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PMT18-05381 City of Menifee Permit No.: PMT18-05381 Ar AV 29714 HAUN RD. f MENIFEE, CA 92586 Type: Residential Addition MENIFEE MENIFEE Date Issued: 11/08/2018 PERMIT Site Address: 28229 WINDSAIL CT, MENIFEE, CA Parcel Number: 364-043-014 92584 Construction Cost: $5,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of SOLID ATTACHED PATIO COVER 12.5'X 20',250 SQ. FT Work: Owner Contractor BARRY FRENCH ZACKWOOD INC 28229 WINDSAIL CT 1241 N LAKEVIEW AVE STE H MENIFEE, CA 92584 ANAHEIM, CA 92807 Applicant Phone: 7146609432 KEN CLEGG License Number: 1034914 ZACKWOOD INC 1241 N LAKEVIEW AVE STE H ANAHEIM, CA 92807 Phone: 7146609432 Fee Description Q_yt Amount($) 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 $168.65 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 perjury that 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 ❑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 tense o. 103<< g /Cl 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 improvements covered by this permit.I cannot legally sell a structure that I WORKER'S COMPENSATION DECLARA ION 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 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 website: by Section 3700 of the Labor Code,for the performance of work for which www.leginfo.ca.gov/calaw.html. this permit is issued. Policy# Date NO 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 ❑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 on the property owner's behalf.I have read this number are: application and the information I have provided is correct.I agree to comply Carrier �--y4, t0Y��25 with all applicable city and county ordinances and state laws relating to r L„ F' building construction.I authorize representatives of this city or county to Policy#�1GZ� 1 77 Expires 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 employ any persons in any manner so as to become subject to the CITY BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to tM worker's compe ati n provisions of Section 3700 of the Labor Code,I sXFALUwRE com y wi th visions. ,., Will the applicant or future building occupant handle hazardous material or a I� mixture containing a hazardous material equal to or greater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNINO SECURE WOb' PENS ATION OVE GE IS ❑Yes o�lyo UNLAWFUL,AND SHALL SUBJECT A 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 for guidelines CONSTRUCTION LENDING AGENCY ❑Yes i o 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 rro 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&Safet ode,Section 2550S and 25534 concerning Contractor's License Law for the reason(s)indicated below by the hazar us material r ort g. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 S 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 PROPE WNER OR =ORINT 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 Contractor's State EPA ENOVATION REPG RRP 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 111,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.epa.gov/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 Contractor's 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 Contractor's 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 e MENIFEE At DATE: PERMIT/PLAN CHECK NUMBER Q PLANNING CASE NUMBER TYPE: COMMERCIAL RESIDENTIAL MULTI-FAMILY MOBILE HOME POOL/SPA SIGN SUBTYPE: ADDITION >ALTERATION DEMOLITION ELECTRICAL MECHANICAL NEW PLUMBING RE-ROOF NUMBER OF SQUARES DESCRIPTION OF WORK A L_UA4A-W 00f,%�, PAPT I O COVE—"P, 250 $ PROJECT ADDRESS 2$ Z 2,9 W 10-D SAr)L CT. ZIP 5 ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME 9A-Rg / p ADDRESS 0 Z,'z' q 01/V p S J(_ C� I- PHONE('76-D) SQ 3 a-7o EMAIL APPLICANT NAME ADDRESSS�S,,,, [1 tK) , hA4tjQ �t't' Ci� �JZOFd PH0N��Cj 1 ?jQ�'1 EMAIL CONTRACTOR'S NAME CQ( � C�1JSI�ZUC.TIO/J OWNER BUILDER? YES NO BUSINESS NAME ADDRESS I Z q i k. J-1T K-t V 1 Ew N e-"1 9 z4 j m cA ?-v o 7 PHONE�� ( (_41500 Z EMAIL CONTRACTOR'S STATE LIC NUMBER `� LICENSE CLASSIFICATION VALUATION $ SQ � ' L SQ FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION ACCEPTED B . CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE INVOICE TOTALF1 11 GREEN ( � O 8 SMIP b[ OWNER BUILDER VERIFIED YES NO DRIVERS LICENSE# NOTARIZED LETTER YES NO City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777 www.cityofinenifee.us NIF T - --- City of Menifee - � Building Dept. NOV OV 00 C(NEl2 OjmE+JstOAj-<�'ViL� X �2�e ,� Received K 61 Comk► Ate At.L, vocAL o 6oVG-��ltnl� ACC-AaSS PERvAN-tS W ZO! �U OTC � ©h QrnjC� ac �A 11 1re C:) w �Ztl2-1 C3 U Q— T L \ T � z 11-7 r F >J i D SAFETY DEPARTi E-NIT 1 PROV L a EDBY V ' I plans shall not be construed to be a Dpmit°tr or a,: violation of any provisions of the federa, )r c ordina . This set of approved pans tr.Est L,o.e Aplefion. t �