PMT15-01616 City of Menifee Permit No.: PMT15-01616
29714 HAUN RD.
''4CCELAA.` MENIFEE, CA 92586 Type: Residential Addition
evxarvs'"AWk., MENIFEE Date Issued: 0611512016
PERMIT
Site Address: 29662 COOL MEADOW DR, MENIFEE, Parcel Number: 339-372-012
CA 92584 Construction Cost: $1,600.00
Existing Use: 1 &2 Family Residence Proposed Use:
Description of INSTALL SOLID 126 SQ FTALUMAWOOD PATIO COVER W/ELECTRICAL 1 FAN
Work:
Owner Contractor
ALEJANDRA MUNOZ GUTTERS N COVERS CONSTRUCTION INC
29662 COOL MEADOW 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 City Amount f$1
Retacle�SWi utt�'& lxtur �� �-
Building Permit Issuance 1 27.00 _
Dec aq ndn- a tP r a ., � � ..,... _g. r Kee1 r
GREEN FEE 1 1.00
.v.0.• - � � ate -�sssu.Cr.E;am m...,aka�w}�a� d..�..m''°+� ' �6� 8�
$278.00
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 building 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
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 aW my license is in full force aneffect. Code:The Contractor's License Law does not apply to an owner of a property
License Class b License No. who builds or improves thereon, and who contracts for the projects with a
Expires 414- Signature licensed contractor(s)pursuant to the Contractors State License Law).
WORKERS COMPENSATION DECLARATION
❑ lam 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 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 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:httt) www lecinfo ce govlcalaw.html.
permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier.Jw
Q�cL�r�v� N c`t l-;,, ,, Property Owner or uthcrze-Ayem Date
Expires Policy#sAi L WS
�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.I authorize repres ativas of this city or county to enter the above-
LiI certify that in the performance of the work for which this permit is issued,I identife rty for the insp !lion rposes.
shall not emolov any persons in any manner so as to become subject to the i � ��/�
workers' compensation laws of California, and agree that if I should become
subject to the workers'compensation provisions of Section 3700 of the Labor Pro r or Authorized Agent Date
Code, I shall forthwith comply with those provisions. 05�
City Business License# �� I
Date; Applicant;
WARNING: FAILURE TO SECURE WORKER 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 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 AYES A PERMIT FOR THE CONSTRUCTION OR MODIFICATION
FROM THE SOUTH COAST AIR QUALITY MANAGEMENT
Lender's Address DISTRICT(SCAQMD) SEE PERMITTING CHECKLIST FOR
7NGUIDE LINES
OWNER BUILDER DECLARATIONS PRINT NAME:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
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: '!t' BE WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A
Any city or county that requires a permit to construct, alter, improve, demolish, ipav0 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
Section 7000)of Division 3 of the Business and Professions Code)or that he or )Q)'ES INFORMATION GUIDE AND THE SCAQMD PERMITTING
she is exempt from licensure and the basis for the alleged exemption. Any f" 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($500).) COZDE, SECTIONOUS 25505RIALI�E5533POWY AND 25534 CONCERNING
❑ I, as owner of the property, or my employees with wages as their sole
compensation,will do( )all of or( ) porting of the work, and the structure is PROPERTY OWNE UT ENT
not intended or offered for sale.(Section 7044,Business and Professions Code;
The Contractor's State License Law does not apply to an owner of a property X
who, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale.If,however,
the building or improvement is sold within one year of completion, the Owner-
Builder will have the burden of proving that it was not built or improved for the
purpose of sale).
APPLICATION& SAFETY PERMIT/PLAN CHECK
`Menifee
DATE PERMIT/PLAN CHECK NUMBER P# 1T1i h6/b
TYPE: Ci COMMERCIAL d RESIDENTIAL C? MULTI-FAMILY 10 MOBILE HOME 0' POOL/SPA 0 SIGN
SUBTYPE: O ADDITION - ALTERATION ("DEMOLITION C% ELECTRICAL 0 MECHANICAL I
C' NEW O PLUMBING 0 RE-ROOF-NUMBER OF SQUARES
DESCRIPTION OF WORK f I 07 �/
w I c h ( 6
PROJECT ADDRESS ��ICelp `�, aoot Yd' eadul? -) '. qd5
ASSESSOR'S PARCEL NUMBER 59 —V7a-Oj__':�L LOT Z� L4 TRACT
OWNER NAME
ADDRESS Q LQ(p a, C s - / n 5
PHONE q,'5 1 17251 - b 1 715 EMAIL
APPLICANT NAME r5 f-S tCf C .
ADDRESS C) jc(e q,),Soq
PHONE q61 EMAIL
CONTRACTOR'S NAME e� 4 C f I}JypWNER BUILDER? O YES O NO
BUSINESS NAME
ADDRESS d �dWO
PH0NE(gbl) (,Da, EMAIL
CONTRACTOR'S STATE LIC NUMBERg 059 L0,,l LICENSE CLASSIFICATION
VALUATION$ k2w. SQFT 1 '�LL,Q LSQFT
APPLICANT'S SIGNATURE DATE /
OTYSTAFFUSEONLY
DEPARTMENTDISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
00
BUILDING PLANNING ENGINEERING FIRE I GREEN l SMIP
INVOICE Q' PAID AMOUNT
AMOUNT a�a <; CASH :.i CHECK# :'•CREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT QCASH ')CHECK# C^'CREOITCARD VISA/MC
OWNER BUILDER VERIFIED OYES Ci NO DL NUMBER NOTARIZED LETTER Q YES C% NO
City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-572-6777
www.cityofinenifee.us Inspection Request Line 951-246-6213
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