PMT18-04478 City of Menifee Permit No.: PMT18-04478
29714 HAUN RD.
MENIFEE,CA 92586 Type: Residential Addition
MENIFEE MENIFEE Date Issued: 0 9/1 412 01 8
PERMIT
Site Address: 27541 HEADSAIL DR,MENIFEE,CA Parcel Number: 333-761-014
92585 Construction Cost: $4,600.00
Existing Use: 1 &2 Family Residence Proposed use:
Description of INSTALL SOLID ALUMWOOD PATIO COVER 19'6"X 15&8'X 166",6 LEDS, 1 FAN AND 1 SWITCH
Work: ON POST
Owner Contractor
JOHN BARNHART ANGEUS PATIO COVERS&AWNINGS
27541 HEADSAIL DRIVE 225 SPARKLER LANE
MENIFEE,CA 92585 PERRIS, CA 92571
Applicant Phone:9514431659
ANGEL'S PATIO COVERS&AWNINGS License Number: 900657
225 SPARKLER LANE
PERRIS, CA 92571
Phone:9514431659
Fee Description Pity. Amount I81
Receptacle,Switch,Outlet& Fixture 8 151.00
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 7.55
$327.20
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_Pennit 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 contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and 01 am exempt from licensure under the Contractor's State License Law for
Professions Cade and my license is in full force and effects. the following reason:
License class. bQ.?N Lice se No.
BY my signature below I acknowledge that,except formy personal residence
Expiresi " / USignature t in which I must have resided for at least one year pdorto completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legallysell a structure that 1
have built as an owner-builder if it has not been commicted in its entirety by
01 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 Code,Is available upon request when
compensation,issued by the Director of Industrial Relations as provided for
by Section 3700 of the Labor Code,for the performance of work for which this application is submitted or at the following wehsite:
this permit is issued. www.leeinfo ca.eovycalaw htm1.
Policy# f`"7�V V !�L l �l X / Date
01 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 —1,T<y my signature below I 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 owners behalf.I have read this
number arey}r:��/� r tt-- '' _ application and the information I have provided is correct.I agree to comply
Carriers l (d VV-e S-� f` ' (dt�V )`� 2 with all applicable city and county ordinances and state laws relating to
/1�7G�i building construction.I authorize representatives of this city or county to
Policy# UwG 6,L�i7I /Oxpires �Zk2 e e abov identified pr erty far inspection purposes.
(This section need not to he completed is the permit Is for one-hundred Date U/ 2G S
dollars 100 or less
PR TY OWNER OR AUTHORI2 AGENT
�rtlfy 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 BU51NESS 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,t shal orthwi c mply with t ace provisions. Will the applicant or future building occupant handle hazardous material or a
Applicant Date 0 0 8 mixture containing a hazardous material equal to or greater that the
431Zamounts specified on the Hazardous Materials Information Guide?
WARNING:FA RE TO SECURE WOR R'S COMPENSATION COVERAGE IS 0 Yes a NNo
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN Will the intended use of the building by the aPFilicanlor future building
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR occupant require a permit for the construction or modification from South
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
for guideliIes
CONSTRUCTION LENDING AGENCY 0 Yes ;t a
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) 0 Yes 2rNo
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
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 2550S and 25534 concerning
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous matey Preporting.
Business and Professions Code).Any city or county that requires a permit to jaYes 0 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 OW ER OR AUTHORZED AGENT
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
Business and Professions Code)or that he or she 1s exempt from Rcensure The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
and the basis for the alleged exemption.Any violation of Section 7031.5 by receiving compensation for most work that disturbs paint in a pre-1978
an Applicant for a permit subjects the applicant to a civil penalty of not more residence or childcare facility to be RRP-certified firms and comply with
than($500). required practices.This includes rental property owners and property
managers who do the paint-disturbing work themselves or through their
01,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renova8on Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.epa.gov/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 0 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 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. O No EPA Lead-Safe Certified Firm is required for this project because:
01,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
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
DATE: PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL —c-4ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
�W O PLUMBING ORE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK mzmml01911
/ 11 / i / /i= �- ✓1 .
PROJECTADDRESS
ASSESSOR'S PARCEL NUMBER 333.1�a1• o f�- LOT TRACT
OWNERNAME b
ADDRESS /j' 'e•e
PHONE (�51t�l'r39.43 EMAIL
APPLICANT NAME GG
ADDRESS J r t— a YY /
PHONE (Q5�) u�Gi EMAIL /I .
CONTRACTOR'S NAME OWNER BUILDER? O YES O NO
/
BUSINESS NAME / Q
t
ADDRESS r n NN ....,, �,
PHONE (� EMAIL I O
CONTRACiOR'SSTATE LIC NUM^BER b4O W�-4 LICENSE CLASSIFICATION
VALUATION$ L4 OV L.AQ FT �Q• ��L SQ FT
APPLICANT'S SIGNATURE \ DATE .O
riTYrAFFUSEONLY
DEPARTMENT DISTRIBUTION ACC TED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING GINNEEEEERING FIRE WY� ,�
INVOICE TOTAL ✓2, .Z GREEN SMIP
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.cityofmenifee.us
City Of Menifee Ni
Building Dept.
SEP 14 2018
ReceivAri
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