PMT18-04512 City of Menifee Permit No.: PMT18-04512
,j�� 29714 HAUN RD. Type: Residential Re-Roof
i 1.0 MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 0 911 712 01 8
PERMIT
Site Address: 26750 OAKMONT DR, MENIFEE, CA Parcel Number: 337-371-003
92586 Construction Cost: $10,500.00
Existing Use: Proposed Use:
Description of REMOVE EXISTING COMP, INSTALL NEW FELT, METAL AND COMP COOL ROOF, OWENS
Work: CORNING IN OYSTER SHELL CRRC#0890-0012
Owner Contractor
THOMAS DOYLE FREEMAN AND SONS ROOFING
26750 OAKMONT DR 28320 AGAVE WAY
MENIFEE, CA 92586 MURRIETA,CA 92563
Applicant Phone:9516727500
VINCENT FREEMAN License Number:965749
FREEMAN AND SONS ROOFING
28320 AGAVE WAY
MURRIETA, CA 92563
Fee Description Oft Amount 131
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_Pe"it_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).
Chapter!)(commencing with section 7000)of Division 3 of the Business and D I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and eject , the following reason:
License Class �` ' ens tbb 1b
� By my signature below I acknowledge that except for my personal residence
Expires { _Signature � — in which l must have resided for at least one year prior to completion of
WORKER'S COMPENSATION OECLARATION Improvements covered by this permit.l cannot legally sell a structure that I
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 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 this application is submitted or at the following website:
by Section 3700 of the Labor Cade,for the performance of work for which ww .leeinfo.ca.eov/talaw.html.
this permit is issued. sv
Polity R Date
cave and will maintain worker's compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which O By my signature below 1 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
number are: application and the information 1 have provided is correct.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
Q014�Ztt building construction.I authorize representattves of this City or county to
Policy g `T 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
❑I certify that in the performance of the work for which this permit Is issued, O 3�I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE N —`25
worker's co ensatip laws of California,and agree that if]should become HAZARDOUS MATERIAL DECLARATION
subm)))e tot he yy''orke enzation provisions ofSection 3700 of the Labor
C¢de,I shall 6rthwit comply tl th a provisions. ^T Will the applicant or future building occupant handle hazardous material car a
Allay licant Date _f. .+1 mixture containing a hazardous material equal to or greater that the
amounts speecc'�ed on the Hazardous Materials Information Guide?
WARNING: WORKER'S COMPENSATION COVERAGE IS O Yes Woo
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 hecoDistrict(SCAQM tionor modification
ratio permitting checklist
IN SECTION 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlines
Qua
CONSTRUCTION LENDING AGENCY ❑Yes miEi
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 bouadayi of a school?
(Section 3097 Civil Code) ayes Wi
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Safety ode,Section 25505 and 25534 concerning
Contractor's License Law for the reason hazardousmater( ins)indicated below by the California Health% i g.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 .Qy� D to '
Business and Professions Code).Any city or county that requires a permit to Date ' 1 U
construct alter,improve,demolish or repair any structure,prior to its PROPER WNE ORIZEDAGENT
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 Contractor's State EPA RENOVATION,REPAIR AND PAINTING(FIRP4
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 70315 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($S00). managers who do the paint-disturbing work themselves or through their
❑I,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 www.epa.gov/lead or contact the National Lead Information Center at
not Intended or offered for sale.(Section 7044,Business and Professions I-BOD-424-LEAD(S323).
Code;The Contractor's State License Law does not apply to an owner of a O An EPA Lead-Safe Certified Renovatorwill be responsible for this project
property who,through employees'car 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 Flrm 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 Contractor's 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
VLKUAJ J= ,-QeX-e per_ Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENI FEE
�a
DATE: CA PERMIT/PLAN CHECK NUMBER —D SI I
PLANNING CASE NUMBER
TYPE: O COMMERCIAL &'RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATIONS� O DEMOLITION O ELECTRICAL O MECHANICAL
NEW O PLUMBING WI NUMBER OF SQUARES Si
DESCRIPTION OF WORK vOC3-
PROJECTADDRESS Z�p (� L�I,E/j��T ZIP
ASSESSOR'S PARCEL NUMBER��1�W 3 LOT TRACT 7�C
OWNER NAME
ADDRESS r�
PHONE EMAIL
APPLICANT NAME (
ADDRESS
PHONE l"\ `-T""C7-3Z-"GZ. EMAIL yrVNI\ .QI
CONTRACTOR'S NAME OWNER BUILDER? O YES 8'ITO
BUSINESS NAME
ADDRESS IS.G 024111
PHONE - 2~[S/�� '� EMAIL
CONTRACTOR'S STATE LIC NUMBER Q�� LICENSE CLASSIFICATION _3
VALUATION$ 6710 Q T L SO FT
APPLICANT'S SIGN TORE DATE
DEPARTMENT DISTRIBUTIONCITY
ACCEPTED BY: Y OF MENILLE P& CENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE (�/,•��/ ��/
INVOICETOTAL GREEN I�--� SMIP
OWNER BUILDERVERIFIED 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
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