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PMT18-02480 City of Menifee Permit No.: PMT18-02480 C 29714 HAUN RD. Type: Residential Plumbing :. ccEL:i-%> MENIFEE, CA 92586 MENIFEE Date Issued: 05/21/2018 PERMIT Site Address: 26448 MILENA DR, MENIFEE, CA 92584 Parcel Number: 360-610-010 Construction Cost: $1,600.00 Existing Use: Proposed Use: Description of EXTEND 10,25 L FT GAS LINE FOR FUTURE BBQ & FIRE PIT, TO BE SLEEVED RUNNING UNDER Work: LATTICE PATIO COVER Owner Contractor DAVID A CANDEE 26448 MILENA DR MENIFEE,CA 92584 Applicant License Number: DAVID A CANDEE 26448 MILENA DR MENIFEE, CA 92584 Phone:4088064827 Fee Description Qtv Amount($) Plumbing Fixtures and Vents, fixtures 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee- Plumbing 1 5.80 $149.80 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 building 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 LICENSED DECLARATION property who builds or Improves thereon,and who contracts for the projects with a licensed contractors)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and X I am exempt from licensure under the Contractor's tat 'ce Law fpr Professions Code and my license is in full force and effect the fallowing reason: M?�/N{ `y��,GrSL �y ✓,d[/�I-'j License Class License No. By my signature below I acknowledge that,except for my personal residence Expires 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 ❑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 this permit is issued. www.le mfo.c . ov�Tc�alas9'ptml, q/ Policy# 62b -� Date✓ , �f o D 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 D 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 With all applicable city and county ordinances and state laws relating to Carrier building construction.I authorize representatives of this city or county to Policy# Expires /ante�t�he abo a Identified property for inspection purposes. p (This section need not to be completed is the permit is for one-hundred �6C�4::5\ C�_ew Date x dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, I shall not emolav 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 forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a Applicant 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 15 in Yes INo UNLAWFUL,AND SHALL SUBJECT AN EMPLOYERTO 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 LODE,INTERESTS AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY oYes 'XNo I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 10M 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 WNo 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 California Health al Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the checkmark(s)I have placed next to the applicable Rem(s)(Section 7031.S hazardous a rlal reporting. Business and Professions Code).Any city or county that requires a permit to Dyes . /n 2 � construct,alter,improve,demolish or repair any structure,prior to its C� Date PROPERTY OWNER OR AUTHORIZED AGENT issuance,also requires the applicant for the permit to file a signed statement that he or she 1s licensed pursuant to the provisions of the Contractor's 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 licensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation of Section 7031.5 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 D 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.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-BOD-424-LEAD(5323). Code;The Contractor's State License Law does not apply to an owner of a ❑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. ❑No EPA Lead-Safe Certified Firm is required for this project because: o 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 comply with EPA RRP rule please fill out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ` MENIFEE DATE: PERMIT/PLAN CHECK NUMBERMW PLANNING CASE NUMBER TYPE: O COMMERCIAL OESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA OSIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK PROJECTADDRESS Y` /�oh/4 �y� ZIP ASSESSOR'S PARCEL NUMBER LOT TRACT 2 rS/ OWNER NAME O*7J/ di.fp7 ADDRESS g //I/ PHONE ya8 �a� y�� 7 EMAIL �dLp.��P� �jiMec �. 4a APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES O NO BUSINESS NAME ADDRESS PHONE EMAIL CONTRACTOR'S ST TE LIC NUMBER LICENSE CLASSIFICATION �6 VALUATION$ o ESQ FT �Jn L SO,FT APPLICANT'S SIGNATURE . JI^�� ` " DATE Z e _ DEPARTMENT DISTRIBUTION ACCEPTED BY:� CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICETOTAL GREEN SMIP OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES :1 NO City of Menifee Building &Safety Department 1219714 Haun Rd., Menifee,CA 92586 (951)672-6777 www.cityofmenifee.us NIF PLOT/SITE PLAN N REAR PROPERTY LINE City Of Menifee 44 I Building Dept. A e- MAY 21 201 p eCeNed f e \ 1- ! �°drr I 0 W \•� LU J Se W a W ' � H V7 N CITY OF ME IF C!�� BUILDING AND SAFETY DEPARTMENT Me f�yj PLAN APPROVAL ^ REVIEWED CY*JL'w DATE '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 jobsite until completion. O FRONT PROPERTY LINE ag/ Property Owners Name A,J I R /-/ Property Address alP [ y� �Yi,/Lo/7 I/