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PMT18-05046 City of Menifee Permit No. PMT18-05046 29714 HAUN RD. MENIFEE, CA 92586 Type: Residential Addition MENIFEE MENIFEE Date Issued: 10/19/2018 PERMIT Site Address: 26254 RIM CREEK PATH, MENIFEE,CA Parcel Number: 360-670-009 92584 Construction Cost: $6,285,00 Existing use: 1 &2 Family Residence Proposed Use: Description of INSTALL 560 SQ. FT. 16'X 35'SOLID ALUMAWOOD PATIO COVER WITH 2 FANS,3 LIGHTS, 1 Work: OUTLET Owner Contractor ADRIAN RON PSLQ INC 26254 RIM CREEK PATH 18890 SEATON AVE MENIFEE,CA 92584 #206 Applicant Phone: 9517954260 JOSH HERRICK License Number:919865 PSLQ INC 18890 SEATON AVE PERRIS, CA 92570 Fee Description O�tr Amount lE7 Receptacle, Switch, Outlet&Fixture 6 141.00 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 7.05 $316.70 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_Templale.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 l am under provisions of with a licensed contractors)pursuant to the Contractors State License law). Chapter9(commencing with section 7000)of Division 3 of the Business and O I am exempt from Ilcensure 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. 'S By my signature below l acknowledge that,except formy personal residence Expires- =19 _Signature In which l must have resided for at least one year prior to 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 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 wehshe: by Section 3700 of the Labor Code,for the perfomrance of work for which ,N,Ilw,leeinfo.ca.eov/calaw.h[ml. this permit is issued. Policy# Date O l have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT section 3700 of the Labor Code,for the performance ofthe work for which a By my signature below l 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 owners behalf.I have read this number are: //�x ,,tt`�� application and the information I have provided is tarred.I agree to comply L Carrier (2— with all applicable city and county ordinances and state laws relating to building construction.I authorize representatives of this city or county to Policy9 N5030a sa 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($100)or less PROPERTY OWNER OR AUTHORIZED AGENT "� D I certify that in the performance of the work for which this permit Is Issued, ^iy,C L}{1 I shall not employ any persons In any manner so as to become subject to the CITY BUSINESS LICENSE 11 `2/tJ zV workers compensation laws of California,and agree that if l should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of5ection 3700 of the Labor Code,l shall forthwit mply with those provisions. Will the applicant or future building occupant handle hazardous material or Applicant Date mixture containing a hazardous material equal to or greater that the amounts specified on the Hazardous Materials Information Guide? WARNING:FAILUR TO SECURE WORKER'S COMPENSATION COVERAGE 15 aYes 0190 UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($SOD,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)7 See permitting checklist IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines CONSTRUCTION LENDING AGENCY aYes 2. I hereby affirm that under the penalty of perjury there is a construction Will the proposed building at modified facility be within 100D 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 MN15 OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD I hereby affirm under penalty of perjury thatlam 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 hazardous material re orting. checkmark(s)I have placed nett to the applicable Item(s)(Section 7033.5 pY� o No � _ Business and Professions Code).Any cityor county thatrequires a permitto Date_ _ construct,alter,Improve,demolish or repair any structure,prior to its PROPERTYOWNR RL OR2EDAGENT .—I 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(Chapter9(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 Ilcensure receiving compensation for most work that disturbs paint in a pre-1978 and the basis for the alleged exemption.Any violation ofSectlan 7031S by residence or childcare facility to he 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($500). managers who do the paint-disturbing work themselves orthrough their al,as owner ofthe property,or my employee with wages as theirsole employees.For more information about EPA's Renovation Program visit: compensation,will do( allofurOportion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at not intended or offered for sale.(Section 7D44,Business and Professions 1-800-424-LEAD(5323). Code,The Contractor's State Umnse Law does not apply to an owner of a a An EPA Lead-Safe Certified Renowtorwill be responsible far this project property who,through employees'or personal effort,builds or Improves the property provided that the Improvements are not intended or offered for Certified Firm Name: sale.If,however,the building or improvement is sold within one year of Firm Certification No.: completion,the Owner-Builder will have the burden of proving that It was not built or improved for the purpose ofsele. o No EPA Lead-Safe Certified Firm Is required for this pm)ectbecause: a I,as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors State License law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP Acknowledgement. Sosht�-�cc�=- Gtr�b�z. BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION MENIFEE DATE: PERMIT/PLAN CHECK NUMBER ' tv o Dept. PLANNING CASE NUMBER 99pp RR TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL�SP99 A`u1SIGN SUBTYPE: O ACWITI O PLUMBING ATO RE-ROOF NUMBER OF SQUARES ICA E R#ddfVe a _e DESCRIPTION OF WORK III 4At ..'/ PROJECTADDRESS �Ij cj ZIP ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME n n ADDRESS , PHONE EMAIL APPLICANT NAME p ADDRESS PHONE 4 5�• !j • g o$C/ EMAIL CONTRACTOR'S NAME r OWNER BUILDER? 0 YES C>dO BUSINESS NAME 4 e 1+ •� 4A1 qzs4d ADDRESS t/ C, PHONE I S ��7^4�7� EMAIL CONTRACTOR'S STATE LIC NUMBER �� 9 n5 LICENSE CLASSIFICATION VALUATION$ 5, SQ FT L SQ FT M APPLICANT'S SIGNATURE DATE 1 ozi CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION ACCEPTED BY:�1` A CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE V` INVOICE TOTAL I 3 16 .-1 0 1 GREEN '� SMIP OWNER BUILDER VERIFIED O YES 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.cityofmenifee.us MENIFEE 0 m `< = a < D coN m z n T m O 3 o K O 0 T Imo OJ m r W p z Z -1 rt p i -G < p "n D m r' Obi D SL m v ( n M N a a g m m . + a A o � Y p 'J M � •" v o� � a os � p m r a � n of C1 d Q' ni O r- N N7 R1 r m20i M a W ul d _ r ^� � 0 e o a O m cr n off' o rn o m r Q i Q O m C i ` aZ Z N o * ' m =_..� ---------- ----- ----�-'• ¢e • a y INSPECTICI REQUIRED (De N0 CD �p CD co " m m m {n m `1� w N A a OFFICE COPY N z o " ' -+ O = z Ptitc t�- o 50 4-b