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PMT18-03925 City of Menifee Permit No.: PMT18-03925 `Z`� 29714 HAUN RD. 1 MENIFEE, CA 92586 Type: Residential Addition MENIFEE MENIFEE Date Issued: 08/08/2018 PERMIT Site Address: 30275 CROMWELL CIR, MENIFEE, CA Parcel Number: 358-721-004 92584 Construction Cost: $4,680.00 Existing use: 1 &2 Family Residence Proposed use: Description of INSTALL ATTACHED SOLID 12'X 40'ALUMAWOOD PATIO COVER W/ELECTRICAL 2 FANS Work: Owner Contractor ROBERT&ANISSA RIGGS PSLQ INC 30275 CROMWELL CIR 18890 SEATON AVE MENIFEE,CA 92584 #206 Applicant Phone: 9517954260 JOSH HERRICK License Number: 919885 PSLQ INC 18890 SEATON AVE PERRIS, CA 92570 Fee Description city Amount ISl 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 conttactsfor the pmjects with a licensed contractor(s)pursuant to the Contractor State License Law). I hereby affirm under penalty of perjury that 1 am under provisions of Chapter9(commencing with section 7000)of Division 3 of the Business and D I am exempt from Ilcensure under the Contmctors State License Law for Professions Code and m license is in full force and effect the following reason: License Class License No. -t Bymysfgnature below l acknowledge that,except farmy personal residence Expires 19 -Signature In which l must have resided for at least one yearpdorto completion of WORKER'S COMPENSATION DECLARATION Improvements covered by this permit.I cannot legallysell a structure that I have built as an owner-bulkier if it has not been constructed in Its entirety by O 1 hereby affirm under penalty of perjury one of the following dedarations.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 thisapplicatian is submitted or at the following website: by Section 3700 of the Labor Cade,for the performance of work for which this permit is Issued. www.leeinro.ta.eov/calaw.html. Policy R 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 a By my signature below l 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 owner's behalf.I have read this numberare: ,t n application and the information 1 have provided is correct.I agree to comply Carrier with all applicable city and county ordinances and state laws relating to (f building construction.l authorize representatives of this city or county to Policy LA5noa 5g Expires ,-�2-� f 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 o I certify that inthe performance of the work for which this permit Is Issued, ,5 rIn-5 Ishallnotemolov any persons In any manner so as to become subject to the CITY BUSINESS LICENSE R 0,551 1 tJ IV workers compensation laws ofCalifomia,and agree that if l should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions ofSectian 3700 of the Labor Code,l shall forthwi r mply with those provisions. Will the applicant or future building occupant handle hazardous material or Applicant Date mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURLITC,SECURE WORKER'S COMPENSATION COVERAGE 15 0yes 914o 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 DOLIARS($100,0001,IN occupant require apermit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant Quality Management heconDistrict lSCtionor See permitting from checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines Qua CONSTRUCTION LENDING AGENCY oYes d1g; 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 outerboundary ofaschool? ISection 3097 Civil Cade) aYes OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAC MD permitting checklist I understand my requirements under the State of Contrayaffirmunse Law for the peryurythatlam exempt from the California Health&Safety Code,Section 25S05 and 25534 concerning checkm rk(s Ihave Law forthe to (s)ilubleedbelowby the hazardous material re orting. checkmark(s)I have placednez[to the applicable i[em(sJ(Section 7031.5 oyes D No I _ Business and Professions Cade).Any city or county that requires a permit to Date_ _ construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OWN RR DRREO 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 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 Cade)or that he or she is exempt from limnsure 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 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 IS500). managers who do the paint-disturbing work themselves arthrough their al,as owner of the property,or my employee with wages as their sale employees.For more information about EPA's Renavalkin Pmgmm 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 Contractors State License Law does not apply to an owner of a oAn 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. a 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 Cade: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 g 'D PLANNING CASE NUMBER TYPE: O COMMERCIAL AQRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA 0 SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O N/E�W O PLUMBING O RE-ROOF NUMBER 1OF SQUARES r DESCRIPTION OF WORK /} C� , '; v ,t�wc.�Y :D Co.� w Z 4n PROJECTADDRESS 0 Z 7 Cvi emwe l` �l ( ZIP l Zspj uc ASSESSOR'S PARCEL NUMBER 5 p �a.r-aD� LOT _ TRACT ��p7 ' OWNER NAME wA 9 Kx aklfl, 45 ADDRESS PHONE EMAIL APPLICANT NAME t.-5 C� T� ADDRESS PHONE `�S 1-3 6-q e�y EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES 0,NO BUSINESS NAME ADDRESS Cj 10 4nj, \j r �ev\,L CA 97_5ga PHONE �51, 1` (1-0_ S/, EMAIL CONTRACTOR'S.STATE LIC NUMBER ��q�j L , LICENSE CLASSIFICATION VALUATION$ Q SO FT L SQ FT O APPLICANT'S SIGNATURE DATE OTYSTAFFUSEONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEEBUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING fIRE INVOICE TOTAL el . 0 GREEN ' SMIP OWNER BUILDER VERIFIED O YES 0 NO DRIVERS LICENSE# NOTARIZED LEfFER O YES O NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofmenifee.us G tiR': ENIFE I Z> 9 § § ƒ � § k / k q FA r---------------- -------- -- ---. 7 g p } m q m M _ (A E e a $ a I- a ƒ § \ ; § 2 .- _ 0 [ 7 2 ® k 0 . § \ a (A / ; » § DO § 0 --J n % 2 2 q § . _ ( CD M 2 2 m z / M » m q m , - � k « \ © o m CL § 2 , UEM: � -m L ' m > �' 4 D 0 g 2 ° im C . E o \ ° Ln COPY � z � -tD � � £IL 14 �In _ • HD 113MWOH:)