PMT18-03633 City of Menifee Permit No.: PMT18-03633
29714 HAUN RD.
MENIFEE,CA 92586 Type: Residential Addition
MENIFEE MENIFEE Date Issued: 07/20/2018
PERMIT
Site Address: 29686 ROCK CANYON RD, MENIFEE, CA Parcel Number: 34DA61-014
92584 Construction Cost: $5,700.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL SOLID ATTACHED ALUMAWOOD PATIO COVER WITH 3 FANS AND 2 OUTLETS-538 SQ
Work: FT
Owner Contractor
BARBIE JULIEN PSLQ INC
29686 ROCK CANYON ROAD 18890 SEATON AVE
MENIFEE, CA 92584 #206
Applicant Phone: 9517954260
PSLQ INC License Number:919885
18890 SEATON AVE
PERRIS, CA 92570
Fee Description Qtv Amount($)
Receptacle, Switch, Outlet&Fixture 5 136.00
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
General Plan Maintenance Fee-Electrical 1 6.80
$311.45
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 carded 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_61dg_Perm1t 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 1 am under provisions of with a licensed mntractor(s)pursuant to the Contractors State License law).
Chapter!)(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 and ay license is in full force and effect. /t the following reason:
License Class jy B License No. q By my signature below l acknowledge that,except formy,personal residence
Expires�-1-1:4 Signature in which I must have resided for at least one year pdorta completion of
WORKER'S COMPENSATION DECLARATION rN improvements covered by this permit.I cannot Iegaflysell a structure that I
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-lustre forworkers 7044 of the Business and Professions Cade,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application Is submitted or at the following webdte•
by Section 3700 of the Labor Code,for the performance of work for which yzyny leeinfo.ca.eov/calaw.html.
this permit Is Issued.
Policy# Date
0 l 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 O By my signature below l certify to each of the follawing:I 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
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
PolicyA u501007 59 Expires 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
0 I certify that In the performance of the work for which this permit is Issued, 40I 1�t�
Ishallnotemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE t�—l�`
worker's 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 fortlivi mplymth those provisions. Will the applicant or future building occupant handle hazardous material or
Applicants Date mixture containing a hazardous material equal to or greater that the
9— amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILUR TO SECURE WORKER'S COMPENSATION COVERAGE 15 0 Yes U410—
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 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY OYes
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 Code) Dyes D.Nri
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 checklist l understand my requirements under the State of
Contractor's 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 7031.5 hazardous material re forting.
Business and Professions Code).Any city or county that requires a permit to ¢Yef 0 No —
construct,alter,improve,demolish or repair any structure,priorto its Date_
Issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWN R 611 XUTROOZED AGENT
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 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 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($500). 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.govAead 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 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 Finn Certification No.:
completion,the Owner-Builder will have the burden of proving that it was
not built or improved for the purpose of sale. 0 No EPA Lead-Safe Certified Firm is required for this project because:
0 I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's 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 i*4242 icl-- G.ro� be-p-
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION NIFEE
lzoiLIPI
DATE: 2 O PERMIT/PLAN CHECK NUMBER • O XE
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: O COMMERCIAL O RESIDENTIAL 0 MULTI-FAMILY G MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK 144 n w w4 ..4.4 n cove \/ 'n 2•��'I�
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS 0 YES 0 NO
PROJECTADDRESS I x ZIP [Z �
ASSESSOR'S PARCEL UMBER ;3tW -4 Q1 '64 LOT TRACT
OWNER NAME
City of Menifee
ADDRESS rh
PHONE 95 I.y;y. 3 yy EMAIL
APPLICANT NAME p `,Gp
ADDRESS Received
ecei N
PHONE A51.3700Wq EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES W1
BUSINESS NAME
ADDRESS Z Qld
PHONE 15143YrO356 EMAIL
CONTRACTOR'S STATE LIC NUMBER /11;5-n LICENSE CLASSIFICATION
VALUATION$ C7 1-0 4 SO FT $� L SQ FT
APPLICANT'S SIGNATURE DATE
CITYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING E INEERING FIRE
INVOICE TOTAL 13L L, 4S GREEN SMIP
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
www.cityofmenifee.us
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