PMT18-03684 City of Menifee Permit No.: PMT18-03684
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Addition
MENIFEE MENIFEE Date Issued: 07/25/2018
PERMIT
Site Address: 29653 CAMINO CRYSTAL, MENIFEE, CA Parcel Number: 340-403-029
92584 Construction Cost: $4,250.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL SOLID ATTACHED PATIO COVER WITH 2 FANS,6 CAN LIGHTS AND 3 POST LIGHTS
Work:
Owner Contractor
RICHARD TACADA JOVANIE ALEJANDRO ALATORRE
29653 CAMINO CRYSTAL 23636 CLARA PLACE
MENIFEE, CA 92584 MENIFEE,CA 92587
Applicant Phone:9516096854
JOVANIE ALEJANDRO ALATORRE License Number: 1003269
23636 CLARA PLACE
MENIFEE,CA 92587
Phone:9516096854
Fee Description QQt rr Amount 1Et
Receptacle,Switch, Outlet&Fixture 11 166.00
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 8.30
$342.95
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 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
I 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 70D0)of Division 3 of the Business and ❑I am exempt from licensure under the Contractor's State License law for
Professions Code/hand my license is in full force and effect. �//��//��,, the following reason:
y
Ucense Class \ '� I U se No. ^ aA By my signature below I acknowledge that,except for my personal residence
Expires Signature in which I must have resided for at least one year prior to completion of
improvements covered by this 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.leginfo.ca-gov/calaw.html.permit is issued.
Policy# Date
❑I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 37DO 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 workers 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
Policy# 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
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#
workers compensation laws of California,and agree that If I should became HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Cade,I shall fottAhwi[h comply/wit/htho a provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant ��l)��/IA.L( , l KYGf�—' Date f mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes "No
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES _ _Will the intended-use of the building-by the-applicant-or-futurebuilding
AND CIVIL FINES UP TO ONE HUNDRED ND THOUSA DOLLARS($100,600j,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 forguideli9es
CONSTRUCTION LENDING AGENCY ❑Yes Who
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 forthe performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Cade) ,94Ves ❑No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements underthe State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 ffi No
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 PROPER DWNER 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(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 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
❑I,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 forthis 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:
❑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 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 PRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: OADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS GO YES O NO
1 PROJECT ADDRESS �� ZIP 1 LE7-J v
T� q
ASSESSOR'S PARCEL NUMBER J 22� 'L4 D•3 ' 1 LOT TRACT
OWNER NAME
ADDRESS 7-9 4/1 Building Dept.
PHONE "EMAIL s, /ICO JUL 25 2018
APPLICANT NAME Jhavt�,
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ADDRESS Z903fp 0
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PHONE " r �JS EMAIL / LZ7Z"jI�{r� ..0
CONTRACTOR'S NAME OWNER BUILDER? O YES'-4AO
BUSINESS NAME ' t_ ` O29 �f
ADDRESS
PHONE ( (, (�7J� 7 EMAIL ( lam✓ (-0129
CONTRACTOR'S STA1TEr LIC NUMBER �Or)3�pa! LICENSE CLASSIFICATION
VALUATION $ �I Z�� SQ FT L SO FT
APPLICANT'S SIGNATURE T• C-( �� DATE 112—y
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE��77
INVOICE TOTAL .-1 GREEN SMIP
OWNER BUILDER VERIFIED (DYES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Dep"gf}tfk~aun Rd., Menifee, CA 92586 (951)672-6777
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JUL 2 5 2018 MENIFEE
Received
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Property Owners Name UU ll LCLI�LI �/�L✓�/� /��
Property Address ozwa-053 aw,? 221 51"or,y %�/l��n (/24
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City of Menifee Building&Safety Department 29714 Houn Rd. Menifee,C4 92586 951-677-672-677
wwwcityofinenifee.us