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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 ENIFE ~ |� r-N. - CD \ 2 � « S \ CDIlk (D :R. CD� ; . �CD & z \ ~ r . ƒ 2 = o - - 2 � gj \ m $ _ \ - ƒ\ { 0z ■ I / � \ ƒ � # £ [ \ $ | . � s a { ; � cj:5 OFF1 E COPY