PMT14-02918 City of Menifee Permit No.: PMT14-02918
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Addition
MENIFEE Date Issued: 10/31/2014
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PERMIT
Site Address: 28759 ERIDANUS DR, MENIFEE, CA Parcel Number: 339-353-009
92586 Construction Cost: $2,334.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 272 SQ FT SOLID ALUMAWOOD PATIO COVER WITH ELECTRICAL 2 FANS
Work:
Owner Contractor
ZEFF CASTANON GUTTERS N COVERS CONSTRUCTION INC
28759 ERIDANUS DR 19069 VAN BUERN BOULEVARD#114
MENI FEE, CA 92586 RIVERSIDE, CA 92508
Applicant Phone: 9516728022
KRISTY HENDRICKSON License Number: 945962
GUTTERS N COVERS CONSTRUCTION INC
19069 VAN BUERN BOULEVARD#114
RIVERSIDE, CA 92508
Fee Description Qty Amount
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
$283.00
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 staled,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_Permit_Template.rpt Page 1 of 1
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City Of Menifee
LICENSED DECLARATION
I hereby affirm under penalty or perjury that I am licensed under provisions of ❑ I, as owner of the property an exclusively contracting with licensed
Chapter 9 (commencing with section 7000)of Division 3 of the Business and contractors to construct the project(Section 7044, Business and Professions
Professions Code nd my license is in full force and effect. Code:The Contractor's License Law does not apply to an owner of a property
License Class License No, cam- �
who builds or improves thereon, and who contracts for the projects with a
Expires I "r Signature /?IC licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS'COMPENSATION DECLARATION
❑ I am exempt from licensure under the Contractors'State License Law for the
❑ I hereby affirm under penalty of perjury one of the following declarations: following reason:
I have and will maintain a certificate of consent of self-insure for workers' By my signature below I acknowledge that, except for my personal residence in
compensation,issued by the Director of Industrial Relations as provided for by
Section 3700 of the Labor Code, for the performance of work for which this which must have resided for at least one year prior to completion of
permit is issued, improvements covered by this permit, I cannot legally sell a structure that I have
Policy# built as an owner-building if it has not been constructed in its entirety by licensed
contractors. I understand that a copy of the applicable law, Section 7044 of the
❑ I have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is
section 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:htto'llwww Ieglnfo ca gov/calaw html.
permit is issued.My workers'compensation n insurance carrier and policy number are:
Carrier ., 'FCttrt" /) (J]Z .,° Property Owner or Authorize Agent Date
Expires I Policy# c L.ti '
Name of Agent Phone# ❑ By my Signature below, I certify to each of the following: I am the property
owner or authorized to act on the property owner's behalf. I have read this
(This section need not be completed if the permit is for application and the information I have provided is correct. 1 agree to comply
one-hundred dollars($100)or less) with all applicable city and county ordinances and state laws relating to building
construction. I authorize representatives of this city or county to enter the above-
El I certify that in the performance of the work for which this permit is issued,I identified prop nVfor t e inspection purposes.
shall not emolov any persons in any manner so as to become subject to the
workers'compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Property Owry r or Authorized Agent / Date
Date;
- '
•� ,a City Business License#
Applicant;
WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION
COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS WILL THE APPLICANT OR FUTURE BUILDING
($100,000), IN ADDITION TO THE COST OF COMPENSATION, ❑YES OCCUPANT HANDLEA HAZARDOUS MATERIAL OR
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL
LABOR CODE, INTEREST,AND ATTORNEYS FEES I �AO EQUAL TO OR GREATER THAN THE AMOUNTS
CONSTRUCTION LENDING AGENCY SPECIFIED ON THE HAZARDOUS MATERIALS
I hereby affirm that under the penalty of perjury there is a construction lending INFORMATION GUIDE?
agency for the performance of the work which this permit is issued (Section WILL THE INTENDED USE OF THE BUILDING BY THE
3097 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE
Lender's Name []YES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
Lender's Address NO FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
OWNER BUILDER DECLARATIONS GUIDE LINES
I hereby affirm under penalty of perjury that I am exempt from the Contractor's PRINT NAME:
License Law for the reasons)indicated below by the checkmark(s)I have placed AYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY
next to the applicable item(s)(Section 7031.5. Business and Professions Code: BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, 0 SCHOOL?
or repair any structure, prior to its 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 License Law (Chapter 9 (commencing with I HAVE READ THE HAZARDOUS MATERIAL
Section 7000)of Division 3 of the Business and Professions Code)or that he or F]YES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any CHECKLIST. I UNDERSTAND MY REQUIREMENTS
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY
a civil penalty of not more than($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING
El1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPOR7 ING.
compensation, will do ( ) all of or( ) porting of the work, and the structure is PROPERT O E OR AUT ORIZED GENT
not intended or offered for sale.(Section 7044,Business and Professions Code; _ JlV/I`� �y+,�-�I7
The Contractor's State License Law does not apply to an owner of a property X ( / (%/ /all
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale. If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
CITY OF MENII+EE PLCK No; P 1,1ry
29714 Haun Road Date: Dat r1�1�-D 18
Menifee, CA 92586
Phone: (951)672-6777 Amount: Amouf
Fax:(951)679-3843 Ck#' Ck#: D
Building Combination Permit
s
nv To Be Completed By Applicant
Legal Description: hD S`�- I Lzq I Planning Case: F: L: Rt: R
Property Address: E- + Assessor's Parcel Number: � :3-60 j
1 O(J 1 I
Project/Tenant Nam C rl Unit#: Floor#:
Name: �7 J 1 1 Norl � Fax No.
Property Address: L I •� Unit Number Zip Code
Owner
Email Address:
Name: i I ;n Phone No. Fax No.
II
Applicant Address: Unit Number Zip Code
Email Address: 1�F7 r 1-1 �z.�p, c
Name: P o. g U23 Fex./`Ip, - �i�-`SOSO
Contractor Address: i y� I City Pi v St `�J Zip Co
ow
ontractor s MUM
c n$a NO. Contractor's City Ste e.of a is ense No. Classification:
Number of Squares:
Square Footage
Description of Work: ost of Work:S 24
Applicant's Signature 7j ✓� Dale:
ipleted.By City.Staff Only,
Indicate As R-Received or N/A-Not Applicable
5 Completes sets of fully dimensioned,drawn to sale plans which Include: 1 set of documents which include
❑ Title Sheet ❑ Elevations ❑ Electrical Plan ❑ Geo Tech/Soils Report(on cell only)
❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ TRIe 24 Energy(on 8 Y,x 71)
❑ ❑ ❑ Structural Calculations
Foundation Plan Cross Section ❑ Plumbing Plan ❑ Single Line diagram for elec.services over 400 AMP
❑ Floor Plan ❑ Structural Framing Plan&Details ❑ Shoring Plan ❑ Sound Report-Residential
Class Code: Indicate New Construction Alteration` Addition' Means/Methods
Work Type Repair' Retrofit' Revision to Existing Parini P Required? YES NO
Proposed Building Use(s): Existing Building Use(s):
#Buildings: #Units: #Stories: Will the Building Have a Basement?
Y of N
Bldg.Code Occupancy Group Indicate Indicate if YES or NO Indicate all Geo-tech.Haz.Zone
At Project Construction Spdnklered that apply: Coastal
Zone
Completion: Type(s): C Of O Noise Zone
Required? YES or NO Listed on Historic Resources Inventory
CITY PLANNING STAFF ONLY
APPROVALS: Costal Commiss Arch.Review Board I I Landmark Comm. Planning Comm.Zoning Administrator
Fee Exempt: City Project I JElec.Vehicle Chargerl Landmark Seismic Retrofit penal ase: 'g
Official Approval
Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing
For Staff Use Only
Buddingl5alety I Permit Speciwmt TJ City P anning Civil Engineering EPWM-Adman Transportation Mgmt, I Rent Control
THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY
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