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PMT18-03630 City of Menifee Permit No.: PMT18-03630 29714 HAUN RD. Type: Residential Re-Roof /Ar MENIFEE, CA 92586 MENIFEE MENIFEE Date Issued: 07/20/2018 PERMIT Site Address: 25455 JUNO ST, MENIFEE,CA 92586 Parcel Number: 339-354-006 Construction Cost: $4,500.00 Existing Use: Proposed Use: Description of REMOVE TILE AND INSTALL NEW PAPER AND SHINGLES UNDER SOLAR PANELS Work: CRRC:0890-0009 Owner Contractor GUY COFFEE ANDRES LOPEZ 25455 JUNO STREET 8397 6TH AVENUE MENIFEE, CA 92586 HESPERIA,CA 92345 Applicant Phone:7606692834 ANDRES LOPEZ License Number: 1031055 8397 6TH AVENUE HESPERIA,CA 92345 Fee Description Qtv Amount f$1 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_Bidg_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 contractors)pursuant to the Contractors State License Law). 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 Code and d my license is In full force and effect. the following reason: ^/o.n.... License Clas "C/ -J'�1 License No. 0. � By my signature below I acknowledge that,except for my personal residence Expires I- l-7.0)9 Signature in which I must have resided for at least one year prior to completion of improvements covered bythis 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 ❑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 www.le info.ca. ov calaw.html this permit is issued. 1 Policy# �'I_ L3 ( 2-L) /J abate I �)� ❑I have and will maintain worker's 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 workeescompensatlon 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 Carrier �71�t-C'-c- p)In with all applicable city and county ordinances and state laws relating to y?-f/2 1 -7 building construction.I authorize representatives of this city or county to POIity q#� t,: 1-Z 0 a olff Expires �'"r- 0 I enter the above identified property for inspection purposes. qq ���� (This section need not to be completed is the permit is for one-hundred „�,.,��- Date L.-C7 dollars($100)or less PROPERTY OWNER OR THORI EG NT ❑I certify that In the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should became 0MA2ARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with th!p provisions. r, ,f Will the applicant or future building occupant handle hazardous material or a Applicant Date Zd X mixture containing a hazardous material equal to or greater that the v amounts s9q��cified on the Hazardous Materials Information Guide? RE ❑WARNING:FAILURE TO SECURE WORR'S COMPENSATION COVERAGE IS Yes ao UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building bythe applicant or future building _ AND-CIVILFINESUP TO.ONE-HUNDREDTHOUSAND DOLLARS($100,000"N 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 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guideli s CONSTRUCTION LENDING AGENCY ❑Yes :R•10 I hereby affirm that under the penalty of perjury there is a construction Will the car posed building or modified facility be within 1000 feet of the lending agency for the performance of the work which this permit is issued outer bou dary of a school? (Section 3097 Civil Code) ❑Yes No OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury that am exempt from the permitting ecklist.I understand my requirements under the State of California Contractors License Law for the reason(s)indicated below by the eate ai Safety Code,Section 505 and 25534 concerning 2 checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous Dyes To aerial reporting. -- Business and Professions Code).Any city or county that requires a permit to Date construct,alter,improve,demolish orrepair any structure,priorto its PROPERTY OWNER OR A'G�FOED MENT issuance,also requires the applicant for the permit to file a signed statement that he or sheds licensed pursuant to the provisions of the Contractors State EPA RENOVATION.REPAIR AND PAINTING IRRPI License Law(Chapter9(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 workthemselves or through their ❑1,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 1-800-424-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: ❑II 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: ' I PERMIT/PLAN CHECK NUMBER VkATIS - 3 3D GRADING/PLANNING CASE NUMBER /III OTHER RELATED CASES TYPE: 0 COMMERCIAL d6 RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME O POOL/SPA C SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING &RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK 0 OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS rO YES ,, O NO PROJECTADDRESS ��,<K 0()Lk,0 i� 613V1 ±)t ZIP qpa' 8(0 ASSESSOR'S PARCEL NUMBER ✓'�591 35L4' V D(P LOT TRACT OWNER NAME ADDRESS uno + Spy PHONE L-� EMAIL APPLICANT NAME ADDRESS PHONE &397 6-11�GtJ EMAIL ok 71zo Gro9—z CONTRACTOR'S NAME OWNER BUILDER? O YES ®'NO BUSINESS NAME ADDRESS / �(1, A-L,,� f l C� C Z (�PHONE aJ 6(d—2 &::�zq EMAIL V�Ar tom.. 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