PMT18-02640 City of Menifee Permit No.: PMT18-02640
29714 HAUN RD.
._O\ � MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 05/29/2018
PERMIT
Site Address: 27023 EMERALD COVE CT, MENIFEE, Parcel Number: 333-471-032
CA 92585 Construction Cost: $2,340.00
Existing Use: 1 &2 Family Residence Proposed use:
Description of INSTALL 10'x 24'SOLID ALUMAWOOD PATIO COVER WITH 1 FAN
Work:
Owner Contractor
YVONNE COSIO PSLQ INC
27023 EMERALD COVE COURT 18890 SEATON AVE
MENIFEE, CA 92585 #206
Applicant Phone:9517954260
LOIS MONTINI License Number:919885
PSLQ INC DBA GREENBEE
18890 SEATON AVE
PERRIS,CA 92570
Fee Description Oft Amount 1$1
Receptacle,Switch, Outlet&Fixture 1 116.00
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 5.80
$290.45
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 carded 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 ❑ ]am exempt from licensure 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 license is in full force and eH n which I must have resided for at least one year prior to completion of
License Class Uce s o. 7 r� Improvements covered by this permit,I cannot legalir sell a structure[hat I have
F�cpires — — ignature r built as an owner-building if it has not been constructed in its entirety by licensed
r contractors. I understand that 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:
❑ I hereby affirm under penalty of perjury one the followingdeclarations: hhi3:11 w.leoinfo.ca.covlcalaw.html.
I have and will maintain a certificate of consentt fo
of self-Insure far 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, 1 certify to each of the following:I am the property
❑ I 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 carrier and policy number are: with all applicable city and county ordinances and slate laws relating to building
construction.I authorize representatives of this city or counlyto enter the above-
Carrier T identified property for the Inspection purposes.
Policy# W15/ Expires / (� ^/ .(� Date
L,L Property Owner orAuthorizeedyAgent �( .{(This section need not be c0mpletteedgf the permit is for City Business License# l JY?-4 ✓
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 emolov 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'compensation laws of California, and agree that if I should became 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,I shall o w h comply ith those provisions. / •r�7 ❑YES M O
Applira t; ate; -^F I /ICJ Will the intended use of the building by the applicant or future building
occupant require a rmit for the construction or modification from South
WARNING: FAILURE TO SECURE WORKERS' Coast Air Quali anagement District(SCAQMD)7 See permitting checklist
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL forguidelt
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 II rd g r modified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE boundary of ool?
LABOR CODE,INTEREST,AND ATTORNEYS FEES OYES bNO
CONSTRUCTION LENDING AGENCY I have read the Hazardous Material Information Guide and the SCAQMD
1 hereby affirm that under the penalty of perjury there is a construction lending permitting checklist.I uncle land my requirements under the State of
agency for the performance of the work which this permit is issued(Section California Health 8y4a*Code,Section 25505 and 25534 concerning
3097 Civil Code) hazardous 11fahIffel reporting.
OWNER BUILDER DECLARATIONS ElY
1 hereby affirm under penalty of perjury[hat I am exempt from the Contractor's PIQ
Date 9 17
License Law for the reason(s)indicated below by the checkmark(s)I have placed PROPERTY OWNER OR AU 4ORIZED AGENT
next to the applicable item(s)(Section 7031.5.Business and Professions Code: EPA RENOVATION.REPAIR AND PAINTING fRRP Any city or county that requires a pernil to construct, after,improve,demolish, )
or repair any structure, 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
provisions of the Contractor's Stale 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 firms and comply with
she is exempt from Ifcensure and the basis for the alleged exemption. Any required practices.This includes rental property owners and property
violation of Section 7031.5 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 FDA's 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 /l gyp_„
not intended or offered for sale.(Section 7044,Business and Professions Code; G(, 1�-�
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 project
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-
Builderwill 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
Cade: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
DATE: - D PERMIT/PLAN CHECK NUMBER _ U
TYPE: O COMMERCIAL CIA SIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION ?-EC CCTRICAL O MECHANICAL
�W O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK 14tV DO�
PROIECTADDRE55 DQ r.ewT ZIP 9c9, ::T S
ASSESSOR'S PARCEL NUMBER '3MM{_'II- LOT TRACT
OWNER NAME /v J"� - j�S'
ADDRESS --. L City of Menifee
L.
a
PHONE b O - o� - r�' EMAIL
APPLICANT NAME Q/ z)N I-o 2018
S
ADDRESS °
PHONE ;5 - 33 4-17 6s EMAIL
CONTRACTOR'S NAME USJ4 E lQ 1,!fj OWNER BUILDER? O YES Q441 '
BUSINESS NAME P, a � n Q
ADDRESS / M4 C_14-Q
� 7 ) � f �-
PHONE (� EMAIL _ ,QE C%)IeC.&. D
CONTRACTOR'S STATE LICNUMBER ?1gpgs LICENSE CLASSIFICATION
VALUATION$ � q D SQ FT Fg Lj () L SO FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY:
Pb
PERMIT FEE SMIP GREEN
PLAN CHECK FEE INVOICE TOTAL
OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO
E2!:: >
Pli
e - - - - - -- =- - - - - - --- ®
G f
0 7 10
, k G CD
k / \ \
\ n
a }
§ § 1
2 / / k / 4 q E n
= E 0 ° � ~ < k 99 Z
\ > 7 / - - ( 2 G 2
E E _ ) 7 @ 0 ®
\ \ � � } \ Z
> & ■ s r §
7 } § { m
§ / � �
0 22 �M �
E �
fa 2 M
CLri D m
m C /
/ \ . g
® J $
Z n / /
® ° mA
m 2 CDf %
( / \ �. CCDD / \
ƒ } \ 7 K 2 7 ( f 2
2q
M q � . . . .. . .
/ } JD 3 A o:) a i VH 3 VY 3
rjpLpLto