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PMT15-01777 i City of Menifee Permit No.: PMT15-01777 29714 HAUN RD.MENIFEE, CA 92586 Type: Residential Addition �i MENIFEE Date Issued: 0 612 6/2 01 6 PERMIT 'I Site Address: 26908 N BAY LN, MENIFEE, CA 92585 Parcel Number: 333-460-024 Construction Cost: $4,636.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 462 SQ FT SOLID ALUMAWOOD PATIO COVER WITH 3 FANS, 4 POST LIGHTS, 1 SWITCH Work: Owner Contractor ERENDIRA PEREZ GUTTERS N COVERS CONSTRUCTION INC 26908 N BAY LANE 19069 VAN BUERN BOULEVARD#114 MENIFEE,CA 92585 RIVERSIDE, CA 92508 Applicant Phone: 9516728022 KRISTY HENDRICKSON License Number: 945962 GUTTERS N COVERS CONSTRUCTION INC 19069 VAN BUERN BOULEVARD#114 RIVERSIDE, CA 92508 Fee Description Qty Amount($1 e face Sw'tc,;Qutle- i ur Building Permit Issuance 1 27.00 P GREEN FEE 1 1.00 $313.00 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 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 Codel�n my license is in full f e and effec —` rs� r-('/ .�� Code:The Contractor's License Law does not apply to an owner of a property 1, License Clas License No. J /x, r who builds or improves thereon, and who contracts for the projects with a Expires Signature l4,okll. licensed contractor(s)pursuant to the Contractors State License Law), WORKERS'COMPENSATION DECLARATION ❑ I am exempt from licensure under the Contractors'Stale 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 must have resided for at least one year prior to completion of Section 3ssu of the Labor Code, for the performance of work for which this im improvements covered b this permit, I cannot legally sell a structure that I have permit is issued. P Y P 9 Y - Policy# 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 submitted or at the following Web site:http://www.leginfo,ca.gov/calaw.htm]. permit is issued,My workers'compensation insurance carrier and policy number are: Carrier a(' /)IA /12a fZQ,� /I'' Property Owner or Authorized gent Date Expires 7 ��' Policy# w_�� 7 9- Name of Agent Phone# ❑ By my Signature below, I certify to each of the following: I am the property 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 or county to enter the above. ❑ 1 certify that in the performance of the work for which this permit is issued,I identified propert forte inspection purposes, shall not emolov any persons In any manner so as to become subject to the , workers' compensation laws of California, and agree that if I should become r subject to the workers'compensation provisions of Section 3700 of the Labor pro ert Own r or Authorized Agent Code, I shall forthwith comply with those provisions. P Y /1 (� Date, Date;—� Ape licant;`/_)Sx 1,(��/-GIl��L1"L��'(.✓h+�. City Business License# 055 - / 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, EYES 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 '' N 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 „(NO FROM THE SOUTH COAST AIR QUALITY MANAGEMENT `� 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 ❑YES 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 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 ❑YES 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 N0 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE, SECTION 25505 25533 AND 25534 CONCERNING El1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIAL IAEPORIING. compensation, will do ( ) all of or( )porting of the work, and the structure is PROPER Y OVYNER OR AUTHORIZED AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; n /' The Contractor's Stale License Law does not apply to an owner of a property X_L who, through employees' or personal effort, builds'or improves the property, ] '� provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). & SAFETY PERMIT/PLAN CHECK APPLICATION Menifee DATE 06/25/2015 PERMIT/PLAN CHECK NUMBER TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL ❑MULTI-FAMILY ❑MOBILE HOME ❑ POOL/SPA []SIGN SUBTYPE: ❑ADDITION ❑ALTERATION ❑DEMOLITION ❑ELECTRICAL [:]MECHANICAL ❑NEW ❑PLUMBING ❑RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK SOLID ALUM PATIO COVER WITH 3 FANS 4 POSTLIGHTS AND 1 SWITCH PROJECT ADDRESS 26908 NORTH BAY MENIFEE CA 92585 ASSESSOR'S PARCEL NUMBER LOT TRACT OWNER NAME ERENDIRA PEREZ ADDRESS 26908 NORTH BAY MENIFEE CA 92585 Cit & Safety Dept.Of Menifen PHONE (951)292-1925 EMAIL ullding APPLICANT NAME KRISTY HENDRICKSON JUN 2 6 2015 ADDRESS 19069 VAN BUREN BLVD#114 RIVERSIDE,CA 92508 Received PHONE (951)672-8022 EMAIL CONTRACTOR'S NAME GUTTERS N COVERS OWNER BUILDER? ❑YES W NO BUSINESS NAME GUTTERS N COVERS ADDRESS 19069 VAN BUREN BLVD#114 RIVERSIDE, CA 92508 PHONE (951)672-8022 EMAIL CONTRACTOR'S STATE LIC NUMBER 945962 LICENSE CLASSIFICATION B VALUATION$ $4,636.00 SO FT 462 L SO FT APPLICANT'S SIGNATURE DATE CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP Fr INVOICE PAID AMOUNT AMOUNT sn 'CASH <'.CHECK# u'CREDIT CARD VISA/MC PLAN CHECK FEES PAIDAMOUNT i CASH %CHECK# %CREDIT CARD VISA/MC OWNER BUILDER VERIFIED YES C' NO DL NUMBER NOTARIZED LETTER 0 YES 0 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 — - oj� :� / / y= ( 2 �K -4 z 3 o -M / § f \ 0 2 \ n \ $ f « . � LA _ 2 \ \ 7 W Fr / / \ aai rm t 2 CD 7 N n , M CD n w � k \} m X", . c � I 33, m m � - - � � - - - ? i ƒ , OFFICE COPY �G