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PMT15-01215 i City of Menifee Permit No.: PMT15-01215 29714 HAUN RD. Type: Residential Addition '�i 6C.El..t�k,` MENIFEE, CA 92586 sunemarcrts sdtwtte MENIFEE Date Issued: 05/08/2015 i i t PERMIT Site Address: 25453 WATER WHEEL CT, MENIFEE, CA Parcel Number: 358-430-036 92584 Construction Cost: $8,000,00 Existing use: 1 &2 Family Residence - Proposed use: Description of INSTALL 560 SO FT SOLID ALUMAWOOD PATIO COVER W/ELECTRIC 2 FANS, 5 LIGHTS Work: Owner Contractor CURTIS&SUE DONOHEW SOCAL HOME IMPROVEMENT 25453 WATER WHEEL CT 16331 LAKESHORE DR#G161 MENIFEE, CA 92584 LAKE ELSINORE, CA 92530 Applicant Phone: 9512364282 TROY CRISWELL License Number: 930540 SOCAL HOME IMPROVEMENT 16331 LAKESHORE DR#G161 LAKE ELSINORE, CA 92530 Fee Description Oft r Amount 1$1 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 $309.00 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_Bldg_Permit_Template.rpt Page 1 of 1 i 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 a my license is in full fort and effect. Code:The Contractor's License Law does not apply to an owner of a property j License Class License No.,Tt� who builds or improves thereon, and who contracts for the projects with a Expires M Signature'"- -: '' licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENS TIQN CLARATION ❑ I 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: 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 which I must have resided for at least one year prior to completion of Section 3700 of the Labor Code, 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 I have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available-qp-a-rr',e' when this application is section 3700 of the Labor Code, for the performance of the work for which this submittetlerfif efRollowing Web si t .I legnfo,ca.gov/calaw.htmli permit is issued.My workers'compensation insurance carrier and policy number are: Carrier <0� ^7 ,,,!!! Pr�wn ror Authonzed Agent Date Expires l N Policy# ©�/ z � � ❑ By my Signature below, I certify to each of the following: I am the property Name of Agent /'f'IGYN�L Ls-, Phone# 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 oycoy nty to enter the above- ❑ I certify that in the performance of the work for which this permit is issued,I identified propert for the inspection purposes!/-�" shall not ample 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 any, caner or Authorized Agent Date Code,I shall fo hwi h comply with those provisions. �j gar//p �'` ,— � / ily Business License# 1 Date; / /! Applicant `-" r WARNING: FAILURE ,T S E E WORKERS' HAZARDOUS MATERIAL DECLARATION COMPENSATION COVERACE 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 HANDLE HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE - MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES NO 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 FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address NO 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 forthe reason(s)indicated below by the checkmark(s)I have placed []YES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable items) (Section 7031.5. Business and Professions Code: i BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter, improve, demolish, ­� P70 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 AYES 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 _I.INO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE, SECTION 25505, 25533 AND 25534 C,QRING El I, as owner of the property, or my employees with wages as their sole HAZARDOUS MAT A REPORtING, i` compensation, will do ( ) all of or( ) porting of the work, and the structure is PRO RTY9.W ER OR AUTHORI not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). BUILDING : APPLICATION A-wenifee DATE ZOI i PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL O RESIDENTIAL 0 MULTI-FAMILY 0 MOBILE HOME O POOL/SPA " SIGN SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL O NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES / DESCRIPTION OF WORK / -0 ✓D// �hsY� �7LJ C tAll e t�cql PROJECTADDRESS C� zi � h to ASSESSOR'S PARCEL NUMBERO LOT TRACT OWNER NAME Cur- L5 5-vicf li/v ADDRESS / q 57 PHONE ��3rD 3� — S3 2 / EMAIL APPLICANT NAME ADDRESS PHONE % EMAIL CONTRACTOR'S NAME C Q YID w'' WNER BUILDER? :)YES0 - BUSINESS NAME f / ,, _ ADDRESS � �/ti�(2°SZ'/W/''��///r /6 / (.� L/ 7 �y,,a_. PHONE 9��. Z�7 � q2-0/2- EMAIL CONTRACTOR'S STATEE�LIICC NUMBER /joWS � LICENSE CLASSIFICATION VALUATION$ Q/V V SQ FT S(O O L SQ FT __ APPLICANT'S SIGNATURE--- -- �- _ DATE `') r DEPARTMENTDISTRIBUTIO CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNIN ENGIN (oO ENGINEERING FIRE GREEN SMIP INVOICE � PA AMOUNT AMOUNT OCASH OCHECK# OCREDITCARD VISVMC PLAN CHECK FEES PAIDAMOUNT OCASH 0CHECK# O CREDIT CARD VISA/MC OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER i) YES :) NO City of Menifee Building& Safety Deportment 29714 Houn Rd. Menifee, CA 92585 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 City of eenifee :sling& Sfety Dept. f4AY 0 8 2015 , I LEDGER & TRACK. ne INSPECTION REQUIRED Received Cc> P it (7 r fo (5 2 C l inq +5 _TY DEPARTMENT DATE ae construed to be a permit for,or an .rvisions of the federal,state or city .et of approved plans must be kept on the C6 I� 111 Sum �0✓t�o4,v�W Yhe�ii ck g2-5VI Q-