PMT18-03275 City of Menifee Permit No.: PMT18-03227
29714 HAUN RD.
® MENIFEE, CA 92586 Type: Residential Re-Roof
MENIFEE MENIFEE Date Issued: 06/2612018
PERMIT
Site Address: 26286 CHERRY HILLS BLVD, MENIFEE, Parcel Number: 337-042-017
CA 92586 Construction Cost: $4,500.00
Existing Use: Proposed Use:
Description of REMOVE EXISTING ROCK ROOF MATERIAL, INSTALL NEW WHITE ROCK ROOF
Work: NO TITLE 24 REQUIRED DUE TO MINIMAL ROOF SLOPE
Owner Contractor
HARRY WEAKLEY GARDNER ROOFING COMPANY
328 HARRINGTON COURT 594 WEST SEVENTH STREET
HEMET, CA 92545 SAN JACINTO,CA 92382
Applicant Phone:9516542794
HARRY WEAKLEY License Number: 528309
328 HARRINGTON COURT
HEMET, CA 92545
Phone: 9519262599
Fee Description gty. Amount($)
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
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_Pennit_Templale.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
With a licensed contractors)pursuant to the Contractors State License Law).
I hereby affirm under penalty of perjury that I am under provisions of
Chapter9(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from licensure under the Contractors State License Law for
Professions Cade and my license is In full force and effect. the following reason:
License Class License No. By my signature below I acknowledge that,except for my 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 legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
❑1 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 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:
by Section 3700 of the Labor Code,for the performance of work for which www.leeinfo.ca.eov/calaw.html.
this permit is issued. ,
Policy 4
❑I have and will maintain workers compensation insurance,as required by PROP My OWNER OR AUTHORIAGENT
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
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy 4 Expires enter the Apove identified property for inspection pu/rpo es.
(This section need not to be completed is the permit is for one-hundred ` Date`s Z3
dollars($100)or less PROPE WNER OR AUTHO RED GENT
❑I certify that in the performance of the work for which this permit is issued,
I shall not emolov any persons in any manner so as to became subject to the CITY BUSINESS LICENSE g
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 forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
Applicant Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes o No
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(SCAQMD)?See permitting checklist
IN SECOON 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY ❑Yes o No
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 Cade) o Yes D No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oYes 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 OWNER OR AUTHORIZED AGENT
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 Contractors State EPA RENOVATION,REPAIR AND PAINTING IRRPJ
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
an 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
D 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.¢ov/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 ❑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:
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 CHECKAPPLICATION
Menifee
DATE:6/25/2018 PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL IS RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING i RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK Re-roof rock roof Of condo pt::�Qv per'
PROJECTADDRESS 26286 Cherry Hills Blvd. ZIP 92586
ASSESSOR'S PARCEL NUMBER 337042017-7 LOT 153-158 TRACT 2643
OWNER NAME Harry D. Weakley City of Menifee
oj*ld'nq Dept-
ADDRESS 328 Harrington Ct, Hemet, 92545
PHONE 951-926-2599 EMAIL dcweakley@gmail.com
APPLICANT NAME Harry Weakley
ADDRESS
PHONE EMAIL dcweakley@gmail.com
CONTRACTOR'S NAME Gardner Roofing OWNER BUILDER? O YES XNO
BUSINESS NAME Gardner Roofing
ADDRESS 594 w.7th Street, San Jacinto, Ca, 92583
PHONE 951-654-5854 EMAIL
CONTRACTOR'S STATE LIC NUMBER 528309 LICENSE CLASSIFICATION
VALUATION$ 4500.00 SQ FT approx-{00 L SQ FT
APPLICANT'S SIGNATURE - DATE 6/25/2018
CJTYSTAff_s
DEPARTMENT DISTRIBUTION 1 ,^ CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE ACCEPTED BY: �1, y1(✓-�
PERMIT FEE 1� SMIP x GREEN
PLAN CHECK FEE INVOICE TOTAL I O
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofmenifee.us