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PMT18-01571 City of Menifee Permit No.: PMT18-01571 29714 HAUN RD. �Ap A_> MENIFEE,CA 92586 Type: Residential Addition MENIFEE Date Issued: 04/03/2018 PERMIT Site Address: 30128 PEBBLE BEACH DR, MENIFEE, Parcel Number: 336-144-015 CA 92586 Construction Cost: $4,500.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 14'x 22'SOLID ALUMAWOOD PATIO COVER, NO ELECTRICAL Work: Owner Contractor JOHN WAGY TRADER DAN'S INC 30128 PEBBLE BEACH DRIVE 840 S ROCHESTER AVE STE C MENIFEE,CA 92586 ONTARIO, CA 91761 Applicant Phone:9093900555 DON DAUGHENBAUGH License Number:517575 TRADER DAN'S INC 840 S ROCHESTER AVE STE C ONTARIO,CA 91761 Fee Description Qtv Amount ISI 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 $168.66 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[!censure under the Contractor's State License Law for Professions Code a my license is in full force and effect the fallowing reason: License ClaWSgnathrm License No. 5 �7 By my signature below I acknowledge that,except for my personal residence Expires in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLA p improvements covered by this permit.[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 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.le0rdo.ca.gow/calaw.htmi. Policy If Date ailave 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 worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this number are: ^^ application and the information I have provided is correct.I agree to comply Carrier 1—L� with all applicable cityand county ordinances and statelaws relating to �L �i / building constructs u rize representatives of this city or county to Policy# �SiTS�(�3O Expires v �y e't e i emir dprope for inspection purpos S. r (This section need not to be completed Is the permit is for one-hundred ( G7 l g 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 shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 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 shaB.ferth 00 y with t rovisions. � ��..�� rr������ 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 'f lI amounts spec on the Hazardous Materials Information Guide? WARNING. RE T -REWO R'S COMPENSATION[OVERAGE IS o Yes FIX" UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or fatu,a 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(SCAQMD)?See permitting checklist IN SECTION 37060FTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelin CONSTRUCTION LENDING AGENCY O Ye 3140 i I hereby affirm that under the penalty of perjury there is a construction Will the propose uilding or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer bounce of school? (Section 3097 Civil Code) ❑Yes o OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD 1 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(s)(Section 7031.5 ,rhia�d.rdous maieriaFrep mg. Business and Professions Code).Any city or county that requires a permit to s °No construct,alter,improve,demolish or repair any structure,prior to its Date J issuance,also requires the applicant for the permit to file a signed statement PROPERTY OW R O D AGENT 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 The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt from Ilcensure receiving compensation for most work that disturbs pant in a pre-1978 and the basis for the alleged exemption.Any violation Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with than Applicant for a permit subjects the applicant to a civilit 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.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an ownerof a O property who,through employees'or personal effort,builds or improves the 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 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 out the RRP Acknowledgement. tiLLtAJ / i1t Il�Y1FAIVs[JI✓/I .-.��'�M,�...r� w_ .1/_� BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: / ( PERMIT/PLAN CHECK NUMBER - 1 PLANNING CASE NUMBER TYPE: O COMMERCIAL -01RESIDENTIAL O MULTI-FAMILY MOBILE HOME O POOL/SPA OSIGN SUBTYPE: OADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL 16 NEW O PLUMBING '0 RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK I� 2 Z I d1I!/ A1UVvi&\wood PROJECTADDRESS 3O� Z 0 �-Z 'e- --Q,�S(iVc ZIP ASSESSOR'S PARCEL NUMBER S LOT TRACT Buildinci Dept OWNER NAME J / A ADDRESS 301n � �vt Q�vQ PHONE 151-21 - g333 EMAIL eceiV APPLICANT NAME ADDRESS PHONE EMAIL CONTRACiOR'S NAME ZQ6M JU I OWNER BUILDER? O YES Q N6 BUSINESS NAME `l'`"' /I� ADDRESS q{ ,) lJC.wI-� �tJ— /f' Y2 /lti rft- 61176 PHONE yi'-3gd-t)S-3- EMAIL CONTRACTOR'S STATE -LLII'C NUMBER �� S t LICENSE CLASSIFICATION 9 VALUATION$ 7 (/ SSO, -✓FT ,4 L SO FT :L�7 _APPLICANT'S SIGNATURE DATE /71 OTYSTAFFUSEONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICETOTAL GREEN SMIP % OWNER BUILDER VERIFIED C YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92S86 (951)672-6777 www.cityofinenifee.us enIIP•B: i1 OWNERoh ADDRESS ,IZ • nh CITY ZIPcj�& PHONE LOT NO. *TRACT AR CONTRACTOR ROOMS N' COVERS PROPOSED ADDITION(S) 840 S R #C ONTARIOIO, CA CA 91761 LIC. B-517575 909-390-0555 WORK COMP ICW GROUP WSA5000386-07 EXP6/14/2018 /II t Q f C tti`�X' a r^ rn m 1rn C � rn �i CD a =_.'z ao 7, � o�� �». e a" sn4 a< R P`9