PMT18-02375 City of Menifee Permit No.: PMT18-02375
29714 HAUN RD.
<A_CCBL/ MENIFEE,CA 92586 Type: Residential Addition
'm - 'tf;A " MENIFEE Date Issued: 05/15/2018
PERMIT
Site Address: 27553 HEADSAIL DR,MENIFEE, CA Parcel Number: 333-180-027
92585 Construction Cost: $8,900.00
Existing use: 1 &2 Family Residence Proposed use:
Description of INSTALL 11 X 42 ATTACHED PATIO COVER-SOLID AND LATTICE WITH 2 FANS AND 3 LIGHTS
Work:
Owner Contractor
HELEN HILLIER T F MEADOR CONSTRUCTION
27553 HEADSAIL DRIVE PO BOX 713
MENIFEE, CA 92585 WILDOMAR, CA 92595
Applicant Phone:9518376180
T F MEADOR CONSTRUCTION License Number:639087
PO BOX 713
WILDOMAR, CA 92595
Phone:9518376180
Fee Description Qtv Amount($1
Receptacle,Switch, Outlet&Fixture 5 136.00
Building Permit Issuance 1 27.00
Deck/Patio,non-standard 1 133.00
GREEN FEE 1 1.00
SMIP RESIDENTIAL 1 2.00
General Plan Maintenance Fee- Building 1 6.65
General Plan Maintenance Fee-Electrical 1 6.80
$312.45
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 carded 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
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 contractors)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from Ilcensure under the Contractors State License Law for
Professions Code and my license is in full farce and eff/ect -7 the following reason:
License Class Uce se No. `I'3 `p U B J
By my signature below I acknowledge that,except for my personal residence
Expires 3 U Signature in which I must have resided for at least one year priortocompletlon of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell 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 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 370D of the Labor Code,for the performance of work for which twnv.leeinfo.m.eov/calaw.html.
this permit is Issued.
Policy# Date
vTl have and will maintain workers compensation insurance,as required by
PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which o By my signature below I certify to each of the folio ming:I am the property
this permit is Issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
Carriers`�-'f_V�� with all applicable city and county ordinances and state laws relating to
't n/lob building construction.I authorize representatives of this city or county to
Policy#_( (-f 353q—( � �
Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred a
dollars($100)or less Date
PROPERTY OWNER OR AUTHORIZED AGENT
o l certify that in the performance of the work for which this permit is Issued,
I shall not emoloy any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forth thco p11��9ii)h thus revision. Will the applicant or future building occupant handle hazardous material or
�� t� 10 n mixture containing a hazardous material equal to or greater that the
Applicant Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 oyes ftj 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 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 Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidx�l/1'nes
CONSTRUCTION LENDING AGENCY aYes ,B 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 boultdary of a school?
(Section 3097 Civil Code) oyes crlio
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 reasons)indicated below by the California Health&Safety Code,Section 5505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 gas
material repojji�g.
Business and Professions Code).Any city or county that requires a permit to es oNo� /j/r' � /mil
construct,alter,improve,demolish or repair any structure,prior to Its y� Date i /
Issuance,also requires the applicant for the permit to file a signed statement
PROPERTY OWNER OR AUTHORIZED AGEM
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING(RRPI
License 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 limnsure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7032.5 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 1,as owner of the property,or my employee with wages as their sole employees.For mare information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at
norintended or offered for sale.(Section 7044,Business and Professions 1-BOD-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a o An EPA Lead-Safe Certified Renovator will be respomible 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. o No EPA Lead-Safe Certified Firm is required for this project bemuse:
ci 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RAP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: 51 S I S PERMIT/PLAN CHECK NUMBER
yy��
PLANNING CASE NUMBER
TYPE: O COMMERCIAL ARESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA C SIGN
SUBTYPE: -ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
—
DESCRIPTION OF WORK .r Q I x PArt�0 CtlJe''r`
L,-J � �5 1 ktS c
PROJECTADDRESS 7_55 -3 T•1e&ASAt ZIP 7. 5 F
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME
ADDRESS S41%Vwk
PHONE 9 5 i C�7 2 - 33{(4(,d EMAIL
APPLICANT NAMEP��o✓-
ADDRESS PO f3 c,-A _7 13 C A- c, Z1"CiS
PHONE j S i—S3'" LP 18 d EMAIL �(
CONTRACTOR'S NAME �G Y" Co VAS ( OWNER BUILDER? O YES AO
BUSINESS NAME CL N"t—,
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER C91'7 7 j.� LICENSE CLASSIFICATION i
VALUATION$ �� SQ FT 4I ` � L SO FT �J-
APPLICANT'S SIGNATURE l DATE
I
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BURRING PLANNING ENGINEERING FIRE , 1 O V--
INVOICETOTAL a GREEN SMIP
OWNER BUILDER VERIFIED OYES 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 --
www.cityofinenifee.us City of Menifee A1116G
Building Dept. AFAeM
FIWNd
MAY 15 2018
Received
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CITY OF MENIFEE
BUILDING AND SAFETY DEPARTMENT
PLAN APPROVAL
1
REVIEWED BY �.� • I S •
DATE
'Approval of these plans shall n t be construed to be a permit for,or an
approval of,any viogtion of any rovisions of the federal,state orci &
City of Menifee regulations and ordinances. This of approvedAnsmust n e
Building Dept. jobsite until completion. f
MAY 15 2018
Received