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PMT18-04040 City of Menifee Permit No.: PMT18-04040 29714 HAUN RD. Type: Residential Addition Mir MENIFEE, CA 92586 MENIFEE MENIFEE Date Issued: 0 811 5/2 01 8 PERMIT Site Address: 29417 BREEZEWAY CT, MENIFEE,CA Parcel Number: 333-710-043 92585 Construction Cost: $5,125.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL ATTACHED SOLID 12'X 25'&LATTICE 15'X 7'ALUMAWOOD PATIO COVERS Work: W/ELECTRICAL, 1 FAN,2 LIGHTS Owner Contractor EDWARD&LESLIE HERNANDEZ PSLQ INC 29417 BREEZEWAY CT 18890 SEATON AVE MENIFEE, CA 92585 #206 Applicant Phone:9517954260 JOSH HERRICK License Number:919885 PSLQ INC 18890 SEATON AVE PERRIS, CA 92570 Fee Description Qtv Amount(SI 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 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_BIdg_Permil_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or Improves thereon,and who contracts for the projects hereby affirm under penalty of perjury that l 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 l am exempt from licensure under the Contractors State License Law for Professions Code and Ty license is in full force and effect �/[{ the fallowing reason: Ucense Class--ff License No. 'd By mysigna[ure below I acknowledge that,except formy personal residence Expires •- Iq _Signature In which l must have resided for at least one year prior to completion of improvements covered by this permit.I cannot legallysell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder If it has not been constructed in its entirety by a 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 Cade,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,far the performance of work for which Ay,leeinfo.ca.eov/calaw.html. this permit is Issued. Policy R Date a l have and will maintain workers 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 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 I have provided is correct.I agree to comply Carrier CA t— with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy 115010d Sa Expires -I 2-1 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 01 certify that in the performance of the work for which this permit Is Issued, ©,�5C r I.-) I shall not employ any persons in any manner so as to became subject to the CITY BUSINESS LICENSE 9rJ-40 worker's compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions ofSection 3700 of the Labor Code,I shall forthnwi/u mplywith 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 ��9"'-F-i;' amounts specified on the Hazardous Materials Information Guide? WARNING:FAILUR TO SECURE WORKER'S COMPENSATION COVERAGE IS ciYes 040-0 UNLAWFUL,AND SHALLSUBLECT 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 occupant requires permit for[he construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require Management hewn (SCtionor See permitting ro checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES foastAirllnes Qua CONSTRUCf[ON LENDING AGENCY D Yes hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 3000 feet of the lending agency for the performance of the work which this permit is issued outerboundary ofaschool? (Section 3097 Civil Code) a Yes q,N� OWNER BUILDER DECLARATIONS 1 have read the Hazardous Material Information Guideand the SCAQMD I hereby affirm under penalty of perjury that I am exempt from the permitting checklist I understand my requirements under the State of Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable item(s)(Section 70315 hazardous material to Ia i.ng. Business and Professions Code).Any city or county that requires a permit to pVemi" ONo _ construct,alter,Improve,demolish or repair any structure,prior to its Date_ issuance,also requires the applicant for the permit to file a signed statement PROPERTY OWNR 6Rt ORIZED AGENT that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING fRRPt 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 ilcensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for We alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RAP-certilled 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 arthmugh their 01,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 Iall oforII 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 2-800.424-LEAD(5323). Cade,The Contractor's State License Law does not apply to an owner of a aAn EPA Lead-Safe Certified Renovator will be responslble 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. D No EPA Lead-Safe Certified Firm Is required for this projectbecause: a 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:TheContractor's State Ucense Law does not apply to an owner of a If your project does not comply with EPA FLIP rule please fill out the RRP Acknowledgement. (� BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION " MENIFEE DATE: g 15 PERMIT/PLAN CHECK NUMBER PLANNING CASE NUMBER TYPE: '_; COMMERCIAL �f' RESIDENTIAL 0 MULTI-FAMILY MOBILE HOME POOL/SPA 0 SIGN SUBTYPE: C ADDITION C ALTERATION f;DEMOLITION ,ELECTRICAL 0 MECHANICAL NEW PLUMBING 0 RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK w 1sz, Z PROJECT ADDRESS Z 9 C{ ZIP ASSESSOR'S PARCEL NUMBER LOT v TRACT OWNER NAME S ADDRESS qv{ PHONE EMAIL APPLICANT NAME AP r me , ADDRESS y PHONE r ^9 0 EMAIL CONTRACTOR'S NAME Ca OWNER BUILDER? C:'YESXNO BUSINESS NAME (� ADDRESS Q .(I 4 " PHONE 451, aKY,Q35A EMAIL CONTRACTOR'S STATE LIC NUMBER gig W LICENSE CLASSIFICATION VALUATION$ SQ FF 0 S L SQ FT Ll Q APPLICANT'S SIGNATURE DATE OTYSTAFFUSEONLY DEPARTMENT DISTRIBUTION ACCEPTED BY;,- CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICE TOTAL S GREEN f SMIP Imo" OWNER BUILDER VERIFIED C YES C NO DRIVERS LICENSE# NOTARIZED LETTER G YES 0 NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 Gfn 6r www.cityofmenifee.us ENIFE y y M. x C M = W n O O D rn ° d D m m rt dd m c N -wc o z z SL LA � < m n z o m D m o is. m 5 CIA n rr D G N N C IAo hft m 3 D a Q o z 0 00 :r A m ^ r ° '� m r7'I 3 v_ Ze,j go D A N y " W - r2 m S O r F a 0 D m L Ffi . � 1,h,t D z N � z m m N a D V 20 �` O W m u:m m _. x m Ln m ro rr�---------N- ---------' _ m Ln C 2 o N C (D lu y 3 4 e 3