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PMT18-04935 City of Menifee Permit No.: PMT18-04935li _ 29714 HAUN RD. } r MENIFEE,CA 92586 Type: Residential Addition MENIFEE MENIFEE Date Issued: 1 0/1 012 01 8 PERMIT Site Address: 24509 COMANCHE CREEK DR, Parcel Number: 358-720-017 MENIFEE, CA 92584 Construction Cost: $4,680.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL ATTACHED SOLID 12'X 40'ALUMAWOOD PATIO COVER W/ELECTRICAL 2 FANS Work: REVISIONS APPROVED 10/19/18-GA Owner Contractor TYLER GALLEHER PSLQ INC 24609 COMANCHE CREEK DR 18890 SEATON AVE MENIFEE, CA 92584 #206 Applicant Phone:9517954260 JOSH HERRICK License Number: 919885 PSLQ INC 18890 SEATON AVE PERRIS, CA 92570 Fee Description 01t rr Amount 1El Receptacle,Switch, Outlet&Fixture 3 126.00 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 6.30 $300.95 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 caned on thereunder when in violation of the Building Code or of any other ordinance of City of Menifee.Except as otherwise slated,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 8ldg_Pennit_Template.rpt Page 1 of 1 CITY OF MENIFEE LICENSED DECLARATION property who builds or Improves thereon,and who contracts far 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 D I am exempt from licensure under the Contractors State License Law for Professions Code and m licensee is in full farce and effect /L the fallowing reason: License Class, B License No. '1 By my signature below l acknowledge that,except farmy personal residence Expires '�' �q Signature in which l must have resided for at least one year pdarto completion of improvements covered by this permit.I cannot legallysell a structure that I WORKER'S COMPENSATION DECLARATION have built as an owner-builder if it has not been constructed in its entirety by D I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the appllable 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 webslte: by Section 3700 of the Labor Code,for the performance of work farwhlch wwwlee' fo.ca sots/calaw.html. this permit is issued. Date Policy It PROPERTY OWNER OR AUTHORIZED AGENT D l have and will maintain workers compensaUon insurance,as required by a Ely my signature below l certify to each of the follovring:I am the property section 3700 of the labor Code,for the performance of the work for which owner or authorized to act an the property owners behalf.I have read this this permit is issued.My workers compensation insurance carrier and policy application and the information l have provided is correct.I agree to comply number are: � �V) with all applicable city and county ordinances and state laws relating to Carrier— V C building construction.I authorize representatives ofthiscityorcountyto Pollcyfi N5030a 59 Expires — Z—� 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 a certify that in the performance of the work for which this permit is Issued, CITY BUSINESS LICENSER 5`�0 257 I shall not emalov any persons in any manner so as to became subject to the workers compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Will the applicant or future building occupant handle hazardous material or Code,I shall forthwi mply with those provisions. mixture containing a hazardous material equal to or greater that the Appliaot Date - amounts specified on the Hazardous Materials Information Guide? WARNING:FAILUR TOSECURE WORKER'S COMPENSATION COVERAGE IS oyes 040- 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($3o0,0o0],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)7See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines CONSTRUCTION LENDING AGENCY aYes as< Will the proposed building or modified facility be within 1000 feet of the lending agency affirm for the performance penalty the wof urythere thiss a permits on outer boundary of a school? (Section3 97Civil Code) ormance of the work which this permit is issued oyes r� (Section 3097 Civil Code) 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 l am exempt from the California Health&Safety Code,Section 25505 and 25534 concerning Contractors License law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable hem(s)(Section 7031.5 ¢ye£ D No _ 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 PROPERTYOWN R RAUtROKIZED AGENT Issuance,also requires the applicant for the permit to file a signed statement EPA RENOVATION REPAIRANDPAINTINGIRRPI that he or she is licensed pursuant to the provisions of the Contractors State License Law(Chapter 9(commencing with Section 700D)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 limmure 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 orchikicare facility to be RAP-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 aI,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit: www oa gov/lead or contact the National Lead Information Center at compensation,will re for sal or( ]eon 7044,ion of the work,and Prohe fessions structure Is 1-800-424-LEAD(5323). not intended car offered for sale.(Section 7044,Business and Professions Code,The Contractors State License Law does not apply to an owner of a O An EPA Lead-Safe Certified Renovator will be responsible for this project property who,through employees'or personal effort,builds or improves the Certified Firm Name: property provided that the Improvements are not intended or offered for 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 allo EPA Lead-Safe Certified Firm is required for this project because: not built or improved for the purpose of sale. D 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 Uceme Law does not apply to an owner of a if your project does not camplywlth EPA RAP rule please fill out the RRP Acknowledgement. 