PMT18-03708 City of Menifee Permit No.: PMT18-03708
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Addition
MENIFEE MENIFEE Date Issued: 07/27/2018
PERMIT
Site Address: 31283 SOUTHAMPTON CT, MENIFEE, Parcel Number: 372-301-005
CA 92584 Construction Cost: $3,500.00
Existing Use: 1 &2 Family Residence Proposed use:
Description of INSTALL IT x 32'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS
Work:
Owner Contractor
JASON ALMARIN PSLQ INC
31283 SOUTHAMPTON COURT 18890 SEATON AVE
MENIFEE,CA 92584 #206
Applicant Phone: 9517954260
JOSH HERRICK License Number:919885
PSLQ INC DBA GREENBEE
18890 SEATON AVE
PERRIS, CA 92570
Fee Description Qtv Amount(S)
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 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_Bldg_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 penally of perjurythat I am under provisions of with a licensed contractor(s)pursuantto the Contoctors5tate License Law).
Chapter!)(commencing with section 7000)of Division 3 of the Business and ❑I am exempt from Ilcensure under the ContractprsState License Law for
Professions Code and M license Is in full force and effect the following reason:
Ucense Class, License No._ By my signature below l acknowledge that,except formy personal residence
Expires �.J_ 19 _Signature in which l must have resided for at least one year pdorta 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
O 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 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 www.leminfo.ca.xoy/calaw.htzmI.permit is issued.
Policy# Date
O l have and will maintain worker's compensaUon 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 owner's behalf.I have read this
numberare: application and the information l 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 u7030,R 59 Expires -I 2-1 enter the above identified property for inspection purposes.
(This section need not to be completed is the permit 1s for one-hundred
dollars($100)or less Date
PROPERTY OWNER OR AUTHORIZED AGENT
D I certify that In the performance of the work for which this permit is issued, /�/�L+r 1 n
Ishallnotemolov any persons in any mannerso as to become subject to the CITY BUSINESS LICENSE# 12?2
worker's compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 370D of the Labor
Code,I shall forth�wiittjply mwith those provisions. Will the applicant orfuture building occupant handle hazardous material or
Applicant r/_/ Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURLITO SECURE WORKER'S COMPENSATION COVERAGE IS O Yes 040-0
UNLAWFUL,AND SHALL SUBIELT 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($10D,00D),IN occupant require permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Duality Management hecont(SCtionor See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air ines
Qua
CONSTRUCTION LENDING AGENCY Dyes d1<0
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) 0Yes rzno,
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist 1 understand my requirements under the State of
Contra hereby License Law
a peson(s)ry a[lam exempt by the California Health&Safety Code,Section 25So5 and 25534 concerning
Contractor's License law fortheto the ppicableedbelowby the hazardous material re orting.
checkmark(s)1 have placed next[o the applicable item(s)(Section 70335 Qy¢ D No I _
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 PROPERTY OWN R R ( DRRED AGENT —�—
Date-
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,REPAIRAND PAINTING IRRPI
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-1979
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 orthrough their
Ol,as owner of the property,or my employee with wages as theirsole 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).
Code;The Contractor's State License Law does not apply to an owner of a 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 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 Contractors State License Law does not apply to an ownerof 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: Z/ PERMIT/PLAN CHECK NUMBER PN�"Cl
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: O COMMERCIAL R-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 0- RE-ROOF NUMBER OF SQUARES-
DESCRIPTION DESCRIPTION OF WORKALt , �e l v.q "I �F:e w•r Z Ta^f
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS O YES O NO
PROJECTADDRESS 3l'a83 f=X)AMMfftn ZIP
ASSESSOR'S PARCE�BER ��— '��'vy-' LOT TRACT
OWNER NAME � Q ;n City of Menitee
�Ay uI Lng Dept.
(a�
ADDRESS 31` 2 q ,��� w+ l.s
PHONE l %1--&10,5 6 '�5 /p EMAIL L Z / 2��s
APPLICANT NAME Y0
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME OWNER BUILDER? O YES kNO
BUSINESS NAME � T(� C
ADDRESS Q2 _ 16 �A"cl' �,� 5ve io v , z>1O
PHONE [ -/i ��S� EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION r/
VALUATION$ 5Q Q tS:Q�F�l (� L SQ FT L �J
APPLICANT'S SIGNATURE DATE Z
CITY STAFF USE ONLY _
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL, 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
www.cityofmenifee.us
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