PMT18-03705 City of Menifee Permit No.: PMT18-03705
29714 HAUN RD.
ZI, MENIFEE, CA 92586 Type: Residential Addition
MENIFEE MENIFEE Date Issued: 0712712018
PERMIT
Site Address: 29869 BERRYESSA DR, MENIFEE, CA Parcel Number: 333-741-011
92585 Construction Cost: $1.800.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 11'x 18'SOLID ALUMAWOOD PATIO COVER DOUBLE HEADER WITH 1 FAN, 2 LIGHTS
Work:
Owner Contractor
SARAH BALIZADEH TODD'S PATIO COVERS
29869 BERRYESSA DRIVE 30905 GREENSBORO DR
MENIFEE, CA 92585 TEMECULA,CA 92592
Applicant Phone:9516608665
TODD SKARIN License Number:834251
TODD'S PATIO COVERS
30905 GREENSBORO DR
TEMECULA, CA 92592
Fee Description OQt Amount fSl
Receptacle, Switch,Outlet&Fixture 3 126.00
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 6.30
$300.95
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 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_01d9_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
under penalty of perjury that I am under provisions of
1 hereby a with a licensed contractor(s)pursuant to the Contractors State License Law).
affirm
Chapter9(commencing with section 7000)of Division 3 of the Business and o I am exempt from Iicensure under the Contractor's State License Law for
Professions Code and my license is in full force and effe the following reason:
License Clxass . Uce se Jo. By my signature below I acknowledge that,except formypersonal residence
Expires 3 ' 4SIO
natur In which I must have resided for at least one year priorto completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.1 cannot Iegailysell a structure that I
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 copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's 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 µ,ww.leeinfo.ca.eov/calaw.hmd. '
this permit is issued.
Polity N —Date
-
o 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 '108y my signature below l certify to each of the following:)am the property
this permit is issued.My worker's compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.1 have read this
numberare: 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. authorize representatives of this city or county to
PolicyN Expires ente h h !den Fled property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
dollars($100)or less Date
'ER OW RAUTHORIZED AGENT
-)stl certify that In the performance of the work for which this permit is Issued,
Ishallnotemolov any persons in any manner sow to become subject to the CITY BUSINESS LICENSE
worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's com ensation provisions of Section 3700 of the Labor
Code,I shall
lfffooythw h fy with those provisions. MIT the applicant or future building occupant handle hazardous material or a
Applicant(_- Date Za mixture containing a hazardous material equal to or greater that the
amoun specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS o Yes o No
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 occupa require a permit for the construction or modification from South
ADDITION TO THECOST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coaster quality Management heconDistrict(SCAionorm modification
ingfrom
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST AND ATTORNEYS FEES fowtAguido lines
CONSTRUCTION LENDING AGENCY o Yes 3 No
I hereby affirm that under the penalty of perjury there is a construction Wlllthe urciposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer b ndary of a school?
(Section 3097 Civil Code) o Yes No
OWNER BUILDER DECLARATIONS have re d the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permittin checklist.I understand my requirements under the State of
Contractor's License Law for the reason(s)Indicated below by the California ealth&Safety Code Lion 25505 and 25534 concerning
checkmark(s)i have placed next to the applicable item(s)(Section 7031.5 hazardou m�'a1 r �.
Business and Professions Code).Any city or county that requires a permit to Dyes O � �/
Date
construct,also
alter,improve,demolish or repair permit
to file,priorto to PROPER ER R THORIZED 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 Contractor's 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 70315 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 properly owners and property
than($500). managers who do the paint-disturbing work themselves or through their
o1,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-BD0.424-LEAD(5323).
Code,The Contractor's State License Law does not apply to an owner of a DAn 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:
o 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.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
AM -
DATE: 1 I%s PERMIT/PLAN CHECK NUMBER emrke> -Q 05
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: O COMMERCIAL ') RESIDENTIAL O MULTI-FAMILY O MOBILE HOME POOL/SPA O SIGN
SUBTYPE: O ADDITION C%ALTERATION 0 DEMOLITION O ELECTRICAL ^ MECHANICAL
O NEW " PLUMBING O RE-ROOF NUMBER
OF QUARES
OfDESCRIPTION OF WORK / I SD//r �{, li(.(�J(7ew
a ✓ G vw-
OCCUPANCY GROUP
/� QQ /— CONSTRUCTION TYPE SPRINKLERSYiE7S
PROJECTADDRESS Z / V& � 1 ZIP 4 S
ASSESSOR'S PARCEL MBER 3.3 t4 LOT TRACT NAenite
OWNER NAME a��,, � a City of plailciinci Dent
2 S
ADDRESS �` `�J
PHONE v v�VIAIL
APPLICANT NAM h eive
ADDRESS
PHONE -EMAIL S Y! O0 . Cam.
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CONTRACTOR'S NAME—:71 OWNER BUILDER? C YES 0
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BUSINESS NAME
ADDRESS (� �----- �-
PHONE rO rO!:CMAIL f
CONTRACTOR'S STATE LIC,,,,///N►►►/UUM///�BER 3�(ZS LICENSE CLASSIFICATION
VALUATION$ -r�- 0 AFT L SO FT �/J ii��
APPLICANT'S SIGNATU r DATE • (ram 7
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE pep
INVOICE TOTAL Q'C� 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
".of
www.cityofinenifee.us �
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