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PMT15-01964 i City of Menifee Permit No.: PMT15-01964 ,y�,� '''° .�, 29714 HAUN RD. Type: Residential Addition GCf8.1. MENIFEE, CA 92586 MENIFEE Date Issued: 0 7/1 312 01 5 PERMIT Site Address: 31869 RUXTON ST, MENIFEE, CA 92584 Parcel Number: 360-581-001 Construction Cost: $6,050.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 554 SO FT SOLID ALUMAWOOD PATIO COVER W/ELECTRICAL 1 FAN Work: Owner Contractor TONY&CATHLEEN FAZEKAS PATIO GUY ALUMAWOOD CONTRACTOR 31869 RUXTON ST 41197 GOLDEN GATE CIR STE 108 MENIFEE, CA 92584 MURRIETA, CA 92562 Applicant Phone: 9513330056 LOIS MONTINI License Number: 872839 PATIO GUY ALUMAWOOD CONTRACTOR 41197 GOLDEN GATE CIR STE 108 MURRI ETA, CA 92562 Fee Description Qtv Amount is Building Permit Issuance 1 27.00 GREEN FEE 1 1.00 $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 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 BIdg_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 ❑ 1, 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 apo my licensmk%�_ Code:The Contractor's License Law does not apply to an owner of a property License Class Lic who builds or improves thereon, and who contracts for the projects with a Expires D'��Signatur licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ 1 am exempt from icensure 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 aclmowled e that, for m compensation,issued by the Director of Industrial Relations as provided for by 9 except P y personal residence in Section 3700 of the Labor Code, for the performance of work for which this which I must have resided for at least one year prior to completion of permit is issued. improvements covered by this permit, I cannot legally sell a structure that I have 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 ❑ I 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:h1www Ieeinfo ca gov/calaw html. permit is issued.My tt 4workers'compensation insurance carrier and policy number are: L A Carrier t q Property caner or uthorize Agent Date Expires Policy# (� 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 constrAion. 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 idenf�filied;property for the 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 ,�� df ___-__ - subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those pro isi Property Owner cr Authorized Agent Date Date; rl 6J4 Applicant; City Business License# �7 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, DYES OC UPANT HANDLEA HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE ---MIXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES EQUAL TO OR GREATER THAN THE AMOUNTS - CONSTRUCTIONLENDINGAGENCY 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 Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE Len der's Name ❑YES A,PEr,MIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address 1�/FROM THE SOUTH COAST AIR QUALITY MANAGEMENT 0 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 DYES ,LL-L THE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s) (Section 7031.5. Business and Professions Code: E WITHIN 1000 FEET OF THE OUTER BOUNDARY OF A Any city or county that requires a permit to construct, alter, improve, demolish, QA 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 ARAAATION GUIDE AND THE SCAQMD PERMITTING she is exempt from licensors 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 ❑ 0 UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than ($500).) CODE, SECTION 25505, 25533 AND 25534 CONCERNING ❑ 1, as owner of the property, or my employees with wages as their sole HAZARDOUS///fff��IATERIAL REPORYING. compensation, will do ( )all of or ( ) porting of the work, and the structure is PROPE TYO, NER 04RAUT RIZED 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 U 1.�1/ e 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). PERMIT/PL.PERMIT/PLAN CHECK APPLICATION DATE 145 PERMIT/PLAN CHECK NUMBER ' OR TYPE: O COMMERCIAL c�SIDENTIAL C MULTI-FAMILY O MOBILE HOME 0 POOL/SPA O SIGN .lUDI Trt; O ADDi T iON Ci AL T ERA T ION 0 DEMOLMON '_*-ELEC RiCAL O MECHAIV CAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK 25 IN 4N PROJECT ADDRESS ASSESSOR'S PARCEL NUMBER LOT 95(0 TRACT �� L OWNER NAME ADDRESS F G e PHONE 01 og . a ► 1 ►9 9 EMAIL APPLICANT NAME ADDRESS C PHONE EMAIL CONTRACTOR'S NAME OWNER BUILDER? Q YES �IQO BUSINESS NAME tar ADDRESS zs (0a PHONE EMAIL m CDrY� CONTRACTOR'S STATE LIC NUMBER �nag�-9 LICENSE CLASSIFICATION VAI i iATIONI $ cn rr 55 y I Sn APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE AMOUNT PAID AMOUNT „ CASH 6CHECK# CCREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT 0CASH ()CHECK# OCREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES O NO DLNUMBER NOTARIZEDLETTER <) YES O NO City of Menifee Building & Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinemfee.us Inspection Request Line 951-246-6213 'Y L. Tn City of Menifee dtf'l 39 Building & Safety Dept. JUL il -c ye 2015 Weld r .. V Ih r � SID sA.! C 111 IA\ �FD�T UN REQUiR iNSPE CITY OF MENIFEE BUILDING AND SAFETY DEPARTMEN PLAN APPROVAL DIL 55qB DATE "Approva o t ese plans shall not be construed to be a permit fo u13Tf DN , ' appgtof,any violation of any provisions of:'ie federal,state o city �Deg'vha(ons a iderdinances. This set of approved plans must be I !pt on the jobsite until completion. rGS i n n kbrn�atvMGIQ SN�eJ °Ibq� a.yl ' f � �� e0 4+D -—FAV=—Z IU F 8"1a83c T►oguy AWmgcucraD Cps}TQ N d, , 11 C n 1 r r .. Is n., n _ _ , q`' ;„, Ytytt �iaf �ui�7Gf1 iiTCC:ir- " UXTO��l ST• +"tWl�rkc'i-u• ca• cfa%6a 1�1e I\) I F E C C A ure.-H gal`d %s tt)drk �mP:Nv2guaeD a�u�c ` b$SYf7