �y.
PROJECTADDRESS "94-AlY l yVv�At,--3aaKy ZIP V%RM@nbe
ASSESSOR'S PARCEL NUMBER 333-481 -Ck4 LOT TRACT Building Dept.
OWNER NAME A v ?L" k . MAR 2 7 2018
ADDRESS 5% r ,e\) rY\CA O, .` S N d
PHONE EMAIL
APPLICANT NAME
ADDRESS
PHONE RS�-3�6'"-lel EMAIL
CONTRACTOR'S NAME LSPR OWNER BUILDER? O YES 6iNO
BUSINESS NAMES� pp 9 (( jj (�
ADDRESS ZnklN -4ko v (_nn 9-.,j� Ph I Ter`tc`.` 7-59a
PHONE 951-a��-es6 EMAIL /J
CONTRACTOR'S STATE LIC NUMBER 9/4�g S LICENSE CLASSIFICATION (S
VALUATION$ Q FT 36o L SQ FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL I &CjC) .LA5 I GREEN '� SMIP ,—
OWNER BUILDER VERIFIED O YES 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
ENIFE
City of Venifee
-P r
TRACK Buildi Dept
W, ,k,g REOURED MAR 1 2018
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m U1 D D 'Approval of these plans shall not be con trued to be ermjjgr,or an
Mton ,� Z approval of,any violation of any provisio s of the fed I,s�or city
GO m M O regulations and ordinances. This set of a proved plan'rmust be kept on th
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