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PMT18-04148 City of Menifee Permit No.: PMT18-04148 29714 HAUN RD. 11AF MENIFEE, CA 92586 Type: Residential Addition MENIFEE MENIFEE Date Issued: 08/22/2018 PERMIT Site Address: 29057 WALKER POINT LN, MENIFEE,CA Parcel Number: 333-440-006 92585 Construction Cost: $5,725.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL ATTACHED COMBO LATTICE/SOLID/LATTICE 13'X 40'ALLIMAWOOD PATIO COVER Work: W/ELECTRICAL, 1 FAN,4 LIGHTS Owner Contractor HEATHER BROMAGE PSLQ INC 29057 WALKER POINT LN 18890 SEATON AVE MENIFEE, CA 92585 #206 Applicant Phone:9517954260 JOSH HERRICK License Number: 919885 PSLQ INC 18890 SEATON AVE PERRIS, CA 92570 Fee Description ON Amount($I Receptacle,Switch, Outlet&Fixture 5 136.00 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 6.80 $311.45 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 building 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 Bldg_PennR_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property,who builds or Improves thereon,and who contracts for the pmjects hereby affirm under penalty of perjury that l am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law). Chapter!)(commencing with section 7000)of Division 3 of the Business and a I am exempt from Iicensure under the Contractors Slate License Law for Professions Code and m license is in full force and effect. the following reason: License Class, License No. By my signature below I acknowledge that,except fornry,personal residence Expires �Z`I- Iq -Signature in which i must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot Iegallysell a structure that I have hunt 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 ofseif-insure for workers 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.leginto.co.eov/calaw.hlml. Policylt Date o I 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 D 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 owners behalf.I have read this numberare: application and the information l have provided is tarred.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 Pollcyg u50309752- Expires enter the above identified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred dollars($100)or less Date PROPERTY OWNER OR AUTHORIZED AGENT O I certify that In the performance of the work for which this permit Is Issued, ^� (�2 I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE If (2 5 110-6 workers compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwltj 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:FAILURLITO SECURE WORKER'S COMPENSATION COVERAGE IS oyes 041-0 UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the Intended use of the building by the applicant or(orate building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Duality Management District(SCAQMD)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY aYes d4o 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 aN6- OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD I hereby affirm under penalty of perjury that l am exempt from the permitting checklist.I understand my requirements under the State of Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section Z5505 and 25534 concerning checkmark(s)I have placed next to the applicable items)(Section 70315 hazardous material re rU Business and Professions Cade).Any city or county that requires a permit to oY� c,No _ 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 611UORIZED AGENT thatheorsheis licensed pursuantto the provisions of the Contractors State EPA RENOVATION.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 llcensure receiving compensation far most work that disturbs paint in apre-7978 and the basis for the alleged exemption.Any violation of Section 7031.5 by residence compeor nsation re for to eRRPthat disturbifted poinIco pre-19ply th than Applicant fora permit subjects the applicant toacivil penalryof not more required practices.This includes rental property owners and property than($500). managers who do the paint-disturbing work themselves or through their ol,as owner of the property,or my employee with wages as their sale employees.For more information about EPA's Renovation Program visit: compensation,will do( )all of or( )portion of the work,and the structure is vmmr.eoa.eowlead or contact the National Lead Information Center at not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323). Code,The Contractors State License Law does not apply to an owner of a uAn EPA Lead-safe Certified Renovator Will he responsible for this project property who,through employees'or personal effort,builds or improves the property provided that the Improvements are not Intended or offered for Certified Firm Name: sale.if,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Bunder will have the burden of proving that it was not built or improved for the purpose of sale. O No EPA Lead-Safe Certified Firm Is required for this project because: O 1,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contactors State Ucense Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. �oshtcc�=- e-p- BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE At DATE: PERMIT/PLAN CHECK NUMBER p PLANNING CASE NUMBER TYPE: O COMMERCIAL y,RESIDENTIAL O MULTI-FAMILY O MOBILE HOME (" POOL/SPA O SIGN SUBTYPE: "ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK C� i J j n a CP ( n wr .o�r ',n CsvP r q �l .h�s 7 n�p, ` 1' ) Qom/ C PROJECTADDRESS V5 � J4 Cf( c , n� L�+n ZIP I/15 1 ASSESSOR'S PARCEL NUMBER 3553 -L44t tW(0 LOT _ TRACT OWNER NAME ��h[f roq ADDRESS K PHONE / 51 - 2' - 9 OIJ� EMAIL APPLICANT NAME CS C�- ADDRESS Q c PHONE (/�-3�-�"qn$`� EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YESXNO BUSINESS NAME OL ADDRESS Ia nl;L a,� PHONE gs) a3tf-0351 /� [EMAIL CONTRACTOR'S STATE LIC NUMBER I�I iqy�7 LICENSE CLASSIFICATION //''�� VALUATION$ -) pZ�j'I SO FT L/ L SO FT �( / 0 p APPLICANT'S SIGNATURE DATE //A OTYSTAFFLISE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICETOTAL L� GREEN SMIP I OWNER BUILDER VERIFIED OYES 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.cityofinenifee.us 4 /ENIFE" i! 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