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PMT15-01888 City of Menifee Permit No.: PMT15-01888 29714 HAUN RD. MENIFEE, CA 92586 Type: Residential Addition j MENIFEE Date Issued: 07/07/2015 PERMIT Site Address: 31864 WHITFIELD ST, MENIFEE, CA Parcel Number: 360-653-002 92584 Construction Cost: $3,000.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 14'x 22' SOLID ALUMAWOOD PATIO COVER WITH 1 FAN,2 LIGHTS Work: Owner Contractor CHRISTINA DOOLEY-CUMMINGS PATIO GUY ALUMAWOOD CONTRACTOR 31864 WHITFIELD STREET 41197 GOLDEN GATE CIR STE 108 MENIFEE, CA 92584 MURRIETA, CA 92562 Applicant Phone: 9513341765 LOIS MONTINI License Number: 872839 PATIO GUY ALUMAWOOD CONTRACTOR 41197 GOLDEN GATE CIR STE 108 MURRIETA, CA 92562 Phone: 9513341765 Fee Description gyt Amount 1$1 Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 I E KKIgE.TIAU $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 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 license is in If e d ffe t. � Code:The Contractor's License Law does not apply to an owner of a property License Class _License fce a who builds or improves thereon, and who contracts for the projects with a ExpiresLlJ 'N u Y (�ignatureUr� � i(../ J licensed contractor(s)pursuant to the Contractors State License Law), WORKERS'COMPENSATION DECLARATION ❑ I am exempt from licensors under the Contractors Slate 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 is which I 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 rovements 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. 1 understand that a copy of the applicable law, Section 7044 of the 3—"Ir-h1ve and will maintain workers' compensation insurance, as required by Business c!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 su it E /oi P f Mowing Web site:http�//www leginfo ca ciov/calaw html, permit is issued.My workers'compensation ins rance carrier and policy number are: .-- Carrier �/y 4"5 /[_. r-/� ,� / Prop w er or Authorrze Agent Date Expires `y" C3 Policy# Iq-j/ 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- El I certify that in the performance of the work for which this permit is issued,I ide tiff d i 5operty for the inspection purposes. shall not employ any persons in any manner so as to become subject to the ' v workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Property Owner or Authorized A w Code,I shall forthwith comply with those prov i ns P Y gent Date City Business License# Date; — `/ pplican WARNING: FAILURE TO SECURE WORKERS' HAZARDOUS MATERIAL DECLARATION 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 ($900,000), IN ADDITION TO THE COST OF COMPENSATION, EIYES OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE �,(v11XTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES 2-NO EQUAL TO OR GREATER THAN THE AMOUNTS CONSTRUCTION LENDINGAGENCY 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 Lender's Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE der's Name ❑YES/APERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address MO 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 AYES WILL THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(Section 7031,5. Business and Professions Code: .BEVJITHIN 1000 FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter, improve, demolish, � 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 BNO_ UNDER THE STATE OF CALIFORNIA 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 MAT RIAL F EPORYING. compensation, will do ( )all of or( ) porting of the work, and the structure is PROPER"-�y�6 t UFHORI ED AGENT not intended or offered for sale.(Section 7044, Business and Professions Code; j /) //�q �_.. The Contractor's Slate License Law does not apply,to an owner of a property X // �U 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- - Builderwill have the burden of proving that it was not built or improved for the purpose of sale). BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION AMenifee DATE - to - 15 PERMIT/PLAN CHECK NUMBER TYPE: 0 COMMERCIAL 'VgSIDENTIAL " MULTI-FAMILY O MOBILE HOME :; POOL/SPA O SIGN SUBTYPE: O ADDITION O ALTERATION C% DEMOLITION GkELECTRICAL O MECHANICAL "EW OPLUMBING C> RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK pl ) PROJECTADDRESS ASSESSOR'S PARCEL NUMBER APQ-Lp_P;�5 -C)O7L LOT TRACT OWNER NAME ADDRESS1% I ST • PHONE ^ 88 O EMAIL APPLICANT NAME D t1bATrJW1 ADDRESS S prc PHONE 9SI 3 EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES CRJO� BUSINESS NAME ADDRESS D bL 'a S PHONE qs'1 _ 333 (� $ EMAIcbmL n ^ Q� CM CONTRACTOR'S STATE LIC NUMBER { d�0 LICENSE CLASSIFICATION VALUATION $ DD . SOFT D p LSO FT / �+ APPLICANT'S SIGNATURE • DATE 1f� 7 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CI TV OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN I SMIP INVOICE PAID AMOUNT AMOUNT CASH OCHECK# <%CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT O CASH C CHECK# 0 CREDIT CARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DL NUMBER NOTARIZED LETTER C' YES O NO City of Menifee Building& Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenilee.us Inspection Request Line 951-246-6213 City & Safety ©®pt• 1, 7 Building JUL 0 7 2015 3a >„ I OL II CL T Lo'yNT Received 3 > t� � >rp 1 e rz. DL1 . !A 0 'I ._. MM R1 CITY OF MENIFEE BUILDING AND SAFETY ULO RTIViL , PLAN APPROVAL REVIEWED BY q / se plans shall not be construed to I approval of,any violation of any provisions of the fferal,state or city regulations and ordinances. This set of approved pl ins must be kept on the jebsite until completion. 1 CG A O 1 3 Df c.an}M4+.�r.2rar- 14 a �L V;C rlogu L4ml4L0Aj0 C 4fVe,+®r j� C.hi�lSTf ►vA3l DDs,�� . rrinitru�s 411R� �joldGr► gq4FeCtr4e .yy. 168 L o i+ 7-F i e j h c-r-. n''1el-A I Ge 1 C.A end'. Surer -4S011313s ta7drk cDMi':N3tj4RD 4 -WC b8S'Yt7