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PMT18-04554 City of Menifee Permit No.: PMT18-04554
29714 HAUN RD. Type: Residential Re-Roof
4.' MENIFEE,CA 92586
MENIFEE MENIFEE Date Issued: 0 9/1 912 01 8
PERMIT
Site Address: 28311 MOUNTAIN VIEW PL, MENIFEE, Parcel Number: 350-122-007
CA 92587 Construction Cost: $7.000.00
Existing Use: Proposed Use:
Description of REROOF OVERLAY OVER EXISTING ONE LAYER W/OWENS CORNING IN FOREST BROWN
Work: CRRC#0890-0018
Owner Contractor
DAVID DAVIDSON GCA ROOFING SERVICES
28311 MOUNTAIN VIEW PL 26210 NOTRE DAME CT
MENIFEE, CA 92587 HEMET, CA 92544
Applicant Phone: 9514424801
ANDRES A CARNALLA License Number: 1039030
GCA ROOFING SERVICES
26210 NOTRE DAME CT
HEMET, CA 92544
Fee Description t r Amount($I
Building Permit Issuance 1 2700
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 f Ifforce and effect. the following reason:
License Class — '7 Lice se No. O By my signature below I acknowledge that,except for my personal residence
Expires ss 1 () 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 Cade,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.leginfo.ca.gov/calaw.htmi.
this permit is issued.
Policy H Date
PROPERTY OWNER OR AUTHORIZED AGENT
I'd
A 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 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
GAL k� 1 with all applicable city and county ordinances and state laws relating to
Carrier �u a building construction.I authorize representatives of this City or county to
Q 1 w�
Policy0 - 1 Z �� 1 C� -Expires Jr '76(1�i 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 emOloy 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 workers compensaae rovis' n f Section 3700 of the Labor
Cade,I sh II f hwith comply w lh thoo e pr visi ns. Will the applicant or future building occupant handle hazardous material or a
Date -l ' 1`1 ' b mixture containing a hazardous material equal to or greater thatt e
Applicant amounts specified on the Hazardous Materials Information Guide.
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE 15 ❑Yes *
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 1$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
CONSTRUCTION LENDING AGENCY ❑Yes 00
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 'ONO
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the California Health&Safety Code,Sectio 5505 and 25534 concerning
Contractors License Law for the reasons)indicated below by the ha dous material reportin
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 s ❑No
Business and Professions Code).Any city or county that requires a permit to Date `' V
construct,alter,improve,demolish or repair any structure,priorto its PROPERTY OWNER OR AUTHORIZEDAGENT
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 IRRP)
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 Cade)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 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( I all of or( I 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 Pmfessions 1-800-424-LEAD 15323).
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 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
0 _ . , Qs (20�rRz Ita. Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION ' MENIFEE
DATE: 19 PERMIT/PLAN CHECK NUMBER O O
GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES
TYPE: ® COMMERCIAL 41 RESIDENTIAL G MULTI-FAMILY ®MOBILE HOME ®POOL/SPA ®SIGN
SUBTYPE: ADDITION ®ALTERATION ®DEMOLITION ®ELECTRICAL ®MEC ANICAL
®NEW ()PLUMBING 19RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK $
OCCUPANCY GROUP CONSTRUCTION TYPE M� SPRINKLERS YES ®NO
PROJECT ADDRESS p�Q?�` I VC pUh-EGA i h V IP y�i. 17�,C'P_ .I I lf'n C f'. ZIP 01
ASSESSOR'S PARCEL NUMBER 35D—laE 4:)QT7 LOT 5�LS TRACT cla Sl
OWNER NAME +
ADDRESS \t Q
PHONE )2-5 EMAIL Umm
APPLICANT NAME Q 1
ADDRESS 2 t,%>J
PHONE G����V12 "'1-[-�� 1 EMAIL !�cokSufv ce-54kNpkle
CONTRACTOR'S NAME & OWNER BUILDER? () EdQNO
BUSINESS NAME C,
ADDRESS b YrQ
PHONE Q''S,� �U7..' N�) EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ SQ FT L SQ FT 1
APPLICANT'S SIGNATURE JI I DATE IIG f�
CITY STAFF USE
DEPARTMENT DISTRIBUTION ACCEPTED �F MENIFEE BU9NESSLI�NSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL I .�Q GREEN ( � SMIP
OWNER BUILDER VERIFIED OYES 0 NO DRIVERS LICENSE# NOTARIZED LETTER G YES = NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 _-:
wmv.cityofm enifee.0 s
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MENIFEE PMT18-04154
AUG. 30, 2018
[DO NOT PAY- THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: MENIFEE PLAN CHECK #.: PMT18-04154
PREPARED BY: ALI SADRE, S.E. DATE: AUG. 30, 2018
BUILDING ADDRESS: 27190 SUN CITY BLVD.
BUILDING OCCUPANCY: B; V-B/SPR.
BUILDING AREA Valuation Reg. VALUE ($)
PORTION ( Sq. Ft.) Multiplier Mod.
BUILDING
DEMOLITION
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code MNF Manual Input
1997 UBC Building Permit Fee W i
1997 UBC Plan Check Fee
Type of Review: ❑ Complete Review ❑ Structural Only
❑ Other
❑ Repetitive Fee x
Repeats o Hourly 21 Hrs. @
- -J EsGII Fee $120.00 $240.00
' Based on hourly rate
Comments:
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