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PMT18-03444 City of Menifee Permit No.: PMT18-03444 29714 HAUN RD. IF MENIFEE,CA 92586 Type: Residential Re-Roof MENIFEE MENIFEE Data Issued: 07/11/2018 PERMIT Site Address: 27037 MONK ST,MENIFEE, CA 92586 Parcel Number: 335-304-001 Construction Cost: $6,500.00 Existing Use: Proposed Use: Description of TEAR OFF EXISTING ROOF, INSTALL 30#FELT AND REROOF W/OWENS COOL ROOF IN SIERRA Work: GRAY CRRC#0890-0013 Owner Contractor TERRY GUPNGERICH SUDDUTH CONSTRUCTION INC 27037 MONK ST 1010 N BATAVIA ST STE F MENIFEE,CA 92586 ORANGE, CA 92867 Applicant Phone:7146333619 MENIFEE, CA License Number: 847279 Fee Description gyt Amount fSl 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_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). Chapler9(commencing with section 7000)of Division 3 of the Business and a 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 /3/ �35 LIFinse No. �G/�z By mysignature below I acknowledge that,except formypersonal residence Expires 930/g- Signature_- in which lmust have resided for at least one year pdorlo completion of p WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot leg llVsell constructed structure that I have built as an owner-builder if it has not been constructed in its entirely by o I hereby affirm under penalty of perjury one of the fallowing declare lions:I licensed contractors.I understand that a copy of the applicable law,Section have and will maintain a certificate of consent of self4nsure 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 car at the following websile: by Section 3700 of the Labor Code,for the performance of work for which winopplic Lion is submitted [ml. this permit is issued. Policy R Date 'cfFa—ve and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the La bar Code,for the performance of the work for which o By my signature below I certify to each of the following:I am the property this permit is issued.My workefs 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 Carrier S''7/� with all applicable city and county ordinances and stale laws relating to building construction.I authorize representatives of this city or county to Policy `TD'TT3�S-�f Expires 3 " /Y-� 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 a I certify that in the performance of the work for which this permit is issued, ems' I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE 9 worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions or Section 3700 of the Labor Code,lshall.)ortlhwilhcom(p1'y vrit revisions. Will the applicant or future building occupant handle hazardous material ora Applicant_ l' -rV�^"� Date S-�L��y� mixture containing a hazardous material equal to or greater that the amounts spe9ed on the Hazardous Materials Information Guide. WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS aYes 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 SECTION 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY aYes e'I o4— I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 fee[of the lending agency for the performance of the work which this permit is issued outer boundary of a school? (Section 3097 Civil Cade) ayes a4z OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Gufdeand the SCAQM0 I hereby affirm under penalty of perjury that 1 am exempt from the permitting checklist.I understand my requirements under the State of California Health&Safety Code,Section 25505 and 25534 concerning Contractors License Law for the reason(s)indicated below by the hazardou aI rial reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 s o No Business and Professions Code).Any city or county that requires a perrnit to n--, Date,} construct,alter.improve.demolish or repair any structure,prior to its PROPERTY WNER OR Al1THORREO 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 IRRPI License Law(Chapter 9(commencing with Section 70001 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 Iicensure 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($SOD). managers who do the paint-disturbing work themselves or through their a1,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-BOM24-LEAD(5323). Code;The Contractors State License Law does not apply to an owner of a o 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 Finn 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. D 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 RII out the RRP Acknowledgement. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ME IFE 31, bidd- 11a DATE: PERMIT/PLAN CHECK NUMBER 1 GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: O COMMERCIAL CI-RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAAL� O MECHANICAL O NEW O P!!L/U'+MBING O RE-ROOF NUMBER OF SCLUARES 2e DESCRIPTION OF WORK OCCUPANCYGROUP CONSTRUCTION TYPE J�®D)`' /�J' SPRINKLERS OYES ONO PROJECTADDRESS ZIP ASSESSOR'S PARCEL NUMBER 3?j5�3V "" ' LOT 1;)L4_ TRACT kG13I p6. OWNER NAME ADDRESS / 2 7 a 3 7 O PHONE �n7 �-rEMAIL APPLICANT NAME C,-/� / ADDRESS/ Q22 (/ / J PHONE 17�G� 36 EMAIL CONTRACTOR'S NAME vim" �j¢/Z /`P OWNER BUILDER? OYES OfQt __ e BUSINESS NAME ADDRESS /V //�♦ 11 /^ —� �JIZi` /� �� PHONE /G/� '3(0/ EMAIL CONTRACTOR'S STATE LICNUMBER 5 LICENSE CLASSIFICATION VALUATION$ `p Q SO FT L SO FT APPLICANT'S SIGNATURE DATE OTYSTAFFUSEONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CnY OF MENIFEE B-USJNES ICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE 44 INVOICETOTAL I0,50 -010 GREEN SMIP � OWNER BUILDER VERIFIED O YES 0 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 ENIFE H o o w Z n n w n v_� y n n y m 0 D O Oy p A 3 E.? m m n m D J o J .^. 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