pmt18-05072 City of Menifee Permit No.: PMT18-05072
14611, 29714 HAUN RD. Type: Residential Addition
MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 1012212018
PERMIT
Site Address: 25842 LAZY CLOUD WAY, MENIFEE,CA Parcel Number: 335-500-029
92585 Construction Cost: $4,500.00
Existing use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 16'X 36'SOLID ALUMAWOOD PATIO COVER W/ELECTRIC 6 LED LIGHTS,4 FLOOD
Work: LIGHTS, 1 SWITCH
Owner Contractor
STEVE OERMAN SOUTHERN CALIFORNIA PATIOS INC
25842 LAZY CLOUD WAY 1787 POMONA RD SUITE B
MENIFEE, CA 92585 CORONA, CA 92880
Applicant Phone:9098161288
ALISA DAVIS License Number:948536
SOUTHERN CALIFORNIA PATIOS INC
1787 POMONA RD SUITE B
CORONA, CA 92880
Fee Description ,O�t Amount f$1
Receptacle, Switch,Outlet&Fixture 11 166.00
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 8.30
$342.95
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 carded 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_Pennit Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
1 hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chopter9(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 7 Ucense- o. 6 CI S
By my signature below I acknowledge that,except for my personal residence
Expires 30 / Signature // in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I Cannot legally sell a structure that I
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 worker's 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided far this application is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which wvnv leeinfo.ca.eov/calasv.html.
this permit is issued.
Polity q Date
❑I 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 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 lTlYl yv5A with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy q SLSJQ i i7i 6E Expires -3 / enter the above identified property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred Date
dollars($1D0)or less PROPERTY OWNER OR AUTHORIZED AGENT
o I certify that in the performance of the work for which this permit Is issued,
1 shall not emoiov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE q
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 forth th-cp ply with tls provisions. Will the applicant or future building occupant handle hazardous material or
Applican[� Date 2 /� mixture contaified a the Hazardouus s
Marial equal In or Information
ude7hat e
amounts s ecified an the Hazardous Materials Information Guide?
WARNIN :FAILURETO SECURE WORKER'S COMPENSATION COVERAGE IS ❑Yes �Na
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
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES Coast Air Quality Management District(SCAQMD)?See permitting checklist
for guidelines
CONSTRUCTION LENDING AGENCY Dyes B(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 agency for the performance of the work which this permit is issued outer boupdory of a school?
(Section 3097 Civil Code) oyes d No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
i hereby affirm under penalty of perjury that I am exempt from the permitting checklist.I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 2SS34 concerning
hazardou material reporting.
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5
Dyes Na
Business and Professions Code).Any city or county that requires a permit to Date
construct,after,improve,demolish or repair any structure,prior to its PROPERTY O JER OR AU HORIZEDAGENT
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 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 fora 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.eca.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-80D-424-LEAD(5323).
Code:The Contractor's 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. o No EPA Lead-Safe Certified Firm is required for this project because:
D 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.
BUILDING R SAFETY PERVIIT/PLAN CHECK APPLICATION __ MENIIFEE
DATE: PERMIT/PLAN CHECK NUMBER O
PLANNING CASE NUMBER
TYPE: O COMMERCIAL RESIDENTIAL O MULTI-FAMILY O MOBILE HOME POOL/SPA O SIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
`a'NEW O PLUMBING O RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK So i l i'i Vt0 C0tp2Y c.,ad h
PROJECTADDRESS tatZy (- ijyct, {,tleg/ ZIP gZSF��
I
ASSESSOR'S PARCEL NUMBER '655- %0-0;;kq LOT TRACT
OWNER NAME S V`P ef'WlO.t
ADDRESS Z S 1 t2 Q9lf I/1/OL
PHONE q5l -23I- 2 17 fo EMAIL
APPLICANT NAME
ADDRESS Yi.7 6ArV yLat
PHONE � j Z73 ` /�2 t/ EMAIL ql s1 SU m catt - ce,h
CONTRACTOR'S NAME YY, j f L'LTU OWNER BUILDER? v YES NO
BUSINESS NAME 41 �f /�d
ADDRESS rr // PQYwb'yLt1 /J,,t'�/ {� C./PJYz�ytpl CST ��
PHONE 90q-016— I2D 25 EMAIL k Le 75-kel i AeO- CQIlj,
CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION
VALUATION$ <I S cc) SO FT L SQ FT
APPLICANT'S SIGNATURE DATE /0 Z z-h g
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY, CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE rC�
INVOICE TOTAL GREEN l SMIP 1�
OWNER BUILDER VERIFIED OYES Q 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.cityofinenifee.us "
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LDING AND SAF TY DEPARTY LIST
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B 0DATE
val of these plans shall not nstrued to be a perr<tcr,or an
al of,any violation of any p visions ofthe federal,sts:e or city
tions and ordinances. This et of approved plans must be kept on the
e until completion.
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