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 section7000)of Division 3 of the Business and o l am exempt from llcensure under the Contractor's State License law for Professions Code and My license is in full force and effect /t the fallowing reason: License Classes License No. 9 1'S By my signature below l acknowledge that,except formy,personal residence Expires 14-1- 19 _SignatureJJq;; in which l must have resided for at least one year prior to completion of WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot Iegaliysell a structure that 1 have built as an owner-builder if It has not been constructed in its entirety by a 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 websile: by Section 3700 of the Labor Code,for the performance of work for which www.leninfo.ca.Rov/caIaw.html.permit is issued. Policy R Date o l have and will maintain worker's compensatbn insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 37110 of the labor Code,for the performance of the work for which a By my signature below l certify to each of the follovnng:I am the property this permit is issued.My worker's Compensation insurance carder and policy owner or authorized to act on the property owner's behalf.I have read this number are: n7� ,,tt '� application and the information I have provided is correct.I agree to Comply L--�Carrier �C with all applicable city and County ordinances and state laws relating to building constructtpn.I authorize representatives of this city or county to Policyg N5o3oa5a Expires - Z-) 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 o I certify that in the performance of the work for which this permit Is Issued, ^���� shall not employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE g E� worker's compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall forthQQwit mply with those provisions. Will the applicant or future building occupant handle hazardous material or ApplicantL Date mixture containing a hazardous material equal to or greater that the ����""'' amounts specified on the Hazardous Materials Information Guide? WARNING:FAILUR TO SECUREWORKER'S COMPENSATION COVERAGE IS ❑Yes 0111a UNLAWFUL,AND SHALLSUBIECT 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($100,000),IN occupant require a permit for the construction or modification from South ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist IN SECHON 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY ci Yes hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the lending agencyfor the performance of the work which this permit is issued outerboundary ofaschool? (Section 3097 Civil Code) aYes s 0 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD hereby affirm under penalty of perjury that l am exempt from the permitting checklist l understand my requirements underthe State of Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning checkmark(s)I have placed next to the applicable Items)(Section 70315 hazardous material re Iarting. ¢Yes' a No _ Business and Professions Code).Any dry or county that requires a permit to Date- construct,alter,improve,demolish or repair any structure,prior to its PROPERTY OWN R dR hUtROKIZED AGENT issuance,also requires the applicant forthe permit to file a signed statement thatheorshe is licensed pursuantto the provisionsofthe Contractor's State EPARENOVATION.REPAIRAND PAINTING IRRPI License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Cade)or that he or she is exempt from llcensure The EPA Renovation, compensation for most nd that disturb Rules painrequt contractors and the basis for the alleged exemption.Any violation of Section 7032.5 by receiving compensattonfory to Wnrkthatdl5tufirmsnticomply with an Applicant for a permit subjects the applicant to a civil penalty of not more required or childcare This Include be RRP-certified owners comply with than($SOD). required practices.This includes rental property owners and property managers who do the pain[-dis[urbtng work themselves orthrough their ol,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 doIIall of or()portion of the work,and the structure is www.eoa.eowlead 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 Contractor's State License Law does not apply to an owner of a oAn 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 projectbecause: a I,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 pmject does not comply with EPA RRP rule please fill out the RRP Acknowledgement BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: Q IO PERMIT/PLAN CHECK NUMBER PLANNING CASE NUMBER TYPE: C>COMMERCIAL 5kRESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING `O RE- OOF NUMBER OF SQUARES 7 (� DESCRIPTION OF WORK AkcW PROJECTADDRESS Q SUQ Cmg%'c_1 Qiw. �V( ZIP J ASSESSOR'S PARCEL NUMBER 3-JS' 1� � LOT �� TRACT OWNER NAME ADDRESS 9 PHONE �� �5-51a-rj�-QH EMAIL APPLICANT NAME C �C ADDRESS PHONE W-3 Pa$C� EMAIL CONTRACTOR'S NAME L- n(y/I OWNER BUILDER? O YES NO BUSINESS NAME ADDRESS nn kQ ,(�.et Cx-(� �a T'Ov"mo cj 9 2-.5io PHONE �5� -p _a- 5 L EMAIL CONTRACTOR'S STATE LIC NUMBER 91Q M LICENSE CLASSIFICATION VALUATION$ SQ FT /, O L SQ FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: y CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICETOTAL ^�op,gS GREEN �, SMIP OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE p NOTARIZED LETTER 0 YES :% NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofinenifee.us ENIFE�- i; n k - -- ----- -----�- -- - -- --- --- . \ 8 § § S 0 § � � a m a) a) ■ 6 M J a a g r I n & § � E < / 2 a m Z � / § SU § 0, 0 T g » * * z m O= o g / > m 0 T ■ D I gu LU _ . � > \ � q> - m °k \ {R $ G) \ n} & c \ k q f 2/ K § O > M q % \ m CD m / C \ m n JID5= J E �� 7 $ m 2 § 7 g § - M n { � §■ -2M OFFICE COPY Ln Ab n k - - ---- - -- -- --- -- - - - --- -- -- / 8 § 2 o I ° (E) �§ m g 6 m / Sr a $ 2 / o ■ � o ® - � 2 m 7 C > Z � E » ¢ m v E ° 1 r E § g 0 T z 0 f . § o o = M ƒ _ _ mn ■ _n rp w a r & _ k 2 © z $ - / \ }\ \ D S 9 � � D - # rn D \\ / m ( $ k2 } / � / 7 ? 9 \ 7 m z m n � ' . . \ & . m o � � \ a - M, r---) tG) 2 r BLq 00 M - 2 4�Ato » �_ A m , ( �� OFFICE COPY