PMT18-02527 City of Menifee Permit No.: PMT18-02527
29714 HAUN RD.
<ACCE L/4? MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 05123/2018
PERMIT
Site Address: 27068 RED ROCK CT, MENIFEE, CA Parcel Number: 333-412-024
92585 Construction Cost: $7.500.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL ATTACHED SOLID 12'6"X 11.6", 19'X16'SOLID, 12.6"X 9'LATTICE ALUMAWOOD PATIO
Work: COVERS W/ELECTRICAL 2 FANS,3 GFCI OUTLET
Owner Contractor
WADE HURD TRADER DAN'S INC
27068 RED ROCK CT 840 S ROCHESTER AVE STE C
MENIFEE,CA 92585 ONTARIO,CA 91761
Applicant Phone:9093900555
DON DAUGHENBAUGH License Number:517575
TRADER DAN'S INC
840 S ROCHESTER AVE STE C
ONTARIO,CA 91761
Fee Description OQt t Amount f81
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 aldg_Pernit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts far the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and u I am exempt from licensure under the Contractor's State License Law for
Professions Code an my license is in full force and effect. ���� the following reason:
License Class se No. JJ By my signature below I acknowledge that,except for my personal residence
Expires 34 Signature in which I must have resided for at least one year priorto completion of
R'S COMPENSATION DEC improvements covered by this permit.I cannot legally sell a structure that I
WORKE
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 o e 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:
by5ection 3700 of the Labor Code,for the performance of work for which
this permit is issued. www.Ieeinfo.ca.eov/calaw.htmi.
Policy# Date
a4have 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 owner's behalf.I have read this
number are: application and the information I have provided is correct.I agree to comply
Carrier AGE with all applicable city and county ordinances and state laws relating to
I ' �r building construction.I authorize representatives of this city or county to
Polity#lI"SL's 3�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
o I certify that in the performance of the work for which this permit is issued, Q �22
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'sfampmsati rovisions of Section 3700 of the labor
Cade,I s arthwrt �t p t those revisions. 777 Will the applicant or future building occupant handle hazardous material era
Applicant Date v > / mixture containing a hazardous material equal to or greater that the
amounts specs on the Hazardous Materials Information Guide?
WARNING: U RE WORKER'S COMPENSATION COVERAGE IS O Yes o
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES WIII the intended use of the building by the applicant or future building
AND[IVILFINES 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 Quali Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for goideli s
CONSTRUCTION LENDING AGENCY ❑Yes No
I hereby affirm that under the penalty of perjury there is a construction Will the propos d building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boun ry of a school?
(Section 3097 Civil Cade) O 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 25505 and ZS534 concerning
hazer ous male" o ng.
Bhsiness and
I have placed next to the applicable item(s)(Section permit es ❑No J
Business and Professions Code).Any city or county that requires a permit to � Date
construct,alter,improve,demolish or repair any structure,prior to its PROPERTY Obt1D DAGENT
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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING(FIRPI
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
than
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 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( )all of or( )portion of the work,and the structure is www.eoa.aov/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 O 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:
❑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 NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL O�SIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION () ELECTRICAL O MECHANICAL
P4EW O PLUMBING O RE-ROOF NUMBER OF SQUARES
I / /
DESCRIPTION OF WORK 'U // I l q"X l6 / 57 /�1 - 121611 A
� p cou-cly /,�'�:
PROJECTADDRESS 2706 (� ���v� CA- ZIP q'Z 5-S >
ASSESSOR'S PARCEL N' �UMBER WA//,-, LOT TRACT I1 I s
W OWNER NAME u� 4L)l '
ADDRESS Z-766 y C1P" f-aclX—
PHONE °l0�-,�Z,s� O �8 EMAIL
APPLICANT NAME �On Z1{^iP icy
ADDRESS
PHONE SS � EMAIL
CONTRACTOR'S NAME oorns lu" 60vwN� OWNERBUILDER? OYESQ-Nb�
BUSINESS NAME
ADDRESS 5'iD
PHONE ci0q,,�-lo 'Gs5`� EMAIL
CONTRACTOR'S STATE LIC NUMBER S17 S 7$— LICENSE CLASSIFICATION P
VALUATION$ _7' DU SQ FT 15-610 L SQ FT /9
APPLICANT'S SIGNATURE DATE
CITY STAFF USE oNLV
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIF���✓✓,E&BIJiI /�Y✓✓SE NUMBER
BUILDING PLANNING ENGINEERING FIRE ;;�.j.¢J�
INVOICETOTAL ` .14K I GREEN _ SMIP 1-
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.cityofmenifee.us
NIF
OWNER Ghat
ADDRESS 97001
CITY ZIPHONE Z .�
LOT NO. TRACT APN
_._ R & I RAG'f`-
DEE
CONTRACTOR ;n, R �eI, RQIJiR�'I
ROOMS N' COVERS PROPOSED D ITIIQN(S)
840 S ROCHESTER AVE#C
/
ONTARIO; CA 91761 ���(�vi �/ lQiCplUf�
LIC. B-517575
909-390-0555 f"1/�dd.,X 1p y
WORK COMP 5 /�,,
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DA MAY 2 3 018 ,
Al : al of these plans s all not be construed to be a permit for,or an �G yo+®I`,
l �r of,anyviolationo any provisions of the federal,state or city G ce1! ��ns and ordinances. Thu set of approved plans must be kept on thep\ntil completion, /�
`S��O STREET