PMT18-04224 City of Menifee Permit No.: PMT18-04224
29714 HAUN RD.
,/ '1 MENIFEE, CA 92586 Type: Residential Addition
MENIFEE MENIFEE Date Issued: 08/28/2018
PERMIT
Site Address: 30264 CAROB TREE CIR, MENIFEE, CA Parcel Number: 360-621-042
92584 Construction Cost: $4,500.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 12'x 38'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS,4 POST LIGHTS
Work:
Owner Contractor
DOMINIC D R SISNEROS INC
30264 CAROB TREE CIRCLE 30721 DESERT EAGLE WAY
MENIFEE, CA 92584 MENIFEE, CA 92584
Applicant Phone:9512468911
DANIEL SISNEROS License Number..949498
D R SISNEROS INC
30721 DESERT EAGLE WAY
MENIFEE, CA 92584
Fee Description Qtv Amount 1E1
Receptacle, Switch, Outlet&Fixture 6 141.00
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 7.05
$316.70
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_Permk_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 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 ❑I am exempt from licensure under the Contractors State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class C-6/ -O03 License No. /c Zl
By my signature below I acknowledge that,except for my personal residence
Expires 6Z30119 Signatu in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by
❑I hereby affirm under penalty of perjury one of the fallowing 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 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 Cade,for the performance of work for which www.leginfo.ca.gov/calaw.html.permit is issued.
Policy# Date
PROPERTY OWNER OR AUTHORIZED AGENT
❑I have and will maintain workers compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work for which ❑By my signature below I certify to each of the fallowing:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act an the property owners 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
Policy# Expires 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
/0V certify that in the performance of the work for which this permit is issued,
I shall not emplav any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a
mixture containing a hazardous material equal to or greater that the
ApplicatlT�Lic�� Date = 2 amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes )®No
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 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 Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
y
CONSTRUCTION LENDING AGENCY ❑Yes � o
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 Cade) ❑Yes P6 No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractors License Law for the reasons)indicated below by the California Health al Safety Code,Section 25505 and 25534 concerning
hazardous material reporting.
ch nd I have placed next to the applicable item(s)(Section permit as Businessand Professions Code).Any city or county that requires apermit to � Date � 2�
construct,alter,improve,demolish or repair any structure,priorto its PR ERN OWNER OR AUTHORIZED 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,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)orthat he or she is exemptfrom licensure receiving compensation for most work that disturbs paint in a pre-1978
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 or through their
❑1,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( )all of or( )portion of the work,and the structure is www.epa.goy/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 Contractors 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 far 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:
❑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: �j ;2 .c� PERMIT/PLAN CHECK NUMBER
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: O COMMERCIAL 0 RESIDENTIAL G MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: (F)ADDITION O ALTERATION Q DEMOLITION O ELECTRICAL O MECHANICAL
ONEW OPLUMBING ORE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK So 11-d axi�)um t44i o Coves/- IvlOx z -F4.7s
OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS YES ONO
PROJECTADDRESS 3O Z. 6 c/ carob Tree C,r. ZIP IF2S8° .
ASSESSOR'S PARCEL NUMBER a�pO- uqy ()LAo LOT TRACT Building Dept.
OWNER NAME I)Omih i L A11151 2 8 2018
ADDRESS 3026 Cewo6 Tree C,r. d
PHONE �s�- z l�' SS(j G 3 EMAIL ` e c
APPLICANT NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S NAME Q A h J L( $;Sp ya S OWNER BUILDER? OYES NO
BUSINESS NAME pRs�sawasSn<. /JBA xtro
ADDRESS 3072/ /JL�SC/ T Fb SE W /Cn ate 9ZS��
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER 92/9 4/rJ,y �7fLICENSE CLASSIFICATION C-6/ 403
VALUATION$ y S0 0O - SO FT L SQ FT
APPLICANT'S SIGNATURE _�/ DATE CP/z 8�/CY
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTEDBY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICE TOTAL GREEN I _ SMIP I-
OWNER BUILDER VERIFIED YES 0 NO DRIVERS LICENSE It NOTARIZED LETTER 0. YES 0 NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
G1T Op
www.cityofmenifee.us
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