PMT18-02293 City of Menefee Permit No.: PMT18-02293
29714 HAUN RD.
<ACCII L1 MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 0 511 412 01 8
PERMIT
Site Address: 28860 AMERSFOOT WAY, MENIFEE, CA Parcel Number: 337-133-009
92586 Construction Cost: $3,250.00
Existing use: 1 &2 Family Residence Proposed use:
Description of INSTALL 12'x 1T LATTICE ALUMAWOOD PATIO COVER, NO ELECTRICAL
Work:
Owner Contractor
LISA FARRELL-WILLIAMS D R SISNEROS INC
28860 AMERSFOOT WAY 30721 DESERT EAGLE WAY
MENIFEE,CA 92586 MENIFEE,CA 92584
Applicant Phone: 9512468911
DANIEL SISNEROS License Number: 949498
D R SISNEROS INC DBA PATIO PROS
30721 DESERT EAGLE WAY
MENIFEE,CA 92584
Fee Description 01t rr Amount($1
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
$168.65
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
property who builds or improves thereon,and who contracts for the projects
LICENSED DECLARATION with a licensed contractor(s)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of D I am exempt from licensure under the Contractor's State License Law for
Chapter9(commencing with section 7000)of Division 3 of the Business and the following reason:
Professions Code and my license is in full force and effect. personal residence
License Class S/
n 0 Ucense No. ` g By my signature below I acknowledge that,except for my
in which I must have resided for at least one year prior to completion of
Expires 6 30 1 Signatur improvements covered by this permit.I cannot legally sell a structure that
its entirety
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been onstru Lied in law,Section
D I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of applicable
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 www.leginfoca.gov/calaw.ht .
this permit is issued. Date
Policy# PROPERTY OWNER OR AUTHORIZED AGENT
❑I have and will maintain workers compensabon insurance,as required by 0 By my signature below I certify to each of the following:I am the property
section 3700 of the Labor Code,for the performance of the work for which owner or authorized to act an the property owners behalf.I have read this
this permit is issued.My workers compensation insurance carrier and policy application and the information I have provided is correct.I agree to comply
number are: with all applicable city and county ordinances and state lawn relating to
Carrier building construction.)authorize representatives of this city or county to
enter the above identified property for inspection purposes.
Policy# Expires
Date
(This section need not to be completed is the permit is for one-hundred PROPERTY OWNER OR AUTHORIZED AGENT
r1I certify that
i less O
�certitythatinthe performance of the work for which this permit is issued, CITY BUSINESS LICENSE#
I shall not emolov any persons in any manner so as to become subject to the MATERIAL DECLARATION
workers compensation laws of California,and agree that if I should become HAZARDOUS
subject to the workers compensation provisions of Section 3700 of the Labor Will the applicant or future building occupant handle hazardous material or
Code,I shall forthwith comply with se provisions. 5 /�' mixture containing a hazardous material equal to or greater that the
Applica Date amounts specified on the Hazardous Materials Information Guide?
a Yes
WARNING: AILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS Will the intended use of the building by the applicant arfuture building
AND
LCIVILFNES #TOOHALL ONEBJECT AN
ANDRTO OLLARAL1o0,00IES occupant require a permit for the construction or modification from South
ADDITIANDCION TO THE COST OF ONE COMPENSATION,
MPEN DTIO,DAMAGES AS DOLLARS PROVIDED FOR
Coast Air Quality Management District(SCAQMD)?See permitting checklist
N SECTION 3706 OF THE LABOR CODE,,INTEREST,AND ATTORNEYS FEES R forguidelines
Dyes )No
CONSTRUCTION LENDING AGENCY
Will the proposed building or modified facility be within 1000 feet of the
I hereby affirm that under the penalty of perjury there is i construction outer boundary of a school?
lending agency for the performance of the work which this permit is issued DYes XNo
(Section 3097 Civil Code)
I have read the Hazardous Material Information Guide and the SCAQMD
OWNER BUILDER DECLARATIONS permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that 1 am exempt from the California Health&Safety Code,Section 2.5505 and 25534 concerning
Contractor hazardous material reporting.
License Law for the reason(s)indicated below by the
checkmark(s)I have placed next to the applicable Rem(s)(Section 7031.5 4avtgO"ENT
Date
Business and Professions Code).Any city or county that requires a permit to
construct,alter,Improve,demolish or repair any structure,prior to its
issuance,also requires the applicant for the permit to file a signed statement EPA RENOVATION,REPAIR AND PAINTING(RRPI
that he or she is licensed pursuant to the provisions of the Contractors State The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the receiving compensation for most work that at disturbs paint e a pre-1978
Business and Professions Code)or thathe or she it on of
from licensure residence or childcare facility to be RRP-certified firms and comply with
and the basis for the alleged exemption.Any
cant t tlaci of Section of not by
an Applicant for a permit subjects the applicant to a civil penalty of not more required s who d the includes rental property owners and property
than[5500). managers who do the paint-disturbing work themselves or through their
or employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
D 1,as owner of the property, Y % ww eaa eov/lead or contact the National Lead Information Center at
compensation,will do( )all of or( )portion of the work,and the structure is 1.800-424-LEAD(5323).
not intended or offered for sale.(Section 7044,Business and Professions D An EPA Lead-Safe Certified Renovator will be responsible for this project
Code;The Contractors State License Law does not apply to an owner of a
property who,through employees!or personal effort,builds or Improves the Certified Hum Name:
property provided that the improvements are not intended or offered for firm Certification No
sale.If,however,the building or improvement is sold within one year of
completion,the Owner-Builder will have the burden of proving that it was DNo EPA Lead-Safe Certified Firm is required for this project because:
not built or improved for the purpose of sale.
\tea I,as owner of the property am exclusively contracting with licensed
tractors to construct the project(Section 7044,Business and Professions If your project does not comply with EPA RRP rule please fill out the RRP
ziThe Contractors State License Law does not apply to an owner of a Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL KRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: NADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
ONEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK L�J-itt r e 41&,r ila a o, o4e-*/'V
PROIECTADDRESS v2 ��SGO �fY/+Ci'SFUO� bvGy ZIPzSB
ASSESSOR'S PARCEL NUMBER .>- ,-133- �' LOT TRACT
OWNERNAME L%,se- Fu41("- wMI-4n5
ADDRESS oZ F960 �,-_ frnaF-
PHONE 760 �lfn3 55-7 � EMAIL
APPLICANTNAME �`''�`'711 A&C.S
ADDRESS 30-7z/ lQrsew-7 A-_ H2 e"11 '«
PHONE ?s/-a y6 EMAIL
CONTRACTOR'S NAME A-4 SA1eooW_T n OWNER BUILDER? O YES JNNO
BUSINESSNAME pl..$%$/7Y�.S.�i[G, /.j/f /'�-tib /`U $
ADDRESS 30 7-Z t lJ e5e-7
PHONE ysi-ayG- s9ii EMAIL ,�77
CONTRACTOR'S STATE LIC NUMBER 7�/941& LICENSE CLASSIFICATION A -0
VALUATION$ �t a .J r,� SQ FT ;7 64/ L SQ FT /
APPLICANT'S SIGNATURE` DATE
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE 06
INVOICE TOTAL GREEN SMIP 1 —
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE It NOTARIZED LETTER O YES O NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee,CA 92586 (951)672-6777
www.cityofinenifee.us
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