PMT18-03634 City of Menifee Permit No.: PMT18-03634
29714 HAUN RD. Type: Residential Addition
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A& MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 07/20/2018
PERMIT
Site Address: 29681 EASTBANK DR, MENIFEE, CA Parcel Number: 333-720-011
92585 Construction Cost: $4,525.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL SOLID ATTACHED ALUMWOOD PATIO COVER WITH 2 FANS-417 SQ FT
Work:
Owner Contractor
MATTHEW SAUCEDO PSLQ INC
29681 EASTBANK DRIVE 18890 SEATON AVE
MENIFEE, CA 92585 #206
Applicant Phone:9517954260
PSLQ INC License Number:919885
18890 SEATON AVE
PERRIS, CA 92570
Fee Description Qtv Amount M)
Receptacle, Switch,Outlet&Fixture 2 121.00
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 6.05
$295.70
The issuance of this peril 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 peril 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_Pennit_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(commencing with section 700D)of Division 3 of the Business and 0I am exempt from licensure under the Contractor's5tate License Law for
Professions Code and TX license Is in full farce and effect. /! the following reason:
License Class % Z License No.
By my signature below I acknowledge that except formV Personal residence
Expires ,Signature _ In which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
0 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 wwwleeinfo.ca.eov/calaw.html,
this permit is issued.
Policyp Date
❑I have and will maintain worker's compensaton Insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which D By my signature below l certify to each of the following;)am the property
this permit Is Issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
numberare: application and the information I have provided Is coned I agree to comply
Carrier V with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# 14503067 52, Expires enter the above identified property for inspection purposes.
(This section need not to be completed is the permit Is for one hundred
dollars($100)or less Date
PROPERTY OWNER OR AUTHORIZED AGENT
01 certify that in the performance of the work for which this permit is Issued, !2 rIns
Ishallnotemplov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# EL d�j(f
worker's compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
Code,I shall forth�wi/t) mply with those provisions. Will the applicant or future building occupant handle hazardous material or
Appliwnt4J Date mixture containing a hazardous material equal to or greater that the
�' amounts specified an the Hazardous Materials Information Guide?
WARNING:FAILUREITO SECURE WORKER'S COMPENSATION COVERAGE IS a Yes
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the Intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($z00,000),IN occupant requires permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCtionor odi permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air ines
Qua
CONSTRUCTION LENDING AGENCY ayes d1<0
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified fadlity be within 1000 feet of the
lending agencyfor the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) a Yes 2,N6—
OWNER BUILDER DECLARATIONS 1 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 2SS05 and 25534 concerning
checkmark(s)I have placed next to the applicable items)(Section 7031.5 hazardous material re porting.
Business and Professions Code).Any city or county that requires a permit to ¢yef 0No
construct,alter,improve,demolish or repair any structure,prior to its Date— —
issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWN R 6R R1.11HOKIZED AGENT
that he or she is licensed pursuant to the provisians of the Contractor's State EPA RENOVATION.REPAIR AND PAINTING(RRPI
License Law(Chapter 9(commencing wfth 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 licensum receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Section 70315 by residence or childcare facility to be RRP-certlfied 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
❑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.eoa.eov/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).
Cade;The Contractor's State License Law does not apply to an owner of a 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. 0 No EPA Lead-Safe Certified Firm Is required for this project because:
❑1,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 RAP rule please fill out the RRP
Acknowledgement.
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 O ELECTRICAL O MECHANICAL
O NEW O PLUMBING GI RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK ; p pVQT W Z rc-40
OCCUPANCY GROUP ,C�O1NSTRU`C,TION TYPE SPRINKLERS 0 YYEESS CO NO
PROJECTADDRESS ZR�� r�..•�] �bknJ4' , ��C ZIP /Zip7
ASSESSOR'S PARCEL NUMBER 3�[�'T LO• d 1 I LOT TRACT
OWNER NAME QQ/ `k J
ADDRESS ZQp-1 $ ( + ( Building Dept.
PHONE -[oqe' 5c 'I q EMAIL JUL 2 0 2018
APPLICANT NAME `�O C��C,� Received
ADDRESS c
PHONE / -3 7-6- qa%y EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES WO
BUSINESS NAME Corv-tN p�
ADDRESS T
PHONE 991- n kJ1,1 J 2L EMAIL
CONTRACTOR'S STATE LIC NUMBER l C7DCf LICENSE CLASSIFICATION
I
VALUATION$ Lq
G J FT �" ' L SQ FTAPPLICANTS SIGNATURE &;SQ
DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL ?PLS• 0 GREEN SMIP
OWNER BUILDER VERIFIED O YES 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
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www.cityofinenifee.us .%
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