PMT18-02945 City of Menifee Permit No.: PMT18-02945
29714 HAUN RD.
MENIFEE,CA 9258E Type: Residential Addition
MENIFEE MENIFEE Date Issued: 0 611 4/2 01 8
PERMIT
Site Address: 25310 ROCKING HORSE CT,MENIFEE, Parcel Number: 358-540-032
CA 92584 Construction cost: $3,450.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 10'x 26 SOLID ALUMAWOOD PATIO COVER WITH 1 FAN
Work:
Owner Contractor
CINDY&GREG GARRETT PSLQ INC
25310 ROCKING HORSE COURT 18890 SEATON AVE
MENIFEE,CA 92584 #206
Applicant Phone:9517954260
JOSH HERRICK License Number: 919885
PSLQ INC DBA GREENBEE
18890 SEATON AVE
PERRIS, CA 92570
Phone:9512340356
Fee Description OQt Amount($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 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_eldg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for 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 o I am exempt from licensure under the Contractor's State License Law for
Professions Code and m license Is in full force and effect /t the following reason:
License Class p S License No. _ '1 By my signature below l acknowledge that,except formy personal residence
Expires� —Signature in which I must have resided for at least one year prior to completion of
Improvements covered by this permit.I cannot legallysell a structure that I
WORKER'S COMPENSATION DECLARATION 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 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 workers 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 websile:
by Section 3700 of the Labor Code,for the performance of work for which this permit Is issued. www.leeinfo.ca.eov/calaw.html.
Policy g Date
-
o I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation Insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number are: application and the information I have provided Is correct.I agree to comply
Carder— LA)(!- with all applicable city and county ordinances and state laws relating to
Policy 14503o0759 Expires building construction.I authorize representatives of this city or county to
- 2-� enter the above Identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($100)or less PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit is issued, O - r((fr1�
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE p d4
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the labor
Code,I shall forthwit mply with those provisions. WIII the applicant or future building occupant handle hazardous material or
Applicant Date mixture containing a hazardous material equal to or greater that the
7 amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILUR TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes a<o
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($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District canst$fAQMDr?Sea permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES fo Coast
Airlines
Qua
CONSTRUCTION LENDING AGENCY oyes
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) o Yes
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guideand the SCAQMD
hereby affirm under penalty of perjury that I am exempt fromthe permitting checklist.I understand my requirements under the State of
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material re a ng.
Business and Professions Code).Any city or county that requires a permit to uY6 13No
construct,alter,Improve,demolish or repair any structure,prior to its Date_ _r _
Issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWN fR 6R RU11TIO91ZED AGENT
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION,REPAIR AND PAINTING LRRPI
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 apre-1978
and the basis fort he allegedexemption.Aicantny toadlation of Section of not o residence or childcare facility to be RRP-certified firms and comply with
thanApplicant fora permit subjects the applicant toacivrl penalty of not more required practices.This includes rental property owners andproperty
than($500). th
managers who do the paint-disturbing work themselves or through their
in I,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.eoa.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 Contractors State License Law does not apply to an owner of a oAn 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:
a 1,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors 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 -. "RESIDENTIAL Q MULTI-FAMILY b MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW )O P'\LUMBING 0 RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK /.z QJ „�;W �„-d„�.e„o) ��;,� Cpup fkJ , n
CjQ � 1 1"KF / LPR� O enl ee
ZIP 9 De t.
PROJECT ADDRESS
ASSESSOR'S PARCEL NUMBER - 020 LOT TRACT
OWNER NAME ADDRESS S 4m.L ece11�/Q
i �° e
PHONE 751-355-0731 EMAIL
APPLICANT NAME q }.
ADDRESS G
PHONE EMAIL
CONTRACTOR'S NAME ER
2 OWNER BUILD ? 0 YES §ENO
BUSINESS NAME (w'I &-a
ADDRESS zG ZS IIO
PHONE 9/,-a _V3�b Q qC EMAIL
CONTRACTOR'S STATE LIC NUMBER l�-1 p()J LICENSE CLASSIFICATION
VALUATION$ 50•' SQ FT �j(� L SQ FT
I
APPLICANT'S SIGNATURE DATE
OTYSTAFFUSEONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: ,n CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRf \"Y D
INVOICE TOTAL GREEN — SMIP _
OWNER BUILDER VERIFIED 0 YES 0 NO DRIVERS LICENSE# NOTARIZED LETTER 4 YES 0 NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777tccb.
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www.cityofinenifee.us <.<•,`
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City of Menifee
LEDGER & TRACK Building Dept,
INSPECTION REQUIRED JUN 14 2018
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_ D 'Approval of these plans shall not be construed to be a permCor,oM
r� n approval of,any violation of any provisions of the ederal,steor cA
R, m N Z regulations and ordinances. This set of approved p ns must'l5kept on the
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