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PMT15-00875 i City of Menifee Permit No.: PMT15-00875 29714 HAUN RD. Ate. MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 04/08/2015 PERMIT Site Address: 30840 CARRIAGE HILL DR, MENIFEE, Parcel Number: 364-330-016 CA 92584 - Construction Cost: $2,180.00 Existing use: 1 &2 Family Residence Proposed Use: Description of INSTALL 260' LATTICE ALUMAWOOD PATIO COVER Work: Owner Contractor JIM PETERSON GUTTERS N COVERS CONSTRUCTION INC 30840 CARRIAGE HILL DR 19069 VAN BUERN BOULEVARD#114 MENIFEE, CA 92584 RIVERSIDE, CA 92508 Applicant Phone: 9516728022 SEAN DARE License Number: 945962 GUTTERS N COVERS CONSTRUCTION INC 19069 VAN BUERN BOULEVARD#114 RIVERSIDE, CA 92508 Fee Description CRY Amount Deck/Patio, non-standard 1._, 133.00 SMIP RESIDENTIAL 1 1.00 $162.00 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 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_Bidg Permit_Template.rpt Page 1 of 1 i City Of Menifee I 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 and 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 E> License No. Z who builds or improves thereon, and who contracts for the projects with a ExpiresTJ S Signature licensed contractor(s)pursuant to the Contractors State License Law), WORKERS'COMPENSATION DECLARATION ❑ [am exempt from licensure under the Contractors'State License Law for the ❑ 1 hereby affirm under penalty of perjury one of the following declarations: following reason: 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 which must have resided for at least one year prior to completion of Section 3 of the Labor Cade, for the performance of work for which this improvements covered by this permit, I cannot legally sell a structure that I have permit is issued. built as an owner-building if it has not been constructed in its entirety by licensed Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the tt 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:http:L/www.leginfo,ca,cov/calaw,html. permit is issued.My workers'compensation insurance carrier and policy number are: Carrier <Cfd Property Owner or Authorized Agent Date Expires (�i 61 z; Policy# q _L- oc; `s 1� Name of Agent � \ dL Phone# IIV��[i - 17015 ❑ 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. I 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 property for the inspection purposes, shall not em to any persons In any manner so as to become subject to the workers'compensation laws California, and agree that if I should become �CK 2C11 J subject to the workers' compensation sation provisions of Section 3700 of the Labor t®'—�— Code,Ishall forthwith comply with those provisions. Propert�jOwAer.ncAut�Yioried A3 ent Date Date; Applicant - City Business License# ^ � � ; WARNING: FAILURE O 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, DYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES ONO 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 ENT ,ENO DISTRICT SOUTHM THE TRICT(SCAQMD)SEE PERMITTIING CHECKL CHECKLIST 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 reason(s)indicated below by the checkmark(s)I have placed EYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable kem(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, 9 NO 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 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 ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING. compensation,will do ( )all of or( ) porting of the work, and the structure is PROPERTY OWNER OR A THORiZ AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; PP The Contractor's State License Law does not apply to an owner of a property Xwho, through employees' or personal effort, builds or improves the property, --- provided that the improvements are not intended or offered for sale.If,however, - -. - the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). CITY O M1U1®llll'EE PLCK No: i 29714 Haun Road Date: Date: Menifee, CA 92586 Phone: (951)672-6777 Amount: Amount: Fax:(951)679-3843 Ck#: Ck#: Building Combination Permit `5 L,0-T V 3D4aa- Be Completed By Applicant Legal Description: Plannin Case: F: L: Rt: R Pro dy res : _ n. Assessor's Parcel Numb�� 2.�� I f ProjectlrenanLName: Unit#: Floor#: `p Name: ' , I n r�t Fax No. Property Addre y Owner 1 - - Unit' umber Zip Code Email Address:Name: Nc �)cIr� 9 Applicant Unit Number Zip Code Email Address: Name: e N tea � • Contractor A �� r - (� City p L( Staff,q Zlp r ontractor Contractor'yC' Sk�teo 'o License No- �-J u Br�rw s p e No. l- Classification: Number of Squares: Square Footage Description of Work: j j I of- Cost of Work:$ i l \ OatrIt Applicant's Signature Date: .�To Be Completed 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 ❑ Gan Tech/Soils Report(on cd only) ❑ Plot/Site Plan ❑ Roof Plan ❑ Mechanical Plan ❑ Title 24 Energy(on 8 Y x 11) ❑ Foundation Plan El Structural Calculations ❑ Cross Section ❑ Plumbing Plan ❑ Single Line diagram for also.services over 400 AMP ❑ Floor Plan ❑ Structural Framing Plan 8 Details ❑ Shoring Plan I ❑ Sound Report-Residential Class Code: Indicate New Construction Alteration' Addition' Means/Methods Work Type: Repair' Retrofit` Revision to Exisfing Permir 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 allNisted eo-tech. Haz.Zone i At Project Construction Sprinklered that apply: oastal Zone t Completion: Type(s): C Otto oise Zone Rentwired? YES or NO on Historic Resources Inventory CITY PLANNING STAFF ONLY APPROVALS: Costal Commiss Arch.Review Board Landmark Comm. I Planning Comm.Zoning Administrator Fee Exempt: City Project Elec.Vehicle Charger Landmark 1 Seismic Retrofit special Case:eldg. Official A mval Expedite Project(s): Child Care City Project Green Building Landmark Affordable Housing For Staff Use Only 8uildinglSalety I Permit Specialist City Planning I Civil Engineering EPWPA-Armin Transportation Mgml. Rent Control THANK YOU FOR HELPING US CREATE A BETTER COMMUNITY sy ° (m % > 0 / \ \ \ \ } m k \ \ / } _ Q @ _ § / / « w ( / q q 2 � 9 = / � ( � ` / m � \ nm m m _ g f { \ > ) � § 2 R \ m _ 2 , y ( rn 7 � 73 � � - - - - - / - - - - a � � k O S cu | \n / g � g � CD - - - - - - - - - • - • {m � CITY