PMT15-01231 i
IP
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City of Menifee Permit No.: PMT15-01231
29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Addition
9 .0 sdrmso MENIFEE Date Issued: 05/11/2015
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PERMIT a
ry
Site Address: 25473 WATER WHEEL CT, MENIFEE, CA Parcel Number: 358-430-035 l
92584 Construction Cost: $4,700.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL 250 SO FT SOLID ALUMAWOOD PATIO COVER WITH ELECTRICAL 2 FANS, 2 LIGHTS, 2
Work: OUTLETS, 1 CIRCUIT
Owner Contractor
RHODEL&HELEN MANUEL AMERICAN HOME REMODELING INC
25473 WATER WHEEL CT 4375 PRADO RD SUITE 108
MENIFEE, CA 92584 CORONA, CA 92880
Applicant Phone: 9515200654
DAN STINSON License Number: 807029
AMERICAN HOME REMODELING INC
4375 PRADO RD SUITE 108
CORONA, CA 92880
Fee Description Oft Amount
u°Redep acle SwitcFt .Q tie 8�xtur ?2 ;-1 w 4601
%
Building Permit Issuance 1 27.00
_:> '?a 1 $ 00
GREEN FEE 1 1.00
$308.00
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_BAg_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 C 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. who builds or improves thereon, and who contracts for the projects with a
Expires-;.3/—y Signature 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
❑ 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 entirely by licensed
Policy# contractors. I understand that a copy of the applicable law, Section 7044 of the
❑ 1 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'//www leainfo ca pov/calaw htmL
permit is issued.My workers'compensation insurance carrier and policy number are:
Property Owner or Authorized Agent Date
Carrieryae�--4A 01,4
Expires /-//l _Policy# 0B,2�
❑ By my Signature below, I certify to each of the following: I am the property
Name of Agent 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. uthonze 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 p rty f the i p ctfon purposes.
shall not employ any persons in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become S��
subject to the workers'compensation provisions o/fSpetion 3700 of the Labor Prope Owner or Authorized Agent Date
Code,I shall forthwith comply with those pmvisio s.
- City Business License
Date; 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
i. ($100,000), IN ADDITION TO THE COST OF COMPENSATION, ❑YES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A
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 ES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address 0 DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
GUIDE LINES
OWNER BUILDER DECLARATIONS
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 EIYES 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, 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 I HAVE READ THE HAZARDOUS MATERIAL
provisions of the Contractor's State License Law (Chapter 9 (commencing with ' / INFORMATION GUIDE AND THE SCAQMD PERMITTING
Section 7000)of Division 3 of the Business and Professions Code)or that he or }(7YES
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($500).) HNARDO C I�TERIAL51';EPOR�INGD 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole
compensation,will do( )all of or( )porting of the work, and the structure is PROPE WN O k16F21ZED AGENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
`Menifee
DATE PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL y�FttSIDENTIAL " MULTI-FAMILY O MOBILE HOME 0 POOL/SPA 0 SIGN
SUBTYPE: „ADDITION OALTERATION DEMOLITION LECTRICAL 0 MECHANICAL
0 NEW 0 PLUMBING 0 RE-ROOF-NUMBER OF SQUARES I
DESCRIPTION OF WORK ��j1--� Z �� ',2``�O Ll��,•y�a-Lc� c/11 d
PROJECTADDRESS Z 7 ��/� yy�� t'
ASSESSOR'S PARCEL NUMBER ✓bW - L.� 'O"✓ LOT _ O1 TRACT JI Imo'
OWNER NAME
ADDRESS :Z�5 73
PHONE q�/ 3Ck9_ 3_:?>4L"S EMAIL
APPLICANT NAME l (S vtS
ADDRESS
PHONE Cf g2e1-62_zIIL0 EMAIL � �
CONTRACTOR'S NAME d�P✓YClZ<^ P OWNER BUILDER? 0 YES :{ENO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE LIC NUMBER �,7_9 LICENSE CLASSIFICATION
VALUATION$ df7Qzj c-a SOFT ._-2,6'0 L SO FT
APPLICANT'S SIGNATURE DATE
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSJN_F�SSNSE NUMBER
BUILDING PLANNING ENGINEERING FIRE GREEN
INVOICE PAID AMOUNT
AMOUNT CASH Ci CHECK# ::CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT CASH 0 CHECK 9 OCREDITCARD VISA/MC
OWNER BUILDER VERIFIED YES 0 NO DL NUMBER NOTARIZED LETTER 0 YES C, NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-5777
www.cityofinenifee.us Inspection Request Line 951-246-6213