PMT18-03509 City of Menifee Permit No.: PMT18-03509
29714 HAUN RD.
MENIFEE,CA 92586 Type: Residential Addition
MENIFEE MENIFEE Date Issued: 07/16/2018
PERMIT
Site Address: 24075 DEPUTY WAY, MENIFEE,CA Parcel Number: 358-550-013
92584 Construction Cost: $3,500.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL SOLID 14'X 22'ALUMAWOOD PATIO COVER, NO ELECTRICAL
Work:
Owner Contractor
ERIC&CARLA JOHNSON PATIO GUY ALUMAWOOD CONTRACTOR
24075 DEPUTY WAY 41197 GOLDEN GATE CIR STE 108
MENIFEE, CA 92584 MURRIETA, CA 92562
Applicant Phone:9513330056
LOIS MONTINI License Number: 872839
PATIO GUY ALUMAWOOD CONTRACTOR
41197 GOLDEN GATE CIR STE 108
MURRIETA, CA 92562
Fee Description qg! Amount ISI
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
$168.66
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 building 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_Temptate.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 contractor(s)pursuant to the Contractors State License Law).
1 hereby affirm under penalty of perjury that 1 am under provisions of
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 a,�q[[(my license is in full force and effecje the following reason:
License Class /J Uce a \`6�r]j, " By my signature below l acknowledge that,except for my personal residence
Expires Signature_ P /lA!— � in which l 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
a 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 website:
by Section 3700 of the Labor Code,for the performance of work for which w„ w.leeinfo.m.eov/calaw.html.
this permit Is Issued.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
D I have and will maintain workers compensation insurance,as required by
section 3700 of the labor Code,for the performance of the work for which O By my signature below 1 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
numberare: application and the Information 1 have provided is correct.I agree to comply
`��/T ,r { with all applicable city and county ordinances and state laws relating to
Carrier ----y�r'� '�/[�XL/ building construction.l authorize representatives of this city or county to
Polity#=NJvvl�!J 3 Expires t / 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, �
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# 0 I >5
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
Cade,lshallfo Igwi hcomply with th se provisions. Will the applicant or future building occupant handle hazardous material or
ficantri Date mixture containing a hazardous material equal to orgreater that the
A
Pp ��— amounts speJc sad on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS Oyes rsfio
UNLAWFUL,AND SHALLSUBIECTAN 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 O Yes a
I herebyaffirm 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 outerboundaryof .school?
(Section 3097 Civil Code) ❑Yes allo
OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury thatlam 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 hazardous mat reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyes o kc ,t_ _ Yj
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 IRRPL
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(ARP)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.Anyviolation 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($S00). managers who do the palm-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.epa.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a aAn 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. o No EPA Lead-Safe Certified Firm is required for this project bemuse:
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.
PTX"fl� Cu
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: — PERMIT/PLAN CHECK NUMBER
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: O COMMERCIAL O"RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION ' ELECTRICAL O MECHANICAL
N WE O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCrION OF WO X " p L _�> LZ117) 14 Gib D ®--4b
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS O YES ONO
PROJECTADDRESS D I -)/I ZIP
ASSESSOR'S PARCELNUMBER C;50- Q'"�) //LOT TRACT
OWNER NAME
ADDRESSL/
PHONE `"7' / —O Db? 9,EMAIL
APPLICANT NAME /v �N
ADDRESS Zn / /-
PHONE EMAIL
CONTRACTOR'S NAME 1 /�� 0�1 OWNERBUILDERi 0YE59
BUSINESS NAME ("� WI-70 [/
ADDRESS I 7
PHONE ! l r 333 '�D(�1 EMAIL
CONTRACTOR'S STATE LIC NUMBER ?s /LICENSE CLASSIFICATION
VALUATION$ �� SQ 3 `7"FT � , L SQ FT << X/;
APPLICANT'S SIGN /`--'ATURE DATE �o� '
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITYQFUM,% BUS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE %/�J
INVOICE TOTAL GREEN ' i SMIP ...�
OWNER BUILDER VERIFIED OYES 0 NO DRIVERS LICENSE k NOTARIZED LETTER 0 YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
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www.cityofinenifee.us
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i° BUILDING ANb SAFETY DEPARTMENT
PLAN APPRO SAL
REVIEWED
DATE
Approval of these plan hall not 6e construed to be a permit for,or an
appruval of,any violatio of any provisions of the federal,state or city
rey !a'icns and ordina This set of approved plans must he kept on the
cl Oct
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