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PMT15-01330 City of Menifee Permit No.: PMT15-01330 29714 HAUN RD. Type: Residential Addition �4GCln•L-> MENIFEE, CA 92586 MENIFEE Date Issued: OSI18I2015 i i E PERMIT Site Address: 27633 SUNRISE SHORE DR, MENIFEE, Parcel Number: 333-710-013 CA 92585 Construction Cost: $3,475.00 i Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 268 SQ FT SOLID ALUMAWOOD PATIO COVERS W/ELECTRICAL 1 FAN, 2 POSTLIGHTS Work: Owner Contractor DAN ROUSE TRADER DAN'S INC 27633 SUNRISE SHORE DR 840 S ROCHESTER AVE STE C MENIFEE, CA 92585 ONTARIO, CA 91761 Applicant Phone: 9093900555 CHANTEL CAGLE License Number: 517575 TRADER DAN'S INC 840 S ROCHESTER AVE STE C ONTARIO, CA 91761 Fee Description Qtv Amount Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 P•R� DE TIA a ear; . 1p $288.00 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_Bldg_Permit Template.rpt Page 1 of 1 i II 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 y license is in full force and�ecy Code:The Contractor's License Law does not apply to an owner of a property License Claps License No S who builds or improves thereon, and who contracts for the projects with a Expire ignature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATIOA ❑ lam exempt from licensure under the Contractors'Stale 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 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. Policy# built as an owner-building if it has not been constructed in its entirety by licensed y contractors. I understand that a copy of the applicable law, Section 7044 of the have and will maintain workers' compensation insurance, as required by Business and Professions Code,is available upon request when this application is action 3700 of the Labor Code, for the performance of the work for which this submitted or at the following Web site:http,//www.leginfo.m.00v/pfliaw.htmi. permit is issued.My workers'compensation insurance carrier onze Age and policy number are: Carrier G( =R0 v 'Y' Property Owner or ut nt Date Expires i Policy By Signature below, I certify to each of the following: I am the property Name of Agent ne t, - i�o 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 a state laws relating to building constructi author e", resentatives of y or county to enter the above- 'a❑ 1 certify that in the performance of the work for which this permit is issued, I identifi prope�y r the in action purp ses. 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 subject to the workers'compensation pro ons a ion 3700 of the or Property-Owner or u prized Agent D to Code, shall forthwith comply with tho prow i s. O� ,� U) City Business License# 50 Date; Applican, 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 HANDLE A 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 DYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION NO FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address �_ 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 DYES 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 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 k0YES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from licensure and the basis for the alleged exemption. Any ?cam 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).) HAOZDARD E 3TMATERIAL5I�EPORi�INGD 25534 CONCERNING ❑ 1, 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 PRO RTY W R A THORIZED NT 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 44'`Menifee DATE S PERMIT/PLAN CHECK NUMBER TYPE: O COMMERCIAL V SIDENTIAL C MULTI-FAMILY C> MOBILE HOME 0' POOL/SPA O SIGN SUBTYPE: ^DITION O ALTERATION O DEMOLITION () ELECTRICAL O MECHANICAL O NEW O PLUMBING % RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK J(1/ j`# �i PROJECTADDRESS 51_A 53 op -ASSESSOR'S PARCEL NUMBER l!)0> 0 OI"✓ LOT S'I TRACT —f111 CJ� OWNERNAME i Ctjn ADDRESS '2 ­7co PHONE ( 1 ���s-�l-n� EMAIL APPLICANT NAME (2_Y %CVVV4_iLJ_ ADDRESS PHONE C tb9 , q O CK—SSS EMAIL CONTRACTOR'S NAME OWNER BUILDER? OYES BUSINESS NAME ADDRESS (J PHONE joq �J EMAIL CONTRACTOR'S STATE LIC NUMBER ��� LICENSE C SS VALUATION $ q FT 2 O� L SO FT APPLICANT'S SIGNATURE DATE ZS FiCITY STAFF USE ONL Y - - - _ = - DEPARTMENTDISTRIBUIION CITy�Qf Evy N1F��BLICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP UI�/�✓' INVOICE �iir PAID AMOUNT AMOUNT % CASH ',+CHECK# CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT CASH "'CHECK# :'CREDITCARD VISA/MC OWNER BUILDER VERIFIED 0 YES C NO DL NUMBER NOTARIZED LETTER 0 YES '% NO City of Menifee Building& Safety Department 29714 HGLIn Rd, Menifee, CA 92586 95 1-6 72-677 7 www.cityofinenifee.usInspection Request Line 951-246-6213 City of Menifee Building & Safety Dept. OWNER 1 MAY 18 2015 7 ADDRESS 2 CITY ` 3 S\ y- SI�C� LOT NO. SPH0NE (j TRAOT APN _ CONTRACTOR ROOVISN' COVERS PROPOSED ADD�I 10 )840 S ROCHESTEP AVE -C ON BRjo, CA 91761 20JLIC. -517575 F4� 909-390-0555 `I i E n NOP,K CON/lP 1 ( x `�� ✓�k1 taxl/�f X ICW GP,OUP Iv V\/SA5000386-05 ^ q y� `' E P6/14/_015 �XQ : l` lX� �V5 f I L`VI, V1 106all l N nJ � 1 s - CITY OF MENIFEE p1 F UILCf"N4r�;{AN�D SAFE "ICE MEN�pZ,�� PLAN APPROVAL YAw \i!� �• . REVIEWED BY DATE *Approval of these plansshall not be c nstrued to b a permif for,or an W approval of,any violation of any provi ions of the leeral,state or city regulations and ordinances. This set o approved plans must a ept on e Ca jobsite until completion. J ~ FMT1 �' 01a#30 c tom'