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PMT18-03283 City of Menifee Permit No.: PMT18-03283 Air A7 29714 HAUN RD. MENIFEE, CA 92586 Type: Residential Addition MENIFEE MENIFEE Date Issued: 0612912018 PERMIT Site Address: 29413 HONEYWOOD DR,MENIFEE, CA Parcel Number: 340-310-055 92584 Construction Cost: $3,679.00 Existing use: 1 &2 Family Residence Proposed Use: Description of INSTALL 371 SO FT ATTACHED SOLID LATTICE COMBO ALUMWOOD PATIO COVER-NO Work: ELECTRICAL Owner Contractor JOSEPH GERSZTYN PSLQ INC 29413 HONEYWOOD DRIVE 18890 SEATON AVE MENIFEE, CA 92584 #206 Applicant Phone: 9517954260 PSLQ INC License Number:919885 18890 SEATON AVE PERRIS, CA 92570 Phone:9517954260 Fee Description ,Ot rr Amount($1 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 $168.65 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(commeriting with section 700D)of Division 3 of the Business and O l am exempt from licensure under the Contractors state License Law for Professions Code and MX license is in full force and effect. the following reason: License Class B License No. `1 By mysignature 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 WORKER'S COMPENSATION DECLARATION 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 01 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 carat the following website: by Section 3700 of the Labor Code,for the performance of work for which this permit is Issued. www.leginfo.a.eov/plaw.htmL Policy# Date in I have and will maintain workers compensaLbn Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance of the work for which o By my signature below l certify to each of the following:l am the property this permit is issued.My worker's 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 Cartier Val. with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy9 1450106?sa Expires — t Cl 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 01 certify that In the performance of the work for which this permit Is issued, ^�C z'(�I rt� I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE q EL d workers compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forth/jwl/U mplywith those provisions. Will the applicant or future building occupant handle hazardous material or Applicant_ //J Date mixture containing a hazardous material equal to or greater that the �j4 amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURLITO SECURE WORKER'S COMPENSATION COVERAGE IS DYes 0<0 UNLAWFUL,AND SHALLSUIUECT 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 IN SECIONDITION 3 THECOSTOABOR CODE,INTERETMADATTOGES AS ROVIOEDS Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENL7 0Yes diro I hereby affirm that underthe penalty of perjury there is a construction Will the proposed building or modiftied facility he within 3000 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) 0 Yes OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that l am exempt from the permitting checkllsL l 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 2SS34 concerning checkmark(s)i have placed next to the applicable item(s)(Section 713315 hazardous material re sorting. Business and Professions Code).Any city or county that requires a permit to uYa allo _ Date_ construct,alter,improve, applicantemolish forpairanmit to file,prior tsta PROPERTY OWN R R ORIZED AGENT Date— Issuance,also requires the applicant forthe 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(RRP) License Law(Chapter 9(commencing with Section 70013)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 llcensure receiving compensation for most work that disturbs painting pre•3978 and the basis for the alleged exemption.Any violation of Section 70315 by residence compeor nsation faformstcility to work that distulfied firmsanicamre-197ply h than Applicant fora permit subjects the applicant to civil penalty of not more required practices.This Includes rental property,owners and property than($S00). managers who do the paint-disturbing work themselves or through their 01,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.gawrlead 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 oAn EPA Lead-Safe Certified Renovator will he 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. o No EPA Lead-Safe Certified Firm is required for this project because: o I,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. ash t e4242 cCk-- G re44b¢..e_. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ii MENIFEE DATE: PERMIT/PLAN CHECK NUMBER GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: O COMMERCIAL ?A` RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL ONE\W \` ./ O PLU\MBIING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK CLf.CV SE I�`• ) a ICQ Lome V-4_vJo- x � ��• CyvPC 1 \\ S 1 \n o 1 C es c OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS OYES ONO •� PROJECTADDRESS �� ) -er.�y �,,;eo01 �� / l-Fn��F4 ZIP ASSESSOR'S PARCEL NUMBER LOT TRACT city of meffifee OWNER NAME Building Dept. ADDRESS PHONE EMAIL APPLICANT NAME T C. Received ADDRESS PHONE y EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES OK NO BUSINESS NAME a 1`QD r, �+ (� \ Q ADDRESS Z 11d P1,.,cM �,y�. } LU .O��n¢�.,�w � I?C, 1& PHONE EMAIL f/ CONTRACTOR'S STATE LICCNUMBER 919FY5 LICENSE CLASSIFICATION (S VALUATION$ SQ FT L SQ FT 5 / APPLICANT'S SIGNATURE DATE b/06 DEPARTMENT DISTRIBUTION ACCEPTED BY: CIIY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLAN ^^ PLANNING ENGINEERING FIRE Viet- INVOICE TOTAL I I I t,pg ,&DS GREEN Ir_ SMIP I� OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 W W W.Cityofinenifee.us NIF QtY of Menifee N Building Dept. N JUN 2 9 2018 m -- rnn W Received : Ln L: r - -- - --- - --- - -- - - --- - - - - - - --i O 0 i i 70 O Q- O i r�� C7 i C M 4 f�D V F+ •P S �• F+ g C Q c ° < AFL �9,yq��iyq?��.c, C o °� O y QI I 'Di• L e-! d 3 ` Fr n O S/PG /o'Pd dy�PdP O S O. 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