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PMT15-01665 City of Menifee Permit No.: PMT15-01665 29714 HAUN RD. ";4CCFi..1�L MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 06/17/2015 PERMIT Site Address: 26263 DESERT ROSE LN, MENIFEE, CA Parcel Number: 335-520-064 92586 Construction Cost: $8,500.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 368 SO FT SOLID AND LATTICE ALUMAWOOD PATIO COVER WITH 1 FAN, 2 POST Work: LIGHT, 2 GFI OUTLETS Owner Contractor MAURICE MCKEIRNAY HIGHER QUALITY CONSTRUCTION 26263 DESERT ROSE LANE 32833 SAN JOSE COURT MENIFEE, CA 92586 TEMECULA, CA 92592 Applicant Phone: 9516347776 KEVIN GIGUERE License Number: 929362 HIGHER QUALITY CONSTRUCTION 32833 SAN JOSE COURT TEMECULA, CA 92592 Fee Description 31 Amount Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 $299.00 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 and 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 License No. who builds or improves thereon, and who contracts for the projects with a Expires Signature licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'( OMPENSATION DECL RATION ❑ I am 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 permit is iss(u�ed. improvements covered by this permit, I cannot legally sell a structure that I have Policy# 6 f5 7 !/`'I c�'� built as an owner-building if it has not been constructed in Its entirety by licensed 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 submit d or at the following Web site:httw//www.IeoInfo.ca. /1 aw.h I, permit is issued.My workers'compensation insurance carrier and policy number are: Carrier Pro rty wne or-Authorized Agent D,te Expires + � � Policy# By my Signature below, I certify to each of the following: I am the property Name of Agent Phone# wner 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- , ❑ I certify that in the performance of the work for which this permit is issued, I iden'fied property for the inspection 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 !^'7 subject to the workers'compensation provisions of Section 3700 of the Labor property Owr r or Authorized Agent D e Code, I shall forthwith comply with those provisions. �r Date; Applicant; City Business License# � �J WARNING: FAILURE TO StCURE 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, AYES 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 jij�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 Lender's Address FROM THE SOUTH COAST AIR QUALITY MANAGEMENT O 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 for the reason(s)indicated below by the checkmark(s)I have placed AYES 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, 'WNO 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 Iicensure 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 %CPO UNDER THE STATE OF CAL FORN IA HEALTH AND SAFETY a civil penalty of not more than ($500).) CODE, SECTION 25505 25533, AND 25534 CONCERNING ❑ I, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL REPORTING. compensation, will do( )all of or( ) porting of the work, and the structure is PROP RTY OWNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; The Contractor's State License Law does not apply to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION REF Menifee DATE �� I5� PERMIT/PLAN CHECK NUMBER TYPE: 0 COMMERCIAL ><RESIDENTIAL C MULTI-FAMILY <: MOBILE HOME O POOL/SPA CI SIGN SUBTYPE: O ADDITION Q ALTERATION C DEMOLITION ELECTRICAL :; MECHANICAL O NEW r' PLUMBING 0 RE-ROOF-NUMBER OF SQUARES--co—M90 Cove DESCRIPTION OF WORK 0 0 . ' l C c; C D JI+�L BXdgi 8 ifee AD �� /N� �A7P- Dr- kf-o S PROJECTADDRESS �a>roI 7 DI SEA-T J-20SE' AJ ASSESSOR'S PARCEL NUMBER '-/ ,r-('ULt LOT TRACTReceived OWNER NAME s� L 'vI,CPK-cI f�.ri C!l� (� �+/ ADDRESS /abab3 -D&SL* POSE � MU.7JIfGC 9d-sff,E PHONE `7S/l 3170 - (9&YO EMAIL APPLICANT NAME v)A (,- &LJ. - z r ADDRESS L�'I'DO 6 y DJ4-,°/hnl i 17/L t4 1447-)L 7-19 PHONE / Sl ' _/ro v " EMAIL CONTRACTOR'S NAME J-ASo %3 sm,H OWNER BUILDER? :;;YES R NO I BUSINESS NAME � ,6>+€7L Q�hit-1711l�onlS?R�L7"io,..a ADDRESS [9433 SA-" Osc GF TCWC"&Yt M . �'iasC7 PHONE 123y-�I�J7(� EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION �j VALUATION$ SO FT b O L SQ FT APPLICANT'S SIGNATURE DATE ndwffiz-� now DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE ^AA _ PAID AMOUNT AMOUNT QI"�_1 C% CASH `E=CHECK It 0CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT ;) CASH %CHECK# ?.S CREDIT CARD VISA/MC OWNER BUILDER VERIFIED YES O NO DL NUMBER NOTARIZED LETTER 0, YES i% NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213