PMT18-02534 City of Menifee Permit No.: PMT18-02534
29714 HAUN RD. Type: Residential Addition
ACCEL/A. MENIFEE,CA 92586
MENIFEE Date Issued: 0512412018
PERMIT
Site Address: 26343 RIM CREEK PATH, MENIFEE, CA Parcel Number: 360-671-008
92584 Construction Cost: $3,000.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL PATIO COVER 12X25 SOLID ALUMAWOOD
Work:
Owner Contractor
PAMELA STREETER-LAUDERMILL PSLQ INC
26343 RIM CREEK PATH 18890 SEATON AVE
MENIFEE,CA 92584 #206
Applicant Phone:9517954260
PSLQ INC License Number. 919885
18890 SEATON AVE
PERRIS, CA 92570
Fee Description ON Amount(s1
Receptacle, Switch, Outlet&Fixture 2 121.00
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-Electrical 1 6.05
$289.05
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Mantles.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_Bldg_Permil_Template.rpt Page 1 of 1
City Of Menifee
LICENSED DECLARATION ❑ [am exempt from ltcensure under the Contractors'State License Law for the
I hereby affirm under penalty or perjury That I am licensed under provisions of following reason:
Chapter 9(commencing with section 7000)of Division 3 of the Business and By my signature below I acknowledge that, except for my personal residence in
Professions Code and py license is in full force and eff n (y which I must have resided for at least one year prior to completion of
License Class Lice sir//Noo '7 1$ improvements covered by this permit,I cannot legalty sell a structure that I have
Expires — — ignature \1 built as an owner-building if it has not been constructed in its entirety by licensed
r contractors. I understand Ural a copy of the applicable law,Section 7044 of the
WORKERS'COMPENSATION DECLARATION Business and Professions Code,is available upon request when this application is
submitted or at the following Web site:
❑ 1 hereby affirm under penalty of perjury one of the following denlarations: hftp:l/www.leginfo.m.qovlcalaw.htmi.
I have and will maintain a certificate of consent of self-insure for workers'
compensation,issued by the Director of Industrial Relations as provided for by Date
Section 3700 of the Labor Code, for the performance of work for which this
permit Is issued. Property Owner or Authorized Agent
Policy# ❑ By my Signature below, I certify to each of the following:I am the property
❑ 1 have and will maintain workers' compensation insurance, as required by owner or authorized to act on the property owners behalf. I have read this
section 3700 of the Labor Code, for the performance of the work for which this application and the information I have provided is correct. I agree to comply
permit is issued.My workers'compensation insurance carder and policy number are: with all applicable city and county ordinances and slate laws relating to building
� �Q � construction.I authorize representatives of this city or county to enter the above.
Carrier T / identified property,for the inspection purposes.
Policy# Will MONI Expires 7� (� ^�,� Dale
C,L Property Owner orAuthorized Agent
(This section need not be comp)tedrif the permit is for City Business License# ��O�
one-hundred dollars($100)or less)
❑ I certify that in the performance of the work for which this permit is Issued,I HAZARDOUS MATERIAL DECLARATION
shall not emoloy any persons in any manner so as to become subject to the Will the applicant or future building occupant handle hazardous material or a
workers'compensaatkin laws of Caltfomfa, and agree that if I should become mixture containing a azardous material equal to or greater that the
subject to the wo rs'compensation provisions of Section 3700 of the Labor amounts spec r on the Hazardous Materials Information Guide?
Code,1 shall o w h comply ith those provisions. / •/�7 OYES C�RO
Appltc k ete; a / Will the intended use of the building by the applicant or future building
occupant require a permit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' CoastAir Quali anagement District(SCAQMD)?See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL forguideli
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND OYES ❑NO
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, Will the proposed b if id g r modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE boundary ool7
LABOR CODE, INTEREST,AND ATTORNEYS FEES DYES tFNO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I understand my requirements under the State of
agency for the performance of the work which this permit is issued(Section California Health Code,Section 25505 and 25534 conceming
3097 Civil Code) hazardous tbatiffal reporting.
OWNER BUILDER DECLARATIONS ❑Y - --7
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's Dete
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER ORAL �RIZED AGENT
next to the applicable item(s)(Section 7031.5.Business and Professions Code:
Any city or county that requires a permit to construct, alter,improve, demolish, EPA RENOVATION,REPAIR AND PAINTING fRRPI
or repair any sWcture, prior to its issuance,also requires the applicant for the
permit to file a signed statement that he or she Is licensed pursuant to the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors Q
provisions of the Contractor's State License Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint in a pre-1978
Section 7000)of Division 3 of the Business and Professions Code)or that he or residence or childcare facility to be RRP-certified fines and comply with
she is exempt from ficensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 70315 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penalty of not more than($500).) employees.For more information about FPNs Renovation Program visit
www.epa.govAead or contact the National Lead Information Center at
❑ 1, as owner of the property, or my employees with wages as their sole 1-800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the work,and the structure is
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's Slate License Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this projec
who, through employees' or personal effort, builds or improves the property,
provided that the Improvements are not intended or offered for sale.If,however, Certified Firm Name:
the building or Improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the Firm Certification No:
purpose of sale).
❑ I, as owner of the property an exclusively contracting with licensed No EPA Lead-Safe Certified Firm is required for this project because:
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's License Law does not apply to an owner of a property
who builds or improves thereon, and who contracts for the projects with a
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ° MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER
// PLANNING CASE NUMBER
TYPE: O COMMERCIAL t- ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK L. b
Ca M5
PROJECTADDRESS J rLIP
ASSESSOR'S PARCEL NUMBER" - LOT TRACT
OWNER NAME =L - ,
ADDRESS - L
PHONE EMAIL ., 1
APPLICANT NAME d S L/Ljb A) % •L)
ADDRESS
PHONE 9 �'� - L�_J��js EMAIL y�
CONTRACTOR'S NAME _J, S �� ,` OWNER BUILDER? O YES :>N6-
BUSINESS NAME ✓ L /4 B-%
ADDRESS Arq LAn 0 L 9- b
PHONE 9 51- A 34- 6354 EMAIL E- $, C,Q J-J7
CONTRACTOR'S STATE LIC NUMBER q i 9 g LICENSE CLASSIFICATION
VALUATION$ D D SQ FT 3 ,6Z) L SQ FT ^ nI d
APPLICANT'S SIGNATUR i - DATE _a `7 ' �O
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL GREEN SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES 0 NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee,CA 92586 (951)672-6777
www.cityofm en ifee.us
NIF
RIM CREEK PATH
X C..G
< N ❑ O
(D
_+ N to
,/� t C3 CD
O VCD
N
CD
O
° O
r!
_ m C)
rn r v D
rD s r+ c ;o
w > z
m
v A tmi� G�
v, M y r
N P+ m
-h ° d °
3 tA r+ CL m T
a D_ z D
a mo
r
v
o
ou
o � B m rvr
Q 'o 5 D
N' a Z -n
o a m
m M 3
3 0ED
0 =m c p y 1
N D rD > m i�
-1 � o N
m m :E
r m N g � •—►
s
Z ° s
Z m 9 9 !
m w r^ m
a
N _ R
D
Z
R -1
x c) LD ry m
m N rn
m V1 m
c oo m
m p r
C° D
o
In
m o r i - _p
r
WAT
n7 S?