PMT18-02525 City of Menifee Permit No.: PMT18-02525
29714 HAUN RD.
�CCELX. MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 05/2312018
PERMIT
Site Address: 28734 RUSTIC GLEN ST, MENIFEE, CA Parcel Number: 333-500-018
92584 Construction Cost: $5,400.00
Existing Use: 1 &2 Family Residence Proposed use:
Description of INSTALL 17 X 25 SQ FT SOLID ALUMAWOOD PATIO COVER WIELECTRICAL,4 LED LIGHTS, 1 FAN
Work:
Owner Contractor
DEBORAH MYLES ANGEUS PATIO COVERS&AWNINGS
28734 RUSTIC GLEN ST 225 SPARKLER LANE
MENIFEE, CA 92584 PERRIS, CA 92571
Applicant Phone: 9514431659
IRENE GONZALEZ License Number: 900657
ANGEL'S PATIO COVERS&AWNINGS
225 SPARKLER LANE
PERRIS, CA 92571
Fee Description Qtv Amount 1E1
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 1.00
General Plan Maintenance Fee-Building 1 6.65
General Plan Maintenance Fee-Electrical 1 6.80
$311.45
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 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.rpl Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
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
Chapter9(commencing with section 7000)of Division 3 of the Business and 0 I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is to full force and effect. �! the following reason:
'
License Class L' a No. [��OS •f
�— By my signature below lacknowledge that,except farmy personal residence
Expires 0-4 c2 00-) Signature in which l must have resided for at least one year priorto 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 svww.leeinfo.ca.eov/calaw.html.
this permit��iis/sis�iss�I,,u�e�d.1 /� rl -2��
Policy# 6N V yy V I 38 ;f'� L Date
0 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 0 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 owner's behalf.)have read this
number are, ,,I f.��ii ��pp Tr Co. application and the information I have provided is correct.I agree to comply
Carrier_Iut1�''"�1 "hY� a �l C with all applicable city and county ordinances and state laws relating to
T1 building construction.I authorize representatives of this city or county to
Policy# BNuwC U I 5 I2 L Expires )I�all o6l9 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
51 certify that in the performance of the work for which this permit is issued,
I shall not emolov any persons to 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 h rth''wlIith _mply with t ose provisions. Will the applicant or future building occupant handle hazardous material or a
Applica t L Date 5 23 1 D mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE T ECUR WOR R'S(�NSATION COVERAGE IS 0 Yes 11 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($100,000),IN occupant require a permit for the construction car modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Duality Management DistrictconstSCAQMDr?Seepation from
Soutist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY ❑Yes I No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) 0 Yes No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25S05 and 25534 concerning
checkmark(s)I have placed next to the applicable item hazardous material r orting.$)(Section 7031.5 c
Business and Professions Code).Any city or county that requires a permit toQQ
construct,alter,improve,demolish or repair any structure,prior to its & Date
issuance,also requires the applicant for the permit to file a signed statement PROP RTY OWNER AUTHDIZE GENT
that he or she is 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 Cade)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 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
01,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.eua.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 0 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. 0 No EPA Lead-Safe Certified Firm is required for this project because:
❑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 RII out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
1
DATE: �" PERMIT/PLAN CHECK NUMBER O py—o d5aos-
� PLANNING CASE NUMBER
TYPE: O COMMERCIAL 91 RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
NEW OPLUMBING ORE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK 5od PrinrKrii)
PROJECTADDRESS on W ZIP qpr�
ASSESSOR'S PARCEL NUMBER & LOT �� TRACE ( 5
OWNER NAME
ADDRESS r�PHONE J'� � EMAIL ,
APPLICANT NAME L^WL,n+n��'..l`.�
ADDRESS '2 S W i 'j"1' A. ✓A 61 a E_-7-0
PHONE IIq " 'T21 LIS-5V EMAIL
CONTRACTOR'S NAMEoil OWNER BUILDER? O YES ONO
1
BUSINESS NAME
ADDRESS ! Ab-r j /T S
PHONE (��h(p �a�7"� EMAIL �) 15 , NCO
CONTRACiOR'SSTATELICNUMBER 91ti111nri�--��- LICENSECLASSIFICATION
VALUATION$. .r SO FT �'�✓ L SQ FT
APPLICANT'S SIGNATURE DATEarysTAFFusE
"
e __
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL ll,y-S GREEN I_ SMIP '
OWNER BUILDER VERIFIED O YES 0 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.cityofmenifee.us
NIF
�jc�l��el (�l`��'v�c►i�vo�c9
City ot Menifee
o. (1)C ;'ritzy Mtn Building Dept.
LkA wohi-.3 MAY 2 3 2018
ec
LEDGER & TRAC
o a� INSPECTION 13EQUIRED
< yam "
r[Lf7 tir p oy
LLJ
,ac'uO rah M-q l e 5
C-11' 9 a shy
v3)-5ito Oct
c
�V
= M NIFEE
ANG ND SAFETY ri ,
J APP OVAD i2-1V-2�Ocl
Ycly
.VIEW BY f OO
DATE
Approval ofhsc !Iars slid ll,•, :; ,r, �M. tf ,or in
pprovai rf ; ., th> ate 4 r City
gulatio:-:an ' -•. ptonthe