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PMT15-01998 I I City of Menifee Permit No.: PMT16-01998 29714 HAUN RD. CCEL MENIFEE, CA 92586 Type: Residential Addition MENIFEE Date Issued: 0 7/1 412 01 6 PERMIT Site Address: 29054 SHORECLIFF CIR, MENIFEE, CA Parcel Number: 333-542-014 92585 Construction Cost: $6,400.00 Existing Use: 1 &2 Family Residence Proposed Use: Description of INSTALL 592 SQ FT SOLID ALUMAWOOD PATIO COVER WITH 2 FANS, 3 LIGHTS Work: Owner Contractor '. KEVIN PEARSON KYLE KELLY 29054 SHORECLIFF CIRCLE 35406 REDBERRY PALMS COURT MENIFEE, CA 92585 LAKE ELSINORE, CA 92532 Applicant Phone: 9512960908 KYLE KELLY License Number: 948536 KYLE KELLY 35406 REDBERRY PALMS COURT LAKE ELSINORE, CA 92532 Phone: 9098161288 Fee Description (3yt Amount l$1 ce a It jt a ., ure 6; 0 Building Permit Issuance 1 27.00 to - GREEN FEE 1 1.00 $298.00 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_Blug_Permlt_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 my license is in full forc�e.-a�nd Ceffect. Code:The Contractor's License Law does not apply to an owner of a property � License Class License No.�_ S 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'COMPENSATION DECLARATION ❑ I am exempt from lcensure 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 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 improvements covered by this permit, I cannot legally sell a structure that I have permit is issued. 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 W ite' //www leginfo cagov/calaw.html. permit is issued.My workers'compensation insurance carrier and policy number are: ��- -i----------.___ M1/ Propefty Qwner-or7\uthonze ,Agent Date Carrier _ _�---- Expires Policy# ❑ 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 state laws relating to building construction.I authorize representatives of this city or county to enter the above- 0 1 certify that in the performance of the work for which this permit is issued,I identified 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 ,-.- subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. —r -- Property-Owner-or-Authorized-Agent---- Date Business License#( - WARNING: FAILURL'---FO--SECURE----W kKERS' 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 OR A 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 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 FROM THE SOUTH COAST AIR QUALITY MANAGEMENT Lender's Address ❑NO 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, ❑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 ❑NO UNDER THE STATE OF CALIFORNIA HEALTH AND SAFETY a civil penalty of not more than($500).) CODE SECTION 25505 25533 AND 25534 CONCERNING HAZARDOUS MATERIAL REPORTING. ❑ I, as owner of the property, or my employees with wages as their sole c - compensation, will do ( ) all of or( )porting of the work, and the structure is PROPERTY OWNER OR&J.H.ORIZED-AGENT not intended or offered for sale.(Section 7044,Business and Professions Code; �— The Contractor's State License Law does not apply to an owner of a property who, through employees' or personal effort, builds or improves the property, — � provided that the Improvements are not intended or offered for sale. If,however, the building or improvement is sold within one year of completion, the Owner- Builder will have the burden of proving that it was not built or improved for the purpose of sale). I BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION AMenifee DATE 1�1 t�15 PERMIT/PLAN CHECK NUMBER as TYPE: G COMMERCIAL ZRESIDENTIAL C' MULTI-FAMILY CL MOBILE HOME O POOL/SPA <:SIGN SUBTYPE: ADDITION 0 ALTERATION 0 DEMOLITION C ELECTRICAL 0 MECHANICAL () NEW "' PLUMBING 0 RE-ROOF-NUMBER OF SQUARES DESCRIPTION OF WORK JLd a frs PROJECTADDRESS S S ,r .p ASSESSOR'S PARCEL NUMBER LOT TRACT 1 y oMen!' enl ee OWNER NAME v�l n CgyS' Building & Safety Dept. ADDRESS JUL PHONE ef 5; EMAIL APPLICANT NAME '+ e�'P''V�' ADDRESS PHONE ��g - �SL� �� EMAIL CONTRACTOR'S NAME OWNER BUILDER? O YES O BUSINESS NAME �P��. /,�G� �Q -c /� — ADDRESS r .i PHONE (�/�/�� EMAIL CONTRACTOR'S STATE LIC NUMBER LICENSE CLASSIFICATION VALUATION$ SO FT s9p? L SQ FT APPLICANT'S SIGNATURE DATE DEPARTMENT DISTRIBUTION _ CITY OF MENIFEE BUSINESS LICENSE NUMBER BUILDING PLANNING ENGINEERING FIRE GREEN SMIP INVOICE AMOUNT PAID AMOUNT 'CASH %CHECK# <i CREDIT CARD VISA/MC PLAN CHECK FEES PAID AMOUNT (' CASH <'CHECK'# 0 CREDIT CARD VISA/MC OWNER BUILDERVERIFIED C:%YES <% NO DL NUMBER NOTARIZED LETTER % YES (.% 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 �� l K� City of Safety D Building o Safety Dept. C�4 qa��S JUL 14 2015 Received a- h LEDGER & TRACK O W(WI:rTim REQUIRED U LL LL d 0-5 �S �7 (�/"fi ,0 CITY OF MENIFEE Q BUILDING AND SAFETY DEPARTMENT PLAN APPROVAL REVIEWED BY 11�uI�S DATE 3 'Approval of these plans shall not be construed to be a permit for,or an apnrnvai of.any violation of any provisions of the federal,state or dty md, ;nance: rti of arm. ,d Ions mutt be kept on the 'a.i iji