PMT18-03923 City of Menifee Permit No.: PMT18-03923
29714 HAUN RD. Type: Residential Re-Roof
MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 08/08/2018
PERMIT
Site Address: 27247 EL RANCHO DR, MENIFEE, CA Parcel Number: 336-113-001
92586 Construction Cost: $10,000.00
Existing Use: Proposed Use:
Description of TEAR OFF EXISTING ROOF,ADD 30#FELT, REPLACE ROOFING W/LANDMARK COOL ROOF IN
Work: RESAWN SHAKE, CRRC#0668-0118
Owner Contractor
DAN CARPENTER DONNOR ENTERPRISES INC
27247 EL RANCHO DR 20221 PEAR CIRCLE
MENIFEE, CA 92586 PERRIS, CA 92570
Applicant Phone:9519433344
RON HEARTZ License Number: 800984
DONNOR ENTERPRISES INC
20221 PEAR CIRCLE
PERRIS, CA 92570
Fee Description MY Amount($1
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
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_Perma_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 contractors)pursuant to the Contractors State License Law).
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 effect. n the following reason:
q
License Class C e 07 l License No. !�C O By my signature below 1 acknowledge that,except for my personal residence
Expires D I fJ 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 legally sell 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 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
this permit is issued. www.leeinfo.ca.eov/calaw.html.
Polity g Date
o I 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 D By my signature below I certify to each of the following:I am the property
this permit is issued.My worker's compensation insurance artier and policy owner or authorized to act on the property owner's 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 7' Ex ire�s r entertheahove identified property for inspection purposes.
(This section need not to be completed is the permit is for ane-I undred Date
dollars($300)or less PROPERTY OWNER OR AUTHORIZED AGENT
D I certify that in the performance of the work for which this permit is issued,
I shall notemolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE K
worker's compensation laws of Califomla,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the worker's compensation provisions of Section 3700 of the Labor
CodeApple ashall forthwith tom wi chase provisions. mill xture applcontaining
nt or ingah urehazardous
bus mortal equal
l to or greater ousthat
material or
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts kiecified on the Hazardous Materials Information Guide.
WARNING: RKER'S COMPENSATION COVERAGE I o Yes D No
UNLAW LA HALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the in ended use of the building by the applicant or future building
AND CIVIL FI Up TO ONE HONORED THOUSAND DOLLARS($100,000),IN occupant equire a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air uality Management District(SCAQMD)7 See permitting checklist
IN SECTION 37060FTHE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidel nes
CONSTRUCTION LENDING AGENCY ❑Yes No
I hereby affirm that under the penalty of perjury there is a construction Will the roposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outerb ndaryofa5chool7
(Section 3097 Civil Code) o Yes No
OWNER BUILDER DECLARATIONS I have r ad the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the
Contractor's License Law for the reason(s)indicated below by the Cazard Health al Safety Code,Se - OS and 25534 concerning
hazardo s material repo
chsiness and
I have placed next to the applicable item(s)(Section permit oyes o 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 PROPERTYOMC501AUTHORIZED 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 RENOVATIO ,REPAIR AND PAINTING(RRPI
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 7032.5 by residence or childcare facility to be RAP-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
ol,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 I )all of or I )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-BOD-424-LEAD(5323).
Code,The Contractor's State License Law does not apply to an owner of 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. ❑No EPA Lead-Safe Certified Firm is required for this project because:
01,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Cade: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
DATE: - l PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL W RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION CI ELECTRICAL O MECHANICAL
O NEW O PLUMBING 9 RE-ROOF NUMBER OF SQUARES 'z t+'
DESCRIPTION OF WORK -P c"w A= t7rc S n
?o w i 3 e - l _- l vt►� r_
PROJECTADDRESS 2 -1 2.'f '� Ls'C. w�Clto ZIP
ASSESSOR'S PARCEL NUMBER _530 - "-3'Qd1 LOT I0 TRACT Lh
OWNERNAME P4Q ifAa f_ d-q,rr"
ADDRESS 2 �Z /Z yl,wtp
PHONE 9� ., 'f71.,-.�j2.m � EMAIL
APPLICANT NAME (2e ti1
ADDRESS !L fe 41 -yt
PHONE EMAIL
CONTRACTOR'S NAME p � -fZ OWNER BUILDER? 0 YES G NO
BUSINESS NAME a c .r2 so = L2
ADDRESS 2m 2-Z( Amf�V % �s2n
PHONE OLs!? -77IZ—gnF a. ( EMAIL
CONTRACTOR'S STATE LIC NUMBER gO V y LICENSE CLASSIFICATION 3
VALUATION$ l0 mm0 SO FT z(� L SQ FT Z�
APPLICANT'S SIGNATURE DATE
OTYSTAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF M�F�U�INE�$LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE 3 S
INVOICE TOTAL ` ,�(� GREEN ^ SMIP
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE tl NOTARIZED LETTER O YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofinenifee.us
MIENIFEC
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