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PMT18-04279 City of Menifee Permit No.: PMT18-04279 29714HAUN RD. Ifr MENIFEE,CA 92586 Type: Residential Re-Roof MENIFEE MENIFEE Date Issued: 08/29/2018 PERMIT Site Address: 28925 PORTSMOUTH DR, MENIFEE, CA Parcel Number: 339-151-005 92586 Construction Cost: $10,100.00 Existing Use: Proposed Use: Description of REMOVE EXISTING ONE LAYER OF COMP SHINGLES, INSTALL NEW GAF COOL ROOF COMP Work: SHINGLES IN BIRCHWOOD, CRRC#0676-0096 Owner Contractor SHIRLEY LANE ROOFTEK ROOFING&WATERPROOFING 28925 PORTSMOUTH DR 23991 VISTAWAY MENIFEE, CA 92586 MENIFEE, CA 92587 Applicant Phone:9512448524 KATHY VANDERHULE License Number:520957 ROOFTEK ROOFING&WATERPROOFING 23991 VISTAWAY MENIFEE,CA 92587 Fee Description City Amount f8l 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_Permit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects with a licensed contractor(s)pursuant to the Contractors State License Law). I hereby affirm under penalty of perjury that I am under provisions of 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 r Licens o. .��� ^/ By my signature below I acknowledge that,except for my personal residence Expires Signature - 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 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 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 www.le¢info.ca.eov/calaw.html. this permit is issued. Policyg Date PROPERTY OWNER OR AUTHORIZED AGENT 4r�have and will maintain workers compensation insurance,as required by section 3700 of the Labor Code,for the performance of the workfor which in By my signature below I 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 number are: application and the information I have provided is correct.I agree to comply Carrier cSC-��' with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy tl 3 -vZO/b Expires f 41 4? 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 ❑I certify that in the performance of the work for which this permit is issued, I shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE q workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensaa n p ovisions of Section 3700 of the Labor Code,I shall forthwi comply w th th a provisions. Will the applicant orfuture building occupant handle hazardous material or a 's-Ply -�� Date TJ 1 �� mixture containing a hazardous material equal to or greater that the Applicant amounts�specified on the Hazardous Materials Information Guide. WARNING:FAILURETO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes yy o 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 C05T 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 CONSTRUCTION LENDING AGENCY ❑Yes ❑� 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) ❑Yes (,iKNo OWNER BUILDER DECLARATIONS I have read �the Hazardous Material Information Guide and 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 California Health al Safe Contractors License Law for the reason(s)indicated below by the Section 25505 and 25534 concerning hazardous material r orting. checkmark(5)I have placed next to the applicable item(s)(Section 7031.5 )des ❑ 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 PROPERTY 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,REPAIR AND PAINTING(RRP) 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 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 Applicantfor 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 orthrough their ❑I,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.¢pv/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 forthis 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: ❑I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code: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 1-<4h` ` '""le Acknowledgement. DATE:08/29/18 PERMIT/PLAN CHECK NUMBER b O X7 GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: Q COMMERCIAL O RESIDENTIAL 0 MULTI-FAMILY ©MOBILE HOME ©POOL/SPA O SIGN SUBTYPE: ©ADDITION ©ALTERATION ©DEMOLITION Q ELECTRICAL © MECHANICAL ONEW OPLUMBING (E)RE-ROOF NUMBER OF SQUARES 31 Remove existing one layer of composition shingles and install new composition shingles on all sloped roo DESCRIPTION OF WORK surfaces. Install Single Ply TPO membrane on flat roof surface over enclosed patio. OCCUPANCY GROUP CONSTRUCTION TYPE Reroof SPRINKLERS©YES (j)NO PROJECTADDRESS 28925 Portsmouth Drive G� zIP92586 ASSESSOR'S PARCEL NUMBER �i' " �..! LOT TRACT 3 is OWNER NAME Shirley Lane ADDRESS 28925 Portsmouth Drive, Sun City, CA 92586 PHONE 951-746-4932 EMAIL RooftekRoofing@Gmaii.com APPLICANTNAME Rooftek Roofing & Waterproofing ADDRESS 23991 Vista Way, Menifee, CA 92587 PHONE 951-244-8524 EMAIL RooftekRoofing@Gmaii.com CONTRACTOR'S NAME Dan Vanderhule 2WNERSUILDER7 ©YESQNO BUSINESS NAME Rooftek Roofing &Waterproofing ADDRESS 23991 Vista Way, Menifee, CA 92587 PHONE 951-244-8524 EMAILRooftekRoofing@gmaii.com CONTRACTOR'S STATE UC NUMBER 520957 LICENSE CLASSIFICATION C39 VALUATIONS 1 0,1 00.00 SQ FT 310Q L SQ FT APPLICANT'S SIGNATURE DATE 08/2911 8 DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OFMEJEEUSINESS LICENSE NUMBER O -/✓,BUILDING PLANNING ENGINEERING F/RE - 5�L^/L^/(a INVOICETOTAL 1129 IV'1 .10 GREEN r SMIP OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE If NOTARIZED LETTER O YES O NO City of Menifee Building&Safety Department 129714 Haun Rd., Menifee, CA 92586(951)672-6777 www.cityofmenif ee.us Z n n c rZ D () m 0 a o ) m m O m -Di 3 J o N O c o vmi 3 m p LN a m t�i3. -A�-I T (A m m W 3 N c m O V = w j 6 m ON K o w � M T j m Cf n O 2 ^ n p 9 p a y �' Z D o z F A m 73 D o X 3 o x o ° my < o ? 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