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PMT18-02902 City of Menifee Permit No.: PMT18-02902 29714 HAUN RD. Type: Residential Plumbing i& MENIFEE,CA 92586 MENIFEE MENIFEE Date Issued: 0 611 312 01 8 PERMIT Site Address: 26524 RIM CREEK PATH, MENIFEE, CA Parcel Number: 360-820-003 92584 Construction Cost: $800.00 Existing Use: Proposed Use: Description of UNDERGROUND 3/4"POLY GAS LINE FOR FURTURE FIRE PIT AND BBQ Work: Owner Contractor JILL DAGNENICA ESTRADA'S LANDSCAPING 26524 RIM CREEK PATH 145 NORTH SCOVELL AVENUE MENIFEE, CA 92584 SAN JACINTO, CA 92583 Applicant Phone:9515914737 ESTRADA'S LANDSCAPING License Number: 1012450 145 NORTH SCOVELL AVENUE SAN JACINTO, CA 92583 Phone:9515914737 Fee Description Cut Amount t81 Plumbing Fixtures and Vents,fixtures 2 116.00 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 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.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects 1 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 D I am exempt from licensure under the Contractor's State License Law for Professions Code and my license is in full force and effect. the following reason: License Class f— 7 2:7 License No. b l _1A L �� By my signature below I acknowledge that,except for my personal residence Expires'S--2 I ) C Signature .fir-n in which I must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I 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.)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 wehsite: by Section 3700 of the Labor Code,for the performance of work for which sysvw.leeinfo.ca.eov/cataw.html. this permit is issued. Polity R Date ❑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 1 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 Carr-ter with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Polity 4 Expires enter the above identified property for inspection purposes. (This section need not to he completed is the permit is for one-hundred Date dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT ❑1 cerilfy that in the performance of the work for which this permit is issued, I shalt not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 4 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 all forthwith compsy��wth those provisions. Will the applicant or future building occupant handle hazardous material or a Applican -" F/h^-//" Date��—I�. mixture containing ahazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes ❑No UNLAWFUL,AND SHALL SUBJECTAN 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 37060F THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY ❑Yes D No I hereby affirm that under the penalty of perjury there is a construction WIII 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) ❑Yes D 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 ia Safety Code,Section 25505 and 25534 concerning hazardous material reporting. checkmark(s)I have placed next to the applicable items)(Section 7031.5 pYes D No 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 OWN ER OR AUTHORIZED AG ENT 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(RRP) 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 receivingcompensation for most work that disturbs 78 and the basis for the alleged exemption.Any violation of Section 7032.5 by p paint in a ply with an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be rental propertyfied firms and comply with than($500). required practices.This Includes rental property owners and property managers who do the paint-disturbing work themselves or through their O 1,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 I )all of or I )portion of the work,and the structure is www.ena.gov/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 ❑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: D 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: _1 a PERMIT/PLAN CHECK NUMBER T M 1S '-02,a 0Z / PLANNING CASE NUMBER ;C TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY 6 MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING J RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK PROJECTADDRESS 6L! Fp�� I /�1G 7�vPc �j ZIP ASSESSOR'S PARCEL NUMBER �WD •© LQ•00;�> LOT TRACT OWNER NAME ; (,L. City of Menifee ADDRESS j L Building Dept. PHONE�g L 03— �j: EMAIL JUN 13 2018 APPLICANT NAME Ln ` ADDRESS Z e ( C),Iic A rl G !1 - a;c .Goer PHONE Ca S Ll j �_ LJ j EMAIL CONTRACTOR'S NAME \, ',,� n �Z(. OWNER BUILDER? O YES O NO BUSINESS NAME ADDRESS Ll fl1 PHONEC S EMAIL CONTRACTOR'S STATE LIC NUMBER f Q) a 1-1 LICENSE CLASSIFICATION VALUATION$ C� c) . SO FT L SO FT APPLICANT'S SIGNATUR DATE OTYSTAFFUSEONLY DEPARTMENT DISTRIBUTION ACCEPTED BY.+) CITYOFMENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING EN INEERING FIRE INVOICE TOTAL 1 GREEN SMIP OWNER BUILDER VERIFIED O YES Q 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.cityofinenifee.us _e MENIFEE » a. �Y� 1 ell A efAr_ A VJ �°n�reSS1O 0 L� W c)) IK �0- ) 5' t LAM � LILM �xlsT,Lo�J do I 5 O �nClvt 9GO �QP��M Q S Q �apett° �oto�Y �e be�,ep�p° voell �,ep\a°Ssovxll ota�Q V otapQ a�p�°ym pppt°va\oo�°Y�toa�°�cee•'(btsse apptOJto°sa°aot \40' ce9�\a Jo`t\cotnQ \oh5�\e City of Menifee Building Dept. A JUN 13 2018 Received