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PMT18-01690 City of Menifee Permit No.: PMT18-01690 29714 HAUN RD. Type: Residential Re-Roof <A_CCELA>. MENIFEE, CA 92586 MENIFEE Date Issued: 04/1 312 01 8 PERMIT Site Address: 29983 KRATKA RIDGE LN, MENIFEE, CA Parcel Number: 338-282-002 92586 Construction Cost: $7,700.00 Existing Use: Proposed Use: Description of TEAR OFF AND REROOF WITH COMP COOL ROOF Work: GAF:Timberline HD®and Timberline Ultra HDO Aged Chestnut Owner Contractor STEPHANIE MAGANA RANDY'S CLASSIC ROOFING 29983 KRATKA RIDGE LANE 32960 DAILY DR MENIFEE, CA 92586 MENIFEE,CA 92584 Applicant Phone:9516729411 RANDY'S CLASSIC ROOFING License Number: 726425 32960 DAILY DR MENIFEE, CA 92584 Phone:9516729411 Fee Description Oft Amount($1 Building Permit Issuance 1 27.00 Inspections not specified 98 98.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Building 1 4.90 $130.90 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 1 LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects 1 I 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 licensure under the Contractor's State Ucense Law for Professions Code and my license is in full force and effect. the following reason: License Class 3 / Lice No. By my signature below I acknowledge that,except for my personal residence Expir s `` Signature in which I must have resided for at least one year prior to completion of WORKE S COINPENSA710N DECLARATION improvements covered by this permit.I cannot legally sell a structure that have built as an owner-builder if it has not been constructed in Its entirety by WORKEWfS ❑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 www.leeinfo.ca.eov/calaw.html. this permit is issueD © ! ��`Poliry# !A'' b Date yl 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 ❑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: _� 1 ,,Qy application and the information I have provided is correct.I agree to comply Carrier �/ GZ �� '1 C,Y� N with all applicable city and county ordinances and state laws relating to cy C J building construction.I authorize representatives of this city or county to Policy# LL7�A60�c� Expires�7 7(, entertheabove 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 ❑I certify that in the performance of the work for which this permit is issued, I shall not emolov any 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 �µ�R0DU5 MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor �41j Cade,I shall f hwith omply wit those provisions. C^' Will the applicant or future building occupant handle hazardous material or a Applicant Date —� U mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILU TO SECUREWORKER'S COMPENSATION COVERAGE IS OYeso UNLAWFUL,AND SHALL SUBJECT 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($100,00D),IN occupant require a use it the thebuilding construction applicant modification from South ADDITION 3706O TH COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY ❑Yes rNo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 2000 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 7 - OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that 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 al Safety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 myes ❑Na Business and Professions Code).Any city or county that requires a permit to r� �y .' Date construct,alter, demolish or repair any structure,prior to its PR PERTY�ER OR AUTHORIZED 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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING fRRPI Ucense 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 7031.5 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 paint-disturbing work themselves or through their ❑I,as owner of the properly,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( I all of or( )portion of the work,and the structure is www.eoa.aov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professians 1-800-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a ❑An 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. ❑No EPA Lead-Safe Certified Firm is required forthis project because: ❑I,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 fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION �z MENIFEE DATE: —/ PERMIT/PLAN CHECK NUMBER PLANNING CASE NUMBER TYPE: O COMMERCIAL AESIDENTIAL 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 �y DESCRIPTION OF WORK 00 1 6 Sl PROJECTADDRESS 2C�9Q��f7j�� ��� C� 21P ASSESSOR'S PARCEL NUMBER ✓3g .��¢�'o 00cQ. LOT TRACT OWNER NAME ADDRESS L! 9 n4/71�Q PHONE 9�i 3Z Z ��7j EMAIL APPLICANT NAME I Y ��'J 7 I/L� O►C, S ADDRESS PHONE EMAIL CONTRACTOR'S NAME Ct L s OWNER BUILDER? O YES ONO BUSINESS NAME : ct kA, ADDRESS PHONE EMAIL VL Cla CONTRACTOR'S STATE LIC NUMBER 72h yZs LICENSE CLASSIFICATION C —� VALUATION$ a SO FT 2/0n L SQ FT �{ APPLICANT'S SIGNATURE DATE 0TYSTAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PANNING ENG1N ERING FIRE INVOICE TOTAL I�,p,cL7C' 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 City of Menifee www.cityofinenifee.us ` � ° Building Dept. i. APR 13 2018 S ° °, zu, y v nm �1y o A 3 �•2 m m nlll-Da 3 0 c o Z m O m n nz t. 0w' a• m i 'i :,n O n 0 13C N c O n o g m y J 0• m .G O m � 19•f n D Iv C] 0 0- n n 0 D D n in �- D w, N m 3 n a < m m m m D < D ! Z r 3 3 n^ T m A N m o m a m m f z m o .-.IA n 3 0 9 o N m a < o• y n< v D A Z " 0 3 O m 3 N a T m a• r.i » 0 N -' o m �� .'0 •p .m. T H a £ a o ti m m m s m m < o. n F n O O w �o a n n2. 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