PMT18-04955 City of Menifee Permit No.: PMT18-04955
29714 HAUN RD. Type: Residential Addition
M� MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 1011112018
PERMIT
Site Address: 29467 WINDING BROOK DR,MENIFEE, Parcel Number: 340-240-081
CA 92584 Construction Cost: $1.500.00
Existing use: 1 &2 Family Residence Proposed use:
Description of REMOVE EXISTING LATTICE PATIO COVER IN FRONT ENTRYWAY,INSTALL NEW 12'x Y SOLID
Work: ALUMAWOOD PATIO COVER WITH 1 FAN
Owner Contractor
RICHARD&MARGARET FOREMAN PRO INSTALLATION
29467 WINDING BROOK DRIVE 43043 CAMINO CARUNA
MENIFEE, CA 92584 TEMECULA,CA 92592
Applicant Phone:7142348652
TOM MOORE License Number:895950
PRO INSTALLATION
43043 CAMINO CARUNA
TEMECULA. CA 92592
Fee Description Dty, Amount($1
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
$290.45
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errars 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 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_Bidg_Perrng_Template.rpt Page 1 of 1
-Torn Naar Pao),-
CITY OF MENIFEE I(►�tfJl10fiaNt-
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 o I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class License No. By my signature below I acknowledge that,except for my personal residence
Expires Signature in which I must have resided for at least one year prior to completion of
ents 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
o 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 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 Code,for the performance of work for which wwwdeeinfn ca.eov/calaw.html.
this permit is issued.
Date
Policy#
PROPERTY OWNER OR AUTHORIZED AGENT
cave and will maintain workers compensation insurance,as required by
section 3700 of the Labor Code,for the performance of the work forwhlch ❑By 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 an the property owners behalf.I have read this
number are, f application and the information I have provided is correct.I agree to comply
with all applicable city and county ordinances and state laws relating to
Carrier building construction.I authorize representatives of this city or county to
Policy#C&%41 r 24J2r7��xpires 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
D I certify that in the performance of the work for which this permit is Issued,
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should became HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthw ply with those provisions. Will the applicant or future building occupant handle hazardous material or a
it
r (/ mixture containing a hazardous material equal to or greater that the
Applicant �_� Date ! Q L 1 amounts specified on the Hazardous Materials Information Guide?
WARNI :FAILURE SECURE WORKER'S COMPENSATION COVERAGE 15 o Yes ❑No
UN FUL,ANDS ALL 5UB1ECf 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 SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY in Yes o No
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 agencyfor the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) o Yes in No
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,Section 25505 and 2S534 concerning
Contractors License Law for the reason(s)indicated below by the hazardous material reporting.
checkmark(s)I have placed next to the applicable Rem(s)(Section 7031.5 oyes ❑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 PROPERTY OWNER OR AUTHORIZED AGENT
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 IRRPI
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 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
O I,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( )all of or( )portion of the work,and the structure is Www.eoa.eov/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 o 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:
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 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: 10 ��' PERMIT/PLAN CHECK NUMBER
PLANNING CASE NUMBER
TYPE: O COMMERCIAL O RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA O SIGN
SUBTYPE: O ADDITION 0 ALTERATION ODEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK ' X
I Q 1' G�j
PROJECTADDRESS 2-61 �7 Wf f�( (T]' 1 _ ZIP ZJp
ASSESSOR'S PARCEL NUMBER o" M LOT TRA
OWNER NAME
ADDRESS ,.-� Rg City Of Menifee
PHONE 6 1. Z, EMAIL
APPLICANT NAME H�—sfI Zola
ADDRESS Received
PHONE EMAIL
CONTRACTOR'S NAME S' OWNER BUILDER? O YES NO
BUSINESS NAME/
ADDRESS L
PHOA(E �L `Z3`i�'t-4p 7'Z� EMAIL
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
r
VALUATION$ Q FT L SQ FT
APPLICANT'S SIG URE DATE
CITY STAt:j�USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL ,LAC) GREEN SMIP
OWNER BUILDER VERIFIED OYES O NO DRIVERS LICENSE# NOTARIZED LETTER 0 YES 0 NO
City of Menifee Building &Safety Department 129714 Haun Rd., Menifee,CA 92586 (951)672-6777
www.cityofinenifee.us
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��' Q OCT 11 2018 �
Received
LEDGER
j �,,•'f a INSPECTION REQU TRACK
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SI N r F,47 e a
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C� A"i c7-H S4v�t �g
CITY OF MENI E'
BUILDING AN SAFETY DEPARTMENT
PLAN APPRO AL
EVIEWED B
� DATE
� �• —
'?7 h 'Approval of these pla shall not be construed to be a permit tor,Oran
approval of,any violati n oF*y provisions of the federal,state or city
regulations and ordina ces. is set of approved plans must be kept on the
jobsite until completi n,