PMT18-04936 City of Menifee Permit No.: PMT18-04936
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Addition
MENIFEE MENIFEE Date Issued: 1 011 012 01 8
PERMIT
Site Address: 27891 TATE RD, MENIFEE, CA 92585 Parcel Number: 336-490-018
Construction Cost: $3,600.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL ATTACHED SOLID 12'X 24'ALUMAWOOD PATIO COVER W/ELECTRICAL 1 FAN
Work:
Owner Contractor
JOSE MUNOZ PSLQ INC
27891 TATE RD 18890 SEATON AVE
MENIFEE,CA 92585 #206
Applicant Phone: 9517954260
JOSH HERRICK License Number:919885
PSLQ INC
18890 SEATON AVE
PERRIS, CA 92570
Fee Description OQt t Amount ISI
Receptacle, Switch, Outlet&Fixture 1 116.00
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 5.80
$290A5
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
I hereby affirm under penalty of perjurythat 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 o l am exempt from licensure under the Contractor's State License Law for
Professions Code and m license is in full force and effect. the following reason:
License Class License No. 't Bymysignature belowl acknowledge that except formy personal residenca
Expires�L 19 -Signature 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 legallysell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
O 1 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 webske:
by Section 3700 of the Labor Code,for the performance of work for which to,�v,leeinfo.ca.eov/calaw.html.
this permit is issued.
Policy q Date
o l have 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 l 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 owner's behalf.I have read this
number are: application and the information l have provided is correct.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy g_ 1450301R 59 Expires ,-1 Z—� enter the above identified property for inspection purposes.
(This section need not to he completed is the permit is for one-hundred
dollars($100)or less Date
PROPERTY OWNER OR AUTHORIZED AGENT
01 certify that in the performance of the work for which this permit Is Issued, ��C r 10
Ishallnotemnlov any persons In any mannerso as to become subject to the CITY BUSINESS LICENSE If 6A)�,J
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
Code,I shall forthwit mply with those provisions. Will the applicant or future building occupant handle hazardous material or
Applicant Date mixture containing a hazardous material equal to or greater that the
amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILUR TO SECURE WORKER'S COMPENSATION COVERAGE 15 o Yes [r7r.
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 requires permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Alt require
Management hecoDistrict(SDtionor See permitting from
checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Airlares
Qua
CONSTRUCTION LENDING AGENCY oyes
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) ayes
apra-
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAOMD
I hereby affirm under penalty of perjury that l am exempt from the permitting checklist l understand my requirements under the state of
Contractors License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
-Ire sorting.
checkmark(s)I have placed nett to the applicable ftem hazardous mat(sJ(Section 7037.5 Nye o No
Business and Professions Code).Any city or county that requires a permit to Date
_
construct,alter,improve,demolish or repair any structure,priorta its PROPERTY OWN R R ORREDAGENT
issuance,also requires the applicant forthe 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 IR N
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 Applicant for a permit subjects the applicant to a civil penaltyof not more required practices.This Includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
D1,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 doIIall ofor()portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered forsale.(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 aAn 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:
o 1,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 awnerof a If your project does notcomplywith EPA RRP rule please fill out the RRP
Acknowledgement
�osht CIO-- arABF-b"-
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE
- �nlafrr
DATE: \01161a PERMIT/PLAN CHECK NUMBER 'O 3(0
PLANNING CASE NUMBER
TYPE: O COMMERCIAL RESIDENTIAL 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 PLU`MBING 0 RE-ROOF NUMBEROF SQUARES
DESCRIPTION OF WORK t /�
PROJECTADDRESS A -- \ ��jj ZIP
ASSESSOR'S PARCEL NU BER 3".J�p �TlO�� SLOT �� TRACT
OWNER NAME 05_e Arnoz
ADDRESS 4rmC
PHONE EMAIL
APPLICANT NAME
ADDRESS QQ '7y q
PHONE -IS I� >T�`�C Z C( EMAIL
CONTRACTOR'S NAME n OWNER BUILDER? O YES X1NO
BUSINESS NAME
ADDRESS a �nC /� I 11 �v5qo
PHONE �i51 qq EMAIL
9197375
(�� f�
CONTRACTOR'S STATE LIC NUMBER I I(�f 375 LICENSE CLASSIFICATION LJ
VALUATION$ 3604 -' SQ FT L SQ FT
APPLICANT'S SIGNATURE DATE n
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY Of MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL n ,Li''� GREEN ��. SMIP I��
OWNER BUILDER VERIFIED ON YES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES O NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee,CA 92586 (951)672-6777
www.cityofmenifee.us
ENIF�
N
N w
A o
-- - ---- -
I
(7 0
O � O
O � i
d m '
rt v
m C N
nCO
m m m N
O N
d rt 0
D o -1
m
"
z °
v N D 0 8' a 'O W C7 N r
o m
r o (A A z a G z r -< TI
v ."r O S g VZA ; Z
H D CL C ? m
rna' " o v > Z
p cr Z ' „ < v
rn f = r- > m
D T o
r d S
0
V 3 a m
o
N
ot"
m .
PP1 D m CD ° m
T CD � CDz
CD 06)
Z m N v
n co N o
to
xm
m m Ln m
= m
m CA
v �
� = z
N
0 C O
3 COP