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PMT15-01991 Cityof Menifee Permit No.: PMT15-01991 29714 HAUN RD.MENIFEE, CA 92586 Type: Residential Addition ew sm"ems MENIFEE Date Issued: 07/14/2016 PERMIT Site Address: 29099 VERMILLION LN, MENIFEE, CA Parcel Number: 351-261-001 92587 Construction Cost: $4,800.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 14'x 38'SOLID ALUWAWOOD PATIO COVER WITH 2 FANS, 2 LIGHTS Work: Owner Contractor DEBBIE RICHIE PATIO GUY ALUMAWOOD CONTRACTOR 29099 VERMILLION LANE 41197 GOLDEN GATE CIR STE 108 MENIFEE, CA 92587 MURRIETA, CA 92562 Applicant Phone: 9513330056 LOIS MONTINI License Number: 872839 PATIO GUY ALUMAWOOD CONTRACTOR 41197 GOLDEN GATE CIR STE 108 MURRIETA, CA 92562 Fee Description Oft Amount IS Building Permit Issuance 1 27.00 Dec` o a arMEMO 3. :I lijiffl GREEN FEE 1 1.00 $293.00 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 i City Of Menifee LICENSED DECLARATION 1 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 an my license is in full fo n efFac. 8 Code:The Contractor's License Law does not apply to an owner of a property 9 License Class License No. rUx�, who builds or improves thereon, and who contracts for the projects with a Expires nature �,t3 / licensed contractor(s)pursuant to the Contractors State License Law). WORKERS'COMPENSATION DECLARATION ❑ I am exempt from licensors under the Contractors'State License Law for the I' ❑ I hereby affirm under penalty of perjury one of the following declarations: following reason: 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 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 t— 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.loginfo.ca.govicalaw Mani. permit Is issued,My workers'compensation insurance carrier and policy number are: Carrier A /V>/ Property Owner or Aut or¢e Agent Date Expires Policy#� C� L ��7 ❑ 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 slate 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, ids ifie pr perty 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 subject to the workers'compensation prcvisionybf Section 3700 of the ----- fir o ert caner or AuthorizedA Code, shall forthwith comply with those ovis' n P Y gent Date Date; Y —1 / —), City Business License# pplica t; 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, ❑YES O CUPANT HANDLE A HAZARDOUS MATERIAL ORA DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE IXTURE CONTAINING A HAZARDOUS MATERIAL LABOR CODE, INTEREST,AND ATTORNEYS FEES O 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 Lender's Civil Code) APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE der's Name_ YES ERMIT FOR THE CONSTRUCTION OR MODIFICATION Lender's Address ROM THE SOUTH COAST AIR QUALITY MANAGEMENT ❑aN 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 WIL-LTHE PROPOSED BUILDING OR MODIFIED FACILITY next to the applicable item(s)(Section 7031,5. Business and Professions Code: J�NO/BE WITHIN 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 OYES INFORMATION GUIDE AND THE SCAQMD PERMITTING she is exempt from licensure and the basis for the alleged exemption. Any aHff6KLIST. 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($500).) CODE, SECTION/25505, 25533 AND 25534 CONCERNING El1, as owner of the property, or my employees with wages as their sole HAZARDOUS M ERIpL REPORTING. compensation, will do ( ) all of or ( ) porting of the work, and the structure is PROPE 1�1=R/OR AUB £NT not intended or offered for sale, (Section 7044, Business and Professions Code,The Contractor's State License Law does not apply�to an owner of a property X who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). I i i SAFETY PERI\,IIT/PLAN CHECK APPLICATION ♦ t Menifee DATE —/ rj PERMIT/PLAN CHECK NUMBER Q 1 TYPE: O COMMERCIAL C'RESIDENTIAL MULTI-FAMILY O MOBILE HOME POOL/SPA City D Menifee "' �� %l�JfiWin & Safety Dept, SUBTYPE: C.%ADDITION O ALTERATION C; DEMOLITION *-I!1tCTRICAL - MECHANICAL O NEW O PLUMBING O RE-ROOF-NUMBER OF SQUARES JUL 14 2015 DESCRIPTION OF WORK IYX JT 90 Llh (-,(``MA Q0� Iq- . IV�d �"S . ___7 4.t DV E L PROJECT ADDRESS 01k9log - MILLIDA) )q ASSESSOR'S PARCEL NUMBER 15 -Cgt9k - (no' LOT TRACT OWNER NAME L G,I71 ADDRESS — EN 4=6G: PHONE q!5I 3ql!� - p 3 a EMAIL APPLICANT NAME ^^ /v� ADDRESS -4 G PHONE qsl- ?�Ovl-1 EMAIL CONTRACTOR'S NAME Ab /-} rn OWNER BUILDER? C, YES 6i- BUSINESS NAME Lf ADDRESS PHONE EMAIL CONTRACTOR'S STATE LIC NUMBER g ag 3 9 LICENSE CLASSIFICATION VALUATION$ b D SQ FT ,� L SQ FT /� APPLICANT'S SIGNATURE DATE f / 3 CITY STAFF USE ONLY DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE PAID AMOUNT AMOUNT O CASH 0 CHECK# :1 CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT i.%CASH C)CHECK# C%CREDITCARD VISA/MC OWNER BUILDER VERIFIED OYES NO DLNUMBER NOTARIZED LETTER > YES v NO City of Menifee Building& Safety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777 www.cityofinenifee.us Inspection Request Line 951-246-6213 A' L I Ila, Tao � wr Lia / •CMJ F/ "ity of Menifee uiiding & Safety Dep G.A / JUL 14 2015 D` 3 RecE)�Yed LEDGER & 'TRAC "kiftWECTION REQUIA Eli Co L_ r L a - L19NT5 S a -ns►� ' A USCM CITY OF WEE rt PLAN APPROVAL:1YJENT REVIEWED By(o ID /'Approval of these plans shall not be construed to� DATE approval of,any violation of any provisions of the federThe mrt for,or an regulations and ordinances, This set of a ` IL jobsite until completion. ate or City approvedke pt on fh� bm�ou�N6i� SNRD qSl _ 3 �� - D33Q• �► 'uGi-Dr~2 r-b �►c '8'1a835 r-O e6611` 1�.i'E1E Io9UY 4LUM9110w Ccn�Fm:jw 14, M0, 99 VG Rm 1 LI., o n) L NG , -9� c" Cp. aa%bi !a8 MENIFEE , CIO► anw. Sure-" 4. Ga1n3S U-Urk c.DMP:NDtgGARD A'RI;WC bgS*117