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PMT18-05383 City of Menifee Permit No.: PMT18-05383 29714 HAUN RD. o MENIFEE, CA 92586 Type: Residential Electrical MENIFEE MENIFEE Date Issued: 11/08/2018 PERMIT Site Address: 29333 CORAL ISLAND CT, MENIFEE, CA Parcel Number: 333-481-032 92585 Construction Cost: $250.00 Existing Use: Proposed Use: Description of INSTALL NEW NEMA 14-50 OUTLET IN GARAGE Work: Owner Contractor JEREMY KOVAL 29333 CORAL ISLAND COURT MENIFEE, CA 92585 Applicant License Number: JEREMY KOVAL 29333 CORAL ISLAND COURT MENIFEE, CA 92585 Phone:6193631352 Fee Description Qty Amount 1$1 Receptacle, Switch,Outlet&Fixture 1 116.00 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 General Plan Maintenance Fee-Electrical 1 5.80 $149.80 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 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 improvements 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 ❑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.leEinfo.ca.gov/calaw.html. this permit is issued. Policy# Date PROPERTY OWNER OR AUTHORIZED AGENT ❑I have and will maintain worker's compensation insurance,as required by 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 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# Expires enter the abo dentified property for inspection purposes. (This section need not to be completed is the permit is for one-hundred ` / 0 / Date ! le5 dollars($100)or less PROP OWNER OR AUTHORIZED AGENT ❑I certify that in the performance of the work for which this permit is issued, 1 shall not employ any persons in any manner so as to become subject to the CI BUSINESS LICENSE# worker's compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material or a mixture containing a hazardous material equal to or greater that the Applicant Date amounts specified on the Hazardous Materials Information Guide? WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes KNo 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 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 "' 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 ANo 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 2550S and 25534 concerning Contractor's License Law for the reason(s)indicated below by the hazardous material reporting. checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 oyeslo Business and Professions Code).Any city or county that requires a permit to Date Gl construct,alter,improve,demolish or repair any structure,prior to its PROPERTY=TION, R 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 Contractor's State EPA RENDREPAIR AND PAINTING RRP License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt from licensure The EPk Renovation,Repair and Painting(RRP)Rule requires contractors 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 than 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 ❑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.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 MENIFEE DATE: 4, PERMIT/PLAN CHECK NUMBER �Q� GRADING/PLANNING CASE NUMBER/OTHER RELATED CASES TYPE: COMMERCIAL * RESIDENTIAL MULTI-FAMILY MOBILE HOME POOL/SPA SIGN SUBTYPE: ADDITION ALTERATION : DEMOLITION 0 ELECTRICAL MECHANIC* of Menifee NEW PLUMBING RE-ROOF NUMBER OF SQUARES Building Dept. DESCRIPTION OF WORK �+ I � '�� dl)� ' OCCUPANCY GROUP CONSTRUCTION TYPE SPRINKLERS E e:G+I v e PROJECT ADDRESS ZIP a ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME 166VI(L, � ADDRESS �j� lh� J�\v-"� L� "�"l�l��• "i �7 (3� PHONE 6- l 3 EMAIL DC-Sk-„ APPLICANT NAME ADDRESS PHONE EMAIL CONTRACTOR'S NAME ++ OWNER BUILDER? YES NO BUSINESS NAME ADDRESS 1v Lf- A, 0 -ff, !� q PHONE �s(' "O) OiI V EMAIL U4Vgj2 LE 66('fTj cl:::�iLU�L� lq�� CONTRACTOR'S STATE LIC NUMBER ��Ui L LICENSE CLASSIFICATION VALUATION$ cp�50 SQ F L SQ FT APPLICANT'S SIGNATURE DATE // O OTYSTAFFUSEONLY DEPARTMENT DISTRIBUTION ACCEPTED BY: Q�� CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE W�.� INVOICE TOTAL ' GREEN SMIP OWNER BUILDER VERIFIED YES C 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 ENIFE Show all Property Lines SAMPLE PLOT/SITE PLAN Provide location, height and lineal and indicate any slopes footage of all proposed block or wood on the property fences and block retaining walls ------------------------------------ 10 -- Distance 5'-0" Min. i City of Menifee Pools only, all other ; Building Dept. structures-es-Mi . Distance 10'-0" Min Distance 10'-0" ( 4 Dimension j NOV 0 8 2018 Dist a 5' Show proposed and/or tonce 5'- " Min Received existing additions and Dista I a 5'-0" I I identify use, ie... Room Addition, Patio Cover, Balcony, etc... Include o 1 Show proposed and or ■ location, dimensions and if) i existing Detached setb `� CITY OF E Accessory Structure(s), H I nd identify use, ie... M BUILDING AN SA ; Garage, Workshop, Pool �1� PLAN APPR L i or Spa. Include location, COD dimensions and setbacks -73 I Distance 5 0" Min REVIEWED E DATE I Distance 5'-0" Min 'Approval of these pl ;hall not b consil"w .J be a permit for,or an approval of,any vial: )f any prc iisions of the federal, 61*G D LLING regulations and ordiir This se of approved plans must be kept on the jobsite until comple; I I LSE- I I I o ¢ 3 w N H 06 I L) I CITY STREET Requirements: • Plans and notes shall be legible.Each plan shall fill a minimum 81/2"x 11"sheet of paper.Include homeowners name and property address • Show all property lines and the distances of all structures to the property lines.Show all buildings and/or structures on the property, existing and proposed and the distances between those buildings and/or structures • Three(3)copies of the plot plan are required.Some projects may require approval from the Planning Department prior to permit issuance.Please contact the Planning Department to verify minimum setbacks requirements. • Show a North Arrow on the Plot/Site Plan • For proposed Gas,Electrical and/or Plumbing improvements,show meter locations,conduit size,and number of wires,breaker and wire sizes,linear square footage and their respective locations for each of the trades. City of Menifee Building&Safety Department 29714 Haun Rd.Menifee,CA 92586 951-677-672-677 wwwcityofinenifee.us