PMT18-02044 City of Menifee Permit No.: PMT18-02044
29714 HAUN RD.
MENIFEE,CA 92586 Type: Residential Addition
em"e Wt—+ MENIFEE Date Issued: 0 412 712 01 8
PERMIT
Site Address: 27669 LANHAM ST,MENIFEE,CA 92584 Parcel Number: 360-580-014
Construction Cost: $5,500.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 11'6"x IV LATTICE AND 11'6"x 31'SOLID ALUMAWOOD PATIO COVER,WITH 2 FANS,2
Work: LED LIGHTS
Owner Contractor
LEO&DENISE DUARTE T F MEADOR CONSTRUCTION
27669 LANHAM STREET PO BOX 713
MENIFEE,CA 92584 WILDOMAR,CA 92595
Applicant Phone:9518376180
REGINA MEADOR License Number:639087
T F MEADOR CONSTRUCTION
PO BOX 713
WILDOMAR,CA 92595
Fee Description Q_yt Amount fEl
Receptacle,Switch,Outlet&Fixture 4 131.00
Building Permit Issuance 1 27.00
DecklPatio, 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 6.55
$306.20
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 Mantles.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 lildg_Pennit_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 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 Iicensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect the following reason:
License Class_ 3 Uce se No. `-3 9 V 27
/' By my signature below I acknowledge that,except farmV Personal residence
Expires`L 3 U 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 legally sell a structure that I
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 sysysv.leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy# Date
0\I have and will maintain worker's compensation insurance,as required by
PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Cade,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 application and the information I have provided is correct.I agree to comply
Carrier With with all applicable city and county ordinances and state laws relating to
�i building construction.I authorize representatives of this city or county to
Policy#ef Of 35341—f (o Expires /c. � O enter the above Identified property for inspection purposes.
(This section need not to he completed is the permit is for one-hundred s
dollars($100)or less Date
PROPERTY OWNER OR AUTHORIZED AGENT
D I certify that in the performance of the work for which this permit is issued, day aI�7
Ishallnotemolov any persons in any manner so as to become subject tothe CITY BUSINESS LICENSE J�..�t'✓''� �.9%
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
Cade,I shall forth the p I)h those. rovisions. —7 Will the applicant or future building occupant handle hazardous material or
Applicant 1 " Date �� �� / 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 i�No
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 DOLIARS($100,000),IN occupant requires permit for the construction or modification from South
IN SECTION ON TO
06 OF THE
LABOR CODE,INTERTION,DAMADATTOGES AS R ATTORVIDEDNEYS
FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 37060FTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guid�lll1nes
CONSTRUCTION LENDING AGENCY oYes r@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 boupdary of a school?
(Section 3097 Civil Code) oYes o
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
Contractors 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 Vardous material repo i g.
Business and Professions Code).Any city or county that requires a permit to Oyes o No—
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 OR AUTHORIZED AGENT
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING IRRPI
License Law(Chapter9(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
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.Rov/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 oAn 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-Bullder 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:
D 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 complywith EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 127 1 '9 PERMIT/PLAN CHECK NUMBER - oZO"i
TYPE: O COMMERCIAL VRESIDENTIAL O MULTI-FAMILY O MOBILE HOME 0- POOL/SPA O SIGN
SUBTYPE: XADDITION O ALTERATION O DEMOLITION e ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK .11�5TM A b 1 �4'Y-h(-L d I
PROIECTADDRESS OL
ASSESSOR'S PARCEL NUMBER '/,�(f�^f �-��y LOT TRACCitV ofMenifee
OWNER NAME I-Po
�� �rz Building Dept.
if `w��SL 4J
ADDRESS s``°"'C. APR 2 7 2018
PHONE EMAILRe
°
APPLICANT NAME
ADDRESS �]po F�X T—7 13 W i g CVI'N c:
PHONE �151` 83 7— I <�C7 EMAIL
CONTRACTOR'S NAME e 6-- 6> i Sf- OWNER BUILDER? O YES NO
BUSINESS NAME 5C Vv—
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER (o U�-7 LICENSE CLASSIFICATION
!.
VALUATION$ fT,5 J 0✓- SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE
CITK STAFF USE Otlkr___-
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN SMIP `
INVOICE PAID AMOUNT AMOUNT115ay-WI
n n,CASH 0CHECKp CREDITCARD VISA/MC
PLAN CHECK FEES PAID AMOUNT 1 O CASH O CHECK# O CREDITCARD VISA/MC
OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menefee Building&Safety Department 29714 Halm Rd. Menefee, CA 92586 951-672-6777
WWW.Cityofinenifee.LIS Inspection Request Line 951-246-6213
-LEDGER & TR- 4"K
I 1UN "RED ------------------
sr-7
C,
City Of Menifee 6
Building Dept, —V
APR 2 7 2018
fJrG
CITY F MENIFEE
ING AND SAFETY DEPARTMENT
PLAN APPROVAL
REVIEWED BY
DATE
0
'Approval of these plans shall not be construed to be a permit for,or an
approval of,any violation of any provisions of the federal,state or city
regulations and ordinances. This set of approved plans must be kept on the
L jobsite until completion.
11
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