PMT18-02477 City of Menifee Permit No.: PMT18-02477
29714 HAUN RD. Type: Residential Plumbing
<ACCELA.' MENIFEE,CA 92586
MENIFEE Date Issued:
OS/21/2018
PERMIT
Site Address: 30262 LINDEN GATE LN, MENIFEE, CA Parcel Number: 364-240-009
92584 Construction Cost: $1,000.00
Existing Use: Proposed Use:
Description of 100 L FT U/G 3/4"GAS LINE FROM METER TO SITE OF FIRE PIT SITE AND FUTURE BBQ ISLAND,
Work: 100 L FT, 3/4"ELECTRICAL CONDUIT FOR FUTURE POWER TO BBQ ISLAND
Owner Contractor
ALEJANDRO BAEZA K RAINEY CONSTRUCTION
30262 LINDEN GATE LN 31914 SEWALT CT
MENIFEE,CA 92584 MENIFEE, CA 92584
Applicant Phone:9512052363
KYLE RAINEY License Number. 975365
K RAINEY CONSTRUCTION
31914 SEWALT CT
MENIFEE, CA 92584
Fee Description QtV Amount f$)
Plumbing Fixtures and Vents,fixtures 1 116.00
Building Permit Issuance 1 27.00
Inspections not specified 116 116.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Plumbing 1 5.80
General Plan Maintenance Fee- Electrical 1 0.00
$265.80
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 Bidg_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 70DD)of Division 3 of the Business and o I am exempt from licensure under the Contractor's State License Law for
Professions Code anndd my license is in full force and effect. the following reason:
License Class LS Uc nse No. Q1�'1 3�r� By my signature below I acknowledge that,except for my personal residence
Expires 1 y 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 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 this permit is issued. www.leginfo.ca.gov/calaw-htmi.
Policy# Date
O I 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 o 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 owners behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less Date
PROPERTY OWNER OR AUTHORIZED AGENT
(sl+cerlify that in the performance of the work for which this permit is issued,
I shall not emolov 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 become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall f rt with comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applicant Date -K' -7-O amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE79SfiCi! WORKER'S COMPENSATION COVERAGE IS o Yes r o
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINALPENAL7IES 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 Districtconstruction
CAQM tionor modification
permitting checklist
IN SECTION 370fi OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
A_ir�lines
Q^u'_a
CONSTRUCTJON LENDING AGENCY 0Yes l�
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) O Yes t4lioi
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
Contractor's License Law for the reason(s)indicated below by the California Health al Safety Cade,Section 25505 and 25534 concerning
hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5
Business and Professions Code).Any city or county that requires a permit to Gyy Date IZ
construct,alter,improve,demolish or repair any structure,prior to its pR PE� RTy pydNE HORN / 1
issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIRAND PAINTING(RRPI
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 licensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 7031.S by residence or childcare facility to be RRP-certified firms and comply with
an Applicant far 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 sale employees.For more information about EPA's Renovation Program visit:
compensation,will do( J all of or( I portion of the work,and the structure is wwsv.eoa.eov/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 D An 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-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 because:
in 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 RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER D_ In C711T
PLANNING CASE NUMBER
TYPE: O COMMERCIAL W-RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION Q-ELECTRICAL O MECHANICAL
O NEW OLPLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK 3 L OL
4 � Gl&� '2c 5Lb2 -
FIQ,c PIt lr•I
F L9 LAaID . " • Ccn.ai� Fog 2tuj&;� AsVL io j9rgp 1
PROJECTADDRESS �b2joZ LjyvoeIJ ks' ka :41.1. ZIP q2 43
ASSESSOR'S PARCEL NUMBER ] 'I gqob0`1 LOT $5 2 J TRACT o-b LVO?_j
OWNER NAME 1LEJ&,4j)ro SW q
ADDRESS Z(oZ UG ML-:N (a&- j.
PHONE �l„IoL, (pz3.'-ISIo'� EMAIL L �'j 3 e, jAbrM&tL_. UAw
APPLICANTNAME w TQucTw-j
ADDRESS AL L7• F^6� ,(F c g=S"
PHONE 9 ,(, 2aC-. Z3US EMAIL fzA,t� 26 O &c>
CONTRACTOR'S NAM la ,4 .e ,tiE OWNER BUILDER? C%YES O
BUSINESS NAME %t- [.oNS7R+J C5iL01J
ADDRESS ( LT L'C• •- MZNIjZ+E 75-.t}
PHONE C1 T I. 7+D•2343 EMAIL kv_A'sd- wl
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE :�f
s.l.,,
DEPARTMENT DISTRIBUTION ACCEPTED BY: /y}7•j CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE /
INVOICETOTAL J1,5 •gyp GREEN SMIP
OWNER BUILDER VERIFIED O YES 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 �
En
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PLOT/SITE PLAN
City of Menifee REAR PROPERTY LINE
MAY 2 1 2018 1 �psQ,r
Received -
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11 " CIT OF MENIFEE
F3UIl.ilING AND SAFETY DEW RTMENT
P�rE�r PLAN APPROVAL
RE VI11�— .�1
ATE 1�+
'ApF
al of these plans shallnot be con trued to be a permit for,oranappof,anyviolationofanyprovisi of the federal,stateorcity
RuRions and ordinances. Thu set of roved plans must be kept on the
jab ite until completion,
FRONT PROPERTY LINE
Property Owners Name At E it iop (o vgA
Property Address ?o2bZ LlNyr.V GM7G Lam.