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PMT18-01405 City of Menifee Permit No.: PMT18-01405 29714 HAUN RD. 99 CV_ �!.' MENIFEE,CA 92586 Type: Residential Addition MENIFEE Date Issued: 0 312 912 01 8 PERMIT Site Address: 30272 RUSTLER WAY, MENIFEE, CA Parcel Number: 358-510-004 92584 Construction Cost: $2,750.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 12'x 16'SOLID ALUMAWOOD PATIO COVER WITH 1 FAN,2 LIGHTS Work: Owner Contractor JULIE PICONKE PSLQ INC 30272 RUSTLER WAY 18890 SEATON AVE MENIFEE, CA 92584 #206 Applicant Phone:9517954260 JOSH HERRICK License Number:919885 PSLQ INC DBA GREENBEE 1BB90 SEATON AVE PERRIS,CA 92570 Fee Description gyl Amount($1 Receptacle, Switch, Outlet&Fixture 3 126.00 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 6.30 $300.96 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 o I am exempt from licensure under the Contractor's State License Law for Professions Code and Ty license is in full force and effect, the following reason: License Class_ B License No. '1 By my signature below i acknowledge that,except g p y 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 legallysell a structure that i have built as an owner-builder if it has not been constmcted 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 forworker'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 ofthe Labor Code,for the performance of work for which this application is submitted or at the following website: this permit is issued. wwmIeeinfo.ca eov/calaw.html. Policy# Date 01 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 o By my signature below I certify to each of the following:I am the property this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this numberare: application and the information I have provided is correct.I agree to comply Carrier Vv!? with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy If u5o3oa5a Expires - 2-� enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT o I certifythat in the performance of the work for which this permit is issued, C��5q0 Z I shall not emolovany 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 forthwlt mply with those provisions. Will the applicant or future building occupant handle hazardous material or a 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 o Yes 014-0 UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($10D,000),IN WIII 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 37060E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist forguidelines CONSTRUCTION LENDING AGENCY oYes dIvro- I hereby affirm that under the penalty of perjury there is a construction WIII 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) 0 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 Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 2SS05 and 25534 concerning hazardous material re orting.checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 Qy{s o No I 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 OWNER 6R hUTROKIZED AGENT -T— that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRPI 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(RRPJ 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 pre-1978 an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified 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 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.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 Contractor's State License Law does not apply to an owner of a property who,through employees'or personal effort,builds or improves the n An EPA Lead-Safe Certified Renovator will be responsible for this project 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 completion,the Owner-Builder will have the burden of proving that it was Firm Certification No.: not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: 01,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 Oil out the RRP Acknowledgement. Sosh�-r�-cCf�- Gl robe-2_. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION, MENIFEE DATE: y PERMIT/PLAN CHECK NUMBER PLANNING CASE NUMBER TYPE: COMMERCIAL ¢ICRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION C)DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUAREES DESCRIPTION OF WORK t• 4, )✓ �q qo G! F, row e,— w rt1n 2 �f PROJECTADDRESS _ 09 7al KU; 112T v�.I,Z ZIP 1-Z s y —Cityof meniTee ASSESSOR'S PARCEL NUMBER '�"j\�•mil.( LOT TRACT Quildinq Dept. OWNER NAME Jv`\ CDFly p ADDRESS q,,..Q fn, w, d 92-5,?; 7 C/ PHONE q5)-� 1y;5 EMAIL Received APPLICANT NAME SnSI. �C,c� ,^P,B✓'� . ADDRESS p PHONE -nj09jy EMAIL CONTRACTOR'S NAME W T`e.en OWNER BUILDER? 0 YES ENO BUSINESS NAME (1 p ADDRESS 2769to PHONE 9 5)- Aw,0356 EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ 1Z 150 SQ FT ) R� L SQ FT y� APPLICANT'S SIGNATURE - DATE 7�I CITYSTAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: ' 'n CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE 11,`^I(�� INVOICETOTAL 3CO •Q5 GREEN SMIP OWNER BUILDER VERIFIED OYES ';: NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 . G,n of www.cityofinenifee.us MENIFEE' RUSTLER WAY l�' , LEDGER & TRACK '- 5 `. � nVU INSPECTION REQUIRED, CU 5, U C) a o a o p M �. N � m � v rT1 N OJ 1-+ v 1D m City of Menif $ r°, CABuilding Dep . o A o _ o ! m CITY F MENIF E m MAR 2 7 201 F, N G Ln y a rt a BUI ING AND AFETYDEP�tNI iv" Received ' s E- PLA APPROV L 1Z D C 2 c � REV EWED BY &A y C M LtiE a l� Appr at of these plans s all not be construed to be a perriC r 111 appro I of,any violation any provisions of the federal,star, or c regul ons and ordinances This set of approved plans must kepi on the (� johsi until completion. m a o ' IZ lO 15 % M r rN r D "' rt r z z W 0 -- -- - �- - ---- A �� T o o` o m V f3D N N � - a 0 N —yl r O 2 G1 U1 m O w r o m ��+ m ,gyp 70 n Qp w O cn a z v u, n -< X D N 3 M W N C tD � co O A 3