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PMT18-01574 City of Menifee Permit No.: PMT18-01574 29714 HAUN RD. 't1�CCEL/R7. MENIFEE, CA 92586 Type: Residential Electrical MENIFEE Date Issued: 0410412018 PERMIT Site Address: 29614 LIGHTSHORE CV,MENIFEE,CA Parcel Number: 333-560-026 92585 Construction Cost: $800.00 Existing Use: Proposed Use: Description of U/G 100 L FT 3/4"GAS LINE&60 L FT ELECTRIC LINE FOR BBQ AND FIRE PIT Work: Owner Contractor ERIC HURLEY BILL&DAVE'S LANDSCAPE MAINTENANCE INC 29614 LIGHT SHORE CV 1153 HARLEY KNOX BLVD MENIFEE,CA 92585 PERRIS, CA 92571 Applicant Phone:9519436455 DAVID LEIDENFROST License Number:751707 BILL&DAVE'S LANDSCAPE MAINTENANCE INC 1153 HARLEY KNOX BLVD PERRIS,CA 92571 Fee Description CRY Amount f$1 Receptacle,Switch,Outlet& Fixture 1 116.00 Plumbing Fixtures and Vents,fixtures 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Plumbing 1 5.80 General Plan Maintenance Fee-Electrical 1 5.80 $271.60 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 hereby affirm under penalty of perjury that I am under provisions of with a licensed contractors)pursuant to the Contractors State License Law). Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from Iicensure under the Contractor's State License Law for Professions Code and my license U In full force and effect. .7 the following reason: f License Class ��77 ��C -��aa� Licensr�No. � S� By mysignaNre below lacknowledge that,except for my personal residence Expires__�Slgnature L. in which l must have resided for at least one year prior to completion of improvements covered by this permit l cannot legally sell a structure that) WORKER'S COMPENSATION DECLARATION have built as an owner-builder if It has not been constructed in Its entirety by O l hereby affirm under penalty of perjury one of the following declarations:i licensed contractors.l 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 caw w leginfo.ca•¢ov/calaw.hcml. this permit is issued. Policy G �� i W r L/ Date D l 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 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:, )) ` application and the information I have provided Is correct.I agree to comply Carrier ''1 UL L F/v �- j l� f( with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy li � L% �%LI Q/('IJ L Ll Expires 1 I � I enter the above identified property for Inspection purposes. (This section need not to be completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT O l 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 If 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,I shaftFfmthh��t r comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant Date �� S 7 mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oyes a 0 UNLAWFUL.AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES WIIl 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(5CAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY DYes 9,N 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) D Yes ;o No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby aff(rtn under penalty of perjurythatlam 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 al Safety mode,Section 15505 and 25534 concerning hazardr,;smaterlal reporting. checkmark(s)I have placed next to the applicable Item(s)(Section 7031.5 oYes--D No '\ (+ Business and Professions Code).Any city or county that requires a permit to —�� Date_ v �J construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWN R7NTHDt�D AGENT issuance,also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contactors State EPA RENOVATION.REPAIRAND PAINTING fRRP1 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 Iicensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of section 7D31.5 by residence or childcare facility to be RRP-certified firms and comply with an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property than($500). managers who do the pain[-disturbing work themselves prthrough their O I,as owner of the property,or my employee with wages as their sole employees.For mare information about EPA's Renovation Program visit: compensation,will do( )all of or( I portion of the work,and the structure is www.eoa.eoy/lead or contact the National Lead Information Center at not intended or offered fur sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractors State Uceme Law does not apply to an owner of aAn EPA Lead-Safe Certified Renovator will he 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. D No EPA Lead-Safe Certified Firm is required for this project because: a I,as owner of the property am exclusively contracting with licensed contactors 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 fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: PERMIT/PLAN CHECK NUMBER IO- 015T+ L PLANNING CASE NUMBER TYPE: O COMMERCIAL RESIDENTIAL C MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION C DEMOLITION ELECTRICAL O MECHANICAL O NEW ePLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK Il 0 3 b11 cC� J�` �` PROJECTADDRESS pc 7 61 LJ2 tl�l ti. � h ��� CCU V ZIP FLSp S ASSESSOR'S PARCEL NUMBER , ! LOT �� TRACT `D4to^ OWNER NAME '�_ Ir(:_ 1 ADDRESS K 6 L_I' k � S U r Wue'- G r PHONE 1 J 1 G �A 0 0 EMAIL APPLICANT NAME c `s A\j � —t ADDRESS I J�3+ �'� `C— U/< PHONE Ll ,S s EMAIL \�O �c.) I CONTRACTOR'S NAME \J L /S OWNER BUILDER? O YES G-M- BUSINESS NAME \ 1. aWO G ADDRESS } S PHONE 1 4 -5 f8 y U S EMAIL CONTRACTOR'S STATE LIC NUMBER 7 S 7 U ? LICENSE CLASSIFICATION C 7 VALUATION$ V O SO FT L SO FT APPLICANT'S SIGNATURE DATE CITY S7AFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: may__ CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE '11J��_ INVOICE TOTAL GREEN SMIP OWNER BUILDER VERIFIED C YES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES C NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777. www.cityofinenifee.us fi'�. f , FNIFB 'J fJ f t . 1\VU city of-menifee Building Dept- APR 0 It 2018 Received 0=_ ? v'i i 7 4%w Cmm=4 Neu ) r A'g C A A10 C) 6)ANOrL F\ aC pilf— J T j CI* E VYT OF 4AIF"E r-AUESNUORD.SAFETY DEPART6`E PLAN APPROVAL G" 0 1 - A� Vta 'ADoroval of these plans shall not be construed to be F -rm—Arofan approval of,any violation of any provisions of the federal sate c Op regulations and ordinances. This set of approved plans rr.u,- - -xar-.he jobsite until completion. NA ty-� n-as PA�i