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PMT18-01708 City of Menifee Permit No.: PMT18-01708 29714 HAUN RD. Type: Residential Re-Roof '3tCCEL1�� MENIFEE,CA 92586 MENIFEE Date Issued: 04/16/2018 PERMIT Site Address: 29970 CARMEL RD, MENIFEE, CA 92584 Parcel Number: 336-132-008 Construction Cost: $7,000.00 Existing Use: Proposed Use: Description of REMOVE AND REPLACE COMP SHINGLES WITH COOL ROOF COMP SHINGLES Work: CRRC: 0890-0011 OWENS CORNING ANTIQUE SILVER Owner Contractor DALE TEDESCO L F C CONSTRUCTION 29970 CARMEL ROAD 23905 CLINTON KEITH MENIFEE, CA 92584 #114-182 Applicant Phone: 9514905223 L F C CONSTRUCTION License Number: 964147 23905 CLINTON KEITH #114- 182 WILDOMAR, CA 92595 Phone: 9514905223 Fee Description Qtv Amount($) 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. I I I I f� I i i AA_Bldg_Permit_Tem plate.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 ❑I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and efff t. the following reason: License Class 9 LIcens o. i,Ve 1 By my signature below I acknowledge that,except for my personal residence Expires�'3��`� Signature in which I must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by o 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.htrnl. this permit is issued. Policy# Date WT 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: ` application and the information 1 have provided is correct.I agree to comply �11 with all applicable city and county ordinances and state laws relating to Carrier pp��yyhh - building construction.I authorize representatives of this city or county to Policy# UW Expires ' , 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 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# worker's compensation laws of California,and agree that if I should becomeeZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor 'IX Cade,I shall orth h com y with those provisions. Will the applicant or future building occupant handle hazardous material or a IJmixture containing a hazardous material equal to or greater that the Applicant Date I amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS D Yes VVo 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($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist for guidelines CONSTRUCTION LENDING AGENCY ❑Yes Q-3%No 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 0 0 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that I am exerts 0 rom the permitting checklist.I understand my requirements under the State of California He Ith& afety Code,Section 25505 and 25534 concerning Contractor's License Law for the reason(s)indicateddo the hazardous teri reporting. checkmark(s)I have placed next to the applica-Vernop, tion 7031.5 ` Business and Professions Code).Any cityfs,(*yrlft;'tit requir �yaa permit to Cs Date construct,alter,improve,demolish or real ?s�tructure,(p, 0 its PROPERTY NER OR AUTHORIZED AGENT issuance,also requires the applicant for t0permit torfi�-a signed staterrkent., that he or she is licensed pursuant to the provis�or�`"pf tie Contract�(��te EPA RENOVATION,REPAIR AND PAINTING(RRPI License Law(Chapter 9(commencing with Section 000)of Div s lido he The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Business and Professions Code)or that he or she is exempt fr -ensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any viola�oinfaf �flon 7031.5 by residence or childcare facility to be RRP-certified firms and comply with (! an Applicant for a permit subjects the applicant oy c aiWenalty of not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their If o I,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is www.epagov/lead/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the Y property provided that the improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because: I ❑1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractor's State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. ����������|� B[j|LD|��G /� S�`FETYPERK4iT/PLAN (�HE��K ��PPLI[AT|{]N � onxu.m`mmm u~�� - / DATE: PERMIT/PLAN CHECK NUMBER PWIS - r)1 1109 PLANNING CASE NUMBER TYPE: C' COMMERCIAL �;KESIDENTIAL 'c) MULTI-FAMILY C MOBILE HOME POOL/SPA C SIGN SUBTYPE: C) ADDITION ALTERATION C' DEMOLITION C., ELECTRICAL MECHANICAL NEW PLUMBING RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK QuIvAlL �M Wi ASSESSOR'S PARCEL NUMBER TRACT OWNER NAME ADDRESS PHONE EMAIL APPLICANT NAME PHONE EMAIL CONTRACTOR'S NAME BUSINESS NAME Lf C JIL v ADDRESS C" CONTRACTOR'S STATE LIC NUMBER bq LICENSE CLASSIFICATION VALUATION$ SO, L SO.FT APPLICANT'S SIGNATURE DATE iCITYSTAFF-USE ONLY_!-.: M DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERRV6 FIRE �'Q w OWNER BUILDER VERIFIED C;YES NO DRIVERS LICENSE# NOTARIZED LETTER Q YES NO City ofK8enifee Building & Safety Department | Z97l4HaunRd, yWenifee, [A9Z5D6 (gS1)67Z'6777 wm/m/.cityofnenifee.us o o :E a o z n n 03 n to D 0,s O - c �+ r: m m > W N ° 3 0 = O � o --I o O Q Dom, ((A � � cn ml 3 ° O S. 